☰ INDEX
Abdomen & Pelvis
Basic Concept, Tricks and Magic of Anatomy
Brain
Embryology
General Anatomy
Head, Neck and Face
Histology
Lower Limb
Thorax
Upper Limb
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On percussion, a continuous band of dullness was noted to extend upward from the left of the umbilicus to the left axillary region. On palpation, a notch was felt along the anterior border of the swelling. A diagnosis of splenic enlargement was made. Which of the following statements pertaining to the above case is incorrect?", "options": [{"label": "A", "text": "The spleen is situated in the Upper Left Quadrant of the Abdomen beneath the Diaphragm.", "correct": false}, {"label": "B", "text": "The Long Axis of the Spleen lies along the 10 th Rib", "correct": false}, {"label": "C", "text": "A pathologically enlarged Spleen extends downward and forward, toward the Left Iliac Fossa.", "correct": true}, {"label": "D", "text": "The Spleen has a notched Anterior Border caused by Incomplete Fusion of its parts during Development.", "correct": false}], "correct_answer": "C. A pathologically enlarged Spleen extends downward and forward, toward the Left Iliac Fossa.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture1_iSD37nj.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture3_tZwpQa5.jpg"], "explanation": "<p><strong>Ans. C) A pathologically enlarged Spleen extends downward and forward, toward the Left Iliac Fossa.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The spleen is located in the upper left quadrant of the abdomen , just beneath the diaphragm . It's positioned between the 9th and 11th ribs , tucked under the ribcage , which offers it some protection.</li><li>• Option A.</li><li>• upper left quadrant</li><li>• abdomen</li><li>• beneath</li><li>• diaphragm</li><li>• positioned</li><li>• 9th</li><li>• 11th ribs</li><li>• ribcage</li><li>• Option B. The long axis of the spleen is indeed oriented along the line of the 10th rib on the left side . It typically extends from the 9th to the 11th rib , paralleling the curvature of the 10th rib .</li><li>• Option B.</li><li>• along</li><li>• line</li><li>• 10th rib</li><li>• left side</li><li>• extends</li><li>• 9th</li><li>• 11th rib</li><li>• paralleling</li><li>• curvature</li><li>• 10th rib</li><li>• Option D. While it is true that the spleen have a notched anterior border , this is a normal anatomical feature and not related to pathological conditions. The notches on the spleen are due to the incomplete fusion of the splenic lobules during development .</li><li>• Option D.</li><li>• spleen</li><li>• notched anterior border</li><li>• normal anatomical feature</li><li>• incomplete fusion</li><li>• splenic lobules</li><li>• development</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In cases of splenic enlargement , the spleen can extend beyond its usual boundaries in the abdomen . Because of the presence of the left colic flexure and the phrenicocolic ligament , the spleen is unable to expand vertically downward hence it extends downward and forward , toward the right iliac fossa .</li><li>• In cases of splenic enlargement , the spleen can extend beyond its usual boundaries in the abdomen .</li><li>• splenic enlargement</li><li>• beyond</li><li>• usual boundaries</li><li>• abdomen</li><li>• Because of the presence of the left colic flexure and the phrenicocolic ligament , the spleen is unable to expand vertically downward hence it extends downward and forward , toward the right iliac fossa .</li><li>• presence</li><li>• left colic flexure</li><li>• phrenicocolic ligament</li><li>• unable</li><li>• expand vertically downward</li><li>• extends downward</li><li>• forward</li><li>• right iliac fossa</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1188</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg no. 1188</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 66-year-old man underwent anatomical segmentectomy 4a en bloc with the caudate lobe to resect a colorectal liver metastasis located in segment 4a and involving the paracaval portion. Which of the following statements is true?", "options": [{"label": "A", "text": "Caudate Lobe is bounded on the Right by Groove for IVC and on the Left by Fissure for Ligamentum Teres", "correct": false}, {"label": "B", "text": "Posterior Surface of Caudate Lobe is related to Body of T12 L1 Vertebra", "correct": false}, {"label": "C", "text": "Segment 4a is part of Left Hemiliver", "correct": true}, {"label": "D", "text": "Caudate Lobe receives Blood from Right Branch of Hepatic Artery and Portal Vein", "correct": false}], "correct_answer": "C. Segment 4a is part of Left Hemiliver", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture6.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture7.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-102615.jpg"], "explanation": "<p><strong>Ans. C) Segment 4a is part of Left Hemi-Liver.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Caudate lobe is bounded on the right by groove for IVC and on the left by fissure for ligamentum teres: The caudate lobe of the liver is located posteriorly and is bounded on the right by the groove for the inferior vena cava and on the left by the ligamentum venosum , not the ligamentum teres. The ligamentum teres is actually located more anteriorly and to the left , marking the division between the left lateral and left medial segments of the liver .</li><li>• Option A.</li><li>• located posteriorly</li><li>• bounded</li><li>• right</li><li>• groove</li><li>• inferior vena cava</li><li>• left</li><li>• ligamentum venosum</li><li>• more anteriorly</li><li>• left</li><li>• between</li><li>• left lateral</li><li>• left medial segments</li><li>• liver</li><li>• Option B. Posterior surface of caudate lobe is related to body of T12 L1 vertebra: The caudate lobe of the liver lies against the lower thoracic and upper lumbar vertebrae, specifically around the T10 and T11 vertebrae . It's positioned close to these vertebrae due to its posterior location in the liver .</li><li>• Option B.</li><li>• against</li><li>• lower thoracic</li><li>• upper lumbar vertebrae,</li><li>• T10</li><li>• T11 vertebrae</li><li>• positioned</li><li>• vertebrae</li><li>• posterior location</li><li>• liver</li><li>• Option D. Caudate lobe receives blood from right branch of hepatic artery and portal vein : The caudate lobe is unique among liver segments because it receives blood supply from both the right and left branches of the portal vein . This dual supply is a significant consideration in liver surgery and liver transplant procedures .</li><li>• Option D.</li><li>• :</li><li>• receives blood supply</li><li>• both</li><li>• right</li><li>• left branches</li><li>• portal vein</li><li>• consideration</li><li>• liver surgery</li><li>• liver transplant procedures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Liver is divided into two Hemilivers and further into Eight Segments according to the Couinaud Classification . Segment 4 is part of the Left Hemiliver and is subdivided into Segment 4a and 4b . This segmental anatomy is crucial in Hepatic Surgery , such as in the case of resecting Liver Metastases .</li><li>➤ The Liver is divided into two Hemilivers and further into Eight Segments according to the Couinaud Classification .</li><li>➤ two Hemilivers</li><li>➤ Eight Segments</li><li>➤ Couinaud Classification</li><li>➤ Segment 4 is part of the Left Hemiliver and is subdivided into Segment 4a and 4b . This segmental anatomy is crucial in Hepatic Surgery , such as in the case of resecting Liver Metastases .</li><li>➤ Segment 4</li><li>➤ Left Hemiliver</li><li>➤ subdivided</li><li>➤ Segment 4a</li><li>➤ 4b</li><li>➤ Hepatic Surgery</li><li>➤ resecting Liver Metastases</li><li>➤ Caudate Lobe Boundaries :</li><li>➤ Caudate Lobe Boundaries</li><li>➤ Posterior surface of the caudate lobe is related to bodies of T10, T11 &amp; T12 vertebrae .</li><li>➤ Posterior surface</li><li>➤ caudate lobe</li><li>➤ bodies</li><li>➤ T10, T11</li><li>➤ T12</li><li>➤ vertebrae</li><li>➤ Liver segments:</li><li>➤ Right Hemiliver - V, VI, VII, VIII Left Hemiliver - II, III, IVa, IVb</li><li>➤ Right Hemiliver - V, VI, VII, VIII</li><li>➤ Right Hemiliver - V, VI, VII, VIII</li><li>➤ Left Hemiliver - II, III, IVa, IVb</li><li>➤ Left Hemiliver - II, III, IVa, IVb</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg no. 1163</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg no. 1163</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old female, obese and sedentary lifestyle was found to have gallstones as an incidental finding while investigating for acute abdominal pain. She was diagnosed with acute appendicitis and her appendicectomy was done. Few months later, she presented to the ER with complaints of abdominal cramps, mid abdominal pain, abdominal distension and vomiting since that morning. Abdominal X-ray revealed air in the gallbladder and biliary tree. Which of the following could be the most probable site for lodgement of gallstones?", "options": [{"label": "A", "text": "Caecum", "correct": false}, {"label": "B", "text": "Common Bile Duct", "correct": false}, {"label": "C", "text": "Jejunum", "correct": false}, {"label": "D", "text": "Ileum", "correct": true}], "correct_answer": "D. Ileum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture8_UzxQYlD.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture9.jpg"], "explanation": "<p><strong>Ans. D) Ileum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Gallstones are unlikely to lodge in the caecum . The caecum, being the first part of the large intestine and having a wider lumen , is less likely to be the site of obstruction . Gallstones that enter the intestinal tract typically pass through the caecum without causing obstruction .</li><li>• Option A.</li><li>• Gallstones</li><li>• lodge</li><li>• caecum</li><li>• first part</li><li>• large intestine</li><li>• wider lumen</li><li>• site</li><li>• obstruction</li><li>• intestinal tract</li><li>• without causing obstruction</li><li>• Option B. Common bile duct: While gallstones often originate in the gallbladder and can obstruct the common bile duct (leading to conditions like cholangitis or pancreatitis ), this is not consistent with the symptoms and findings described in the scenario. Obstruction of CBD or cystic duct with gallstone will lead to biliary colic , jaundice and cholangitis (fever, right upper quadrant pain and positive Murphy’s sign but no free air).</li><li>• Option B.</li><li>• originate</li><li>• gallbladder</li><li>• obstruct</li><li>• cholangitis</li><li>• pancreatitis</li><li>• Obstruction</li><li>• CBD</li><li>• cystic duct</li><li>• gallstone</li><li>• lead</li><li>• biliary colic</li><li>• jaundice</li><li>• cholangitis</li><li>• Option C. Jejunum: The jejunum, being part of the small intestine , is theoretically a possible site for gallstone obstruction . The caliber of duodenum and jejunum is typically sufficient to allow the passage of large gallstones that cause gallstone ileus .</li><li>• Option C.</li><li>• small intestine</li><li>• possible site</li><li>• gallstone obstruction</li><li>• caliber</li><li>• duodenum</li><li>• jejunum</li><li>• sufficient</li><li>• allow</li><li>• passage</li><li>• large gallstones</li><li>• gallstone ileus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ileum is the most probable site for the lodgement of gallstones in gallstone ileus . The ileum, being the distal part of the small intestine , has a narrower lumen compared to other parts of the intestine . Thus, it is more prone to obstruction by a gallstone , especially a large one . In longstanding cholelithiasis , large gallstones lead to the formation of cholecystoenteric fistula between gallbladder and adjoining part of gut tube . This passage permits entry of gallstone into the small bowel and at the same time the intestinal gas enters the gallbladder and biliary tree . The presence of an ileocaecal valve prevents the entry of gall stone into the large intestine . Obstruction of the small bowel at the ileocaecal valve leads to the classic signs of small bowel obstruction . The symptoms described – abdominal cramps , pain , distension , and vomiting – are consistent with a small bowel obstruction , which is likely caused by a gallstone lodged in the ileum .</li><li>➤ Ileum is the most probable site for the lodgement of gallstones in gallstone ileus . The ileum, being the distal part of the small intestine , has a narrower lumen compared to other parts of the intestine . Thus, it is more prone to obstruction by a gallstone , especially a large one .</li><li>➤ Ileum</li><li>➤ most probable</li><li>➤ site</li><li>➤ lodgement</li><li>➤ gallstones</li><li>➤ gallstone ileus</li><li>➤ distal part</li><li>➤ small intestine</li><li>➤ narrower lumen</li><li>➤ intestine</li><li>➤ more prone</li><li>➤ obstruction</li><li>➤ gallstone</li><li>➤ large one</li><li>➤ In longstanding cholelithiasis , large gallstones lead to the formation of cholecystoenteric fistula between gallbladder and adjoining part of gut tube . This passage permits entry of gallstone into the small bowel and at the same time the intestinal gas enters the gallbladder and biliary tree . The presence of an ileocaecal valve prevents the entry of gall stone into the large intestine . Obstruction of the small bowel at the ileocaecal valve leads to the classic signs of small bowel obstruction .</li><li>➤ longstanding cholelithiasis</li><li>➤ large gallstones</li><li>➤ cholecystoenteric fistula</li><li>➤ gallbladder</li><li>➤ adjoining part</li><li>➤ gut tube</li><li>➤ permits entry</li><li>➤ gallstone</li><li>➤ small bowel</li><li>➤ intestinal gas</li><li>➤ gallbladder</li><li>➤ biliary tree</li><li>➤ ileocaecal valve</li><li>➤ entry</li><li>➤ gall stone</li><li>➤ large intestine</li><li>➤ Obstruction</li><li>➤ small</li><li>➤ bowel</li><li>➤ ileocaecal valve</li><li>➤ classic signs</li><li>➤ small bowel obstruction</li><li>➤ The symptoms described – abdominal cramps , pain , distension , and vomiting – are consistent with a small bowel obstruction , which is likely caused by a gallstone lodged in the ileum .</li><li>➤ abdominal cramps</li><li>➤ pain</li><li>➤ distension</li><li>➤ vomiting</li><li>➤ small bowel obstruction</li><li>➤ caused</li><li>➤ gallstone</li><li>➤ ileum</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 1141</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 1141</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male following a motor vehicle collision was brought to the ER. The patient was stable, his vitals were normal but he kept complaining of mild abdominal pain. CT scan findings showed features suggestive of retroperitoneal haematoma. Which of the following abdominal organs had sustained trauma in this patient?", "options": [{"label": "A", "text": "Abdominal Aorta", "correct": false}, {"label": "B", "text": "Spleen", "correct": false}, {"label": "C", "text": "Pancreas", "correct": true}, {"label": "D", "text": "Liver", "correct": false}], "correct_answer": "C. Pancreas", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture10.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture11_x5bzoCz.jpg"], "explanation": "<p><strong>Ans. C) Pancreas</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Abdominal aorta is a retroperitoneal organ , but trauma to it the patient will present with features of hemorrhagic shock . Patients might present with signs of significant blood loss , shock , and rapidly deteriorating vital signs .</li><li>• Option A.</li><li>• retroperitoneal organ</li><li>• trauma</li><li>• present</li><li>• features</li><li>• hemorrhagic shock</li><li>• signs</li><li>• significant blood loss</li><li>• shock</li><li>• rapidly deteriorating vital signs</li><li>• Option B. The spleen is an intraperitoneal organ , not retroperitoneal. Injuries to the spleen are common in blunt abdominal trauma and can lead to intra-abdominal bleeding , but this would not typically result in a retroperitoneal hematoma. Instead, a splenic injury would more likely lead to hemoperitoneum</li><li>• Option B.</li><li>• spleen</li><li>• intraperitoneal organ</li><li>• Injuries</li><li>• spleen</li><li>• common</li><li>• blunt abdominal trauma</li><li>• lead</li><li>• intra-abdominal bleeding</li><li>• splenic injury</li><li>• lead</li><li>• hemoperitoneum</li><li>• Option D. The liver is an intraperitoneal organ and while it's commonly injured in abdominal trauma , it would more likely cause intraperitoneal bleeding rather than a retroperitoneal hematoma . Liver injuries can range from minor lacerations to major hematomas and active bleeding , but these would typically present as hemoperitoneum .</li><li>• Option D.</li><li>• intraperitoneal organ</li><li>• injured</li><li>• abdominal trauma</li><li>• intraperitoneal bleeding</li><li>• retroperitoneal hematoma</li><li>• Liver injuries</li><li>• range</li><li>• minor lacerations</li><li>• major hematomas</li><li>• active bleeding</li><li>• hemoperitoneum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pancreas is a retroperitoneal organ and injury to it can indeed lead to a retroperitoneal hematoma . Pancreatic injuries in the setting of trauma are relatively uncommon but can occur, especially in motor vehicle collisions due to the compression of the pancreas against the spine .</li><li>➤ The pancreas is a retroperitoneal organ and injury to it can indeed lead to a retroperitoneal hematoma . Pancreatic injuries in the setting of trauma are relatively uncommon but can occur, especially in motor vehicle collisions due to the compression of the pancreas against the spine .</li><li>➤ retroperitoneal organ</li><li>➤ injury</li><li>➤ lead</li><li>➤ retroperitoneal hematoma</li><li>➤ Pancreatic injuries</li><li>➤ setting</li><li>➤ trauma</li><li>➤ relatively uncommon</li><li>➤ especially</li><li>➤ motor vehicle collisions</li><li>➤ compression</li><li>➤ pancreas against</li><li>➤ spine</li><li>➤ They might present with back or abdominal pain and can be associated with relatively stable vitals initially, making this a plausible cause in this scenario.</li><li>➤ They might present with back or abdominal pain and can be associated with relatively stable vitals initially, making this a plausible cause in this scenario.</li><li>➤ back</li><li>➤ abdominal pain</li><li>➤ relatively stable</li><li>➤ vitals</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 121</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 64-year-old male with complaints of weight loss, nausea, vague epigastric pain for the past 6 months was suggested by his family physician to have a CT scan abdomen. Abdominal CT showed a large irregular mass extending posteriorly from the greater curvature of the stomach, impinging on the splenic artery and vein as they pass below. Tissue supplied by which of the following arteries would most likely be affected by compression of the splenic artery?", "options": [{"label": "A", "text": "Right Gastric Artery", "correct": false}, {"label": "B", "text": "Inferior Pancreaticoduodenal Artery", "correct": false}, {"label": "C", "text": "Right Colic Artery", "correct": false}, {"label": "D", "text": "Left Gastroepiploic Artery", "correct": true}], "correct_answer": "D. Left Gastroepiploic Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture12_xYHVSn1.jpg"], "explanation": "<p><strong>Ans. D) Left Gastroepiploic Artery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The right gastric artery supplies blood to the lesser curvature of the stomach . It arises from the proper hepatic artery , not the splenic artery. Therefore, compression of the splenic artery would not typically affect the area supplied by the right gastric artery.</li><li>• Option A.</li><li>• blood</li><li>• lesser curvature</li><li>• stomach</li><li>• proper hepatic artery</li><li>• Option B. Inferior Pancreaticoduodenal Artery supplies the head of the pancreas and the duodenum . It is a branch of the superior mesenteric artery (in some cases, it may receive blood from the gastroduodenal artery , which is a branch of the common hepatic artery ). This artery is not a direct branch of the splenic artery, so compression of the splenic artery would not directly affect the tissue supplied by the inferior pancreaticoduodenal artery.</li><li>• Option B.</li><li>• head</li><li>• pancreas</li><li>• duodenum</li><li>• branch</li><li>• superior mesenteric artery</li><li>• receive blood</li><li>• gastroduodenal artery</li><li>• branch</li><li>• common hepatic artery</li><li>• Option C. The right colic artery is a branch of the superior mesenteric artery and supplies the ascending colon . It has no direct relationship with the splenic artery, and thus, compression of the splenic artery would not affect the area supplied by the right colic artery.</li><li>• Option C.</li><li>• branch</li><li>• superior mesenteric artery</li><li>• supplies</li><li>• ascending colon</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Left Gastroepiploic Artery is a major branch of the splenic artery and supplies the greater curvature of the stomach . It runs along the greater curvature , providing blood to a large portion of the stomach's outer curve . Compression of the splenic artery could lead to reduced blood flow in the left gastroepiploic artery , potentially affecting the tissue it supplies .</li><li>➤ Left Gastroepiploic Artery is a major branch of the splenic artery and supplies the greater curvature of the stomach .</li><li>➤ Left Gastroepiploic Artery is a major branch of the splenic artery and supplies the greater curvature of the stomach .</li><li>➤ major branch</li><li>➤ splenic artery</li><li>➤ supplies</li><li>➤ greater curvature</li><li>➤ stomach</li><li>➤ It runs along the greater curvature , providing blood to a large portion of the stomach's outer curve . Compression of the splenic artery could lead to reduced blood flow in the left gastroepiploic artery , potentially affecting the tissue it supplies .</li><li>➤ It runs along the greater curvature , providing blood to a large portion of the stomach's outer curve . Compression of the splenic artery could lead to reduced blood flow in the left gastroepiploic artery , potentially affecting the tissue it supplies .</li><li>➤ greater curvature</li><li>➤ blood</li><li>➤ large portion</li><li>➤ stomach's outer curve</li><li>➤ splenic artery</li><li>➤ lead</li><li>➤ reduced blood flow</li><li>➤ left gastroepiploic artery</li><li>➤ potentially affecting</li><li>➤ tissue</li><li>➤ supplies</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1150</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 59-year-old male was brought to ER with complaints of profuse upper GI bleed. His past history couldn’t be obtained. His BP was 60/40 and his PR 140/min. Inspite of immediate resuscitation measures initiated, the patient failed to survive. Autopsy showed a deep peptic ulcer in the lesser curvature of stomach. Which of the following arteries would have been penetrated by the ulcer?", "options": [{"label": "A", "text": "Hepatic Artery", "correct": false}, {"label": "B", "text": "Left Gastric Artery.", "correct": true}, {"label": "C", "text": "Left Gastroepiploic Artery.", "correct": false}, {"label": "D", "text": "Gastroduodenal Artery", "correct": false}], "correct_answer": "B. Left Gastric Artery.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture13_5OCP2NA.jpg"], "explanation": "<p><strong>Ans. B) Left Gastric Artery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The common hepatic artery arises from coeliac trunk and soon divides into hepatic artery proper and gastroduodenal artery . The hepatic artery lies in the right free margin of lesser omentum .</li><li>• Option A.</li><li>• arises</li><li>• coeliac trunk</li><li>• divides</li><li>• hepatic artery proper</li><li>• gastroduodenal artery</li><li>• right free margin</li><li>• lesser omentum</li><li>• Option C. The left gastroepiploic artery supplies the greater curvature of the stomach , not the lesser curvature. It's a branch of the splenic artery and is located far from the site of a peptic ulcer on the lesser curvature , making it an unlikely source of bleeding in this scenario.</li><li>• Option C.</li><li>• supplies</li><li>• greater curvature</li><li>• stomach</li><li>• branch</li><li>• splenic artery</li><li>• far</li><li>• site</li><li>• peptic ulcer</li><li>• lesser curvature</li><li>• Option D. The gastroduodenal artery, a branch of the common hepatic artery , supplies the proximal duodenum and the stomach's greater curvature . Gastroduodenal artery runs posterior to the posterior wall of the first part of duodenum and gets eroded in duodenal ulcer .</li><li>• Option D.</li><li>• common hepatic artery</li><li>• supplies</li><li>• proximal duodenum</li><li>• stomach's greater curvature</li><li>• posterior</li><li>• posterior wall</li><li>• first part</li><li>• duodenum</li><li>• gets eroded</li><li>• duodenal ulcer</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left gastric artery is one of the branches of the celiac trunk , which arises from the abdominal aorta . It courses along the lesser curvature of the stomach , providing it with a significant blood supply . When a peptic ulcer develops on the lesser curvature of the stomach , it can erode through the stomach wall and into blood vessels , including those supplied by the left gastric artery . If an ulcer erodes into this artery or one of its branches , it can lead to a serious complication known as gastrointestinal hemorrhage or bleeding . This is because the left gastric artery is a relatively large vessel and can lead to significant bleeding when compromised .</li><li>➤ The left gastric artery is one of the branches of the celiac trunk , which arises from the abdominal aorta . It courses along the lesser curvature of the stomach , providing it with a significant blood supply .</li><li>➤ The left gastric artery is one of the branches of the celiac trunk , which arises from the abdominal aorta . It courses along the lesser curvature of the stomach , providing it with a significant blood supply .</li><li>➤ left gastric</li><li>➤ artery</li><li>➤ branches</li><li>➤ celiac trunk</li><li>➤ arises</li><li>➤ abdominal aorta</li><li>➤ lesser curvature</li><li>➤ stomach</li><li>➤ significant blood supply</li><li>➤ When a peptic ulcer develops on the lesser curvature of the stomach , it can erode through the stomach wall and into blood vessels , including those supplied by the left gastric artery .</li><li>➤ When a peptic ulcer develops on the lesser curvature of the stomach , it can erode through the stomach wall and into blood vessels , including those supplied by the left gastric artery .</li><li>➤ peptic ulcer</li><li>➤ lesser curvature</li><li>➤ stomach</li><li>➤ erode</li><li>➤ stomach wall</li><li>➤ blood vessels</li><li>➤ supplied</li><li>➤ left gastric artery</li><li>➤ If an ulcer erodes into this artery or one of its branches , it can lead to a serious complication known as gastrointestinal hemorrhage or bleeding . This is because the left gastric artery is a relatively large vessel and can lead to significant bleeding when compromised .</li><li>➤ If an ulcer erodes into this artery or one of its branches , it can lead to a serious complication known as gastrointestinal hemorrhage or bleeding . This is because the left gastric artery is a relatively large vessel and can lead to significant bleeding when compromised .</li><li>➤ ulcer erodes</li><li>➤ artery</li><li>➤ branches</li><li>➤ serious complication</li><li>➤ gastrointestinal hemorrhage</li><li>➤ bleeding</li><li>➤ left gastric artery</li><li>➤ relatively large vessel</li><li>➤ significant bleeding</li><li>➤ compromised</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 183</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 183</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44-year-old female was brought to the Emergency Room after a motor vehicle accident. The patient reported that she was a pedestrian on Greams road and while crossing the street, was struck by a car. The patient complained of abdominal tenderness and left shoulder pain and her vital signs were: blood pressure (BP) 90/60, heart rate (HR) 100, and respiratory rate (RR) 14. Her abdomen is tender on palpation of the left upper quadrant, with a faint tire mark over that area; in addition, crepitus (indicating fractured ribs) over the 9 th ,10 th , and 11 th ribs on the left side was noted. CBC which demonstrated an increased white blood count and a decreased hematocrit. Diagnostic peritoneal lavage had a bloody drainage and CT confirmed a complete splenic rupture and fractured ribs. The patient is taken to the O.R. for a splenectomy and a pneumococcal vaccine is delivered to the patient. Which of the following statements pertaining to the above case is true?", "options": [{"label": "A", "text": "Splenic Vein receives the Superior Mesenteric Vein.", "correct": false}, {"label": "B", "text": "Sigmoid Colon also lies in the same Quadrant.", "correct": false}, {"label": "C", "text": "Splenic Artery is a branch from Superior Mesenteric Artery.", "correct": false}, {"label": "D", "text": "Lienorenal Ligament has the Splenic Vessels, Nerves &amp; Lymphatics.", "correct": true}], "correct_answer": "D. Lienorenal Ligament has the Splenic Vessels, Nerves & Lymphatics.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture14_RN5fMnl.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture15_iPI8yP7.jpg"], "explanation": "<p><strong>Ans. D) Lienorenal Ligament has the Splenic Vessels, Nerves &amp; Lymphatics.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The splenic vein does not receive the superior mesenteric vein. Instead, the splenic vein and the superior mesenteric vein merge to form the portal vein . The portal vein is a key component of the hepatic portal system , which carries blood from the gastrointestinal tract and spleen to the liver .</li><li>• Option A.</li><li>• splenic vein</li><li>• superior mesenteric</li><li>• merge</li><li>• form</li><li>• portal vein</li><li>• hepatic portal system</li><li>• carries blood</li><li>• gastrointestinal tract</li><li>• spleen</li><li>• liver</li><li>• Option B. The sigmoid colon is primarily located in the left lower quadrant of the abdomen , not the left upper quadrant where the spleen is located. In the case of this patient, the trauma and symptoms are focused around the left upper quadrant , indicating splenic injury , which would not directly involve the sigmoid colon. Stomach , splenic flexure of the colon , tail of the pancreas , left kidney , and suprarenal gland , as well as the spleen lies in the left upper quadrant . Sigmoid colon is situated in the left iliac fossa .</li><li>• Option B.</li><li>• left lower quadrant</li><li>• abdomen</li><li>• trauma</li><li>• focused</li><li>• left upper quadrant</li><li>• splenic injury</li><li>• Stomach</li><li>• splenic flexure</li><li>• colon</li><li>• tail</li><li>• pancreas</li><li>• left kidney</li><li>• suprarenal gland</li><li>• spleen lies</li><li>• left upper quadrant</li><li>• Sigmoid colon</li><li>• situated</li><li>• left iliac fossa</li><li>• Option C. The splenic artery is not a branch of the superior mesenteric artery. Instead, it originates from the celiac trunk , which is the first major branch of the abdominal aorta . The splenic artery is one of the three primary branches of the celiac trunk , the others being the left gastric artery and the common hepatic artery .</li><li>• Option C.</li><li>• originates</li><li>• celiac trunk</li><li>• first major branch</li><li>• abdominal aorta</li><li>• three primary branches</li><li>• celiac trunk</li><li>• being</li><li>• left gastric artery</li><li>• common hepatic artery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The lienorenal ligament contains the splenic vessels , nerves , and lymphatics . It connects the anterior surface of left Kidney with the posterior lip of the hilum of spleen . In the case of splenic injury , as described, these structures within the lienorenal ligament can be involved or damaged .</li><li>• The lienorenal ligament contains the splenic vessels , nerves , and lymphatics . It connects the anterior surface of left Kidney with the posterior lip of the hilum of spleen .</li><li>• splenic vessels</li><li>• nerves</li><li>• lymphatics</li><li>• connects</li><li>• spleen</li><li>• In the case of splenic injury , as described, these structures within the lienorenal ligament can be involved or damaged .</li><li>• splenic injury</li><li>• lienorenal ligament</li><li>• involved</li><li>• damaged</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 89</li><li>• Ref</li><li>• : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An old woman visited her physician with the following complaints of progressive jaundice over the last week or so, frequent bowel movements with pale, greasy feces, a lack of energy, weight loss, and back pain. The physician ordered a series of tests, which suggested that the jaundice was of an obstructive, not metabolic nature. Abdominal ultrasound demonstrated the presence of a growth on the head of the pancreas, and further tests indicated that the lesion was a pancreatic carcinoma. After consultation with a surgeon, it was decided to have a cholecystojejunostomy performed to correct the obstruction and prevent the discomfort and pruritus that usually accompany obstructive jaundice. Listed below are all important structures at risk for compression by an expanding carcinoma head of pancreas except?", "options": [{"label": "A", "text": "Abdominal Aorta", "correct": true}, {"label": "B", "text": "Inferior Vena Cava", "correct": false}, {"label": "C", "text": "Common Bile Duct", "correct": false}, {"label": "D", "text": "Portal Vein", "correct": false}], "correct_answer": "A. Abdominal Aorta", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture16_GjLPJpi.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture18.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture22_FV0BuiX.jpg"], "explanation": "<p><strong>Ans. A) Abdominal Aorta</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Inferior vena cava with the termination of both renal veins lies behind the head of pancreas . However, the risk of compression of the IVC is lower compared to other structures that are more intimately related to the pancreas.</li><li>• Option B.</li><li>• termination</li><li>• both renal veins</li><li>• behind</li><li>• head</li><li>• pancreas</li><li>• lower</li><li>• Option C. The Common Bile Duct lodges in a groove between the pancreas and the second part of duodenum . The common bile duct is very closely related to the head of the pancreas . In pancreatic head carcinoma , the common bile duct is often compressed or invaded , leading to obstructive jaundice , which is one of the hallmarks of this condition . This is consistent with the patient's presentation of progressive jaundice and pale stools , as bile flow into the intestine is obstructed .</li><li>• Option C.</li><li>• Common Bile Duct</li><li>• between</li><li>• pancreas</li><li>• second part</li><li>• duodenum</li><li>• very closely</li><li>• head</li><li>• pancreas</li><li>• pancreatic head carcinoma</li><li>• compressed</li><li>• invaded</li><li>• leading</li><li>• obstructive jaundice</li><li>• hallmarks</li><li>• condition</li><li>• presentation</li><li>• progressive jaundice</li><li>• pale stools</li><li>• bile flow</li><li>• intestine</li><li>• obstructed</li><li>• Option D. The Portal Vein is formed behind the neck of the pancreas by the union of the superior mesenteric vein and the splenic vein . Given its close proximity, the portal vein is at risk of compression or invasion by a carcinoma in the head of the pancreas . This can lead to portal hypertension and other vascular complications.</li><li>• Option D.</li><li>• Portal Vein</li><li>• neck</li><li>• pancreas</li><li>• union</li><li>• superior mesenteric vein</li><li>• splenic vein</li><li>• risk</li><li>• compression</li><li>• invasion</li><li>• carcinoma</li><li>• head</li><li>• pancreas</li><li>• lead</li><li>• portal hypertension</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The abdominal aorta is located posterior to the pancreas and is not typically at risk of compression from a carcinoma in the head of the pancreas. The pancreas lies anterior to the aorta , and given the aorta's large size and high-pressure flow , it is less likely to be compressed by pancreatic pathology . Therefore, the abdominal aorta is the structure among the options that is least likely to be compressed by an expanding carcinoma of the head of the pancreas .</li><li>• The abdominal aorta is located posterior to the pancreas and is not typically at risk of compression from a carcinoma in the head of the pancreas.</li><li>• located posterior</li><li>• pancreas</li><li>• The pancreas lies anterior to the aorta , and given the aorta's large size and high-pressure flow , it is less likely to be compressed by pancreatic pathology .</li><li>• pancreas lies anterior</li><li>• aorta</li><li>• aorta's large size</li><li>• high-pressure flow</li><li>• compressed</li><li>• pancreatic pathology</li><li>• Therefore, the abdominal aorta is the structure among the options that is least likely to be compressed by an expanding carcinoma of the head of the pancreas .</li><li>• abdominal aorta</li><li>• structure</li><li>• least likely</li><li>• compressed</li><li>• expanding carcinoma</li><li>• head</li><li>• pancreas</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 127</li><li>• Ref</li><li>• : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 127</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 69-year-old, slightly obese female presented with complaints of nausea, epigastric pain, vomiting, and tenderness, which she described as radiating or boring through her back for the past 48 hours. Her total cholesterol was elevated (greater than 200) on her last trip to the physician’s office. On physical examination, she is slightly tachycardic, BP – 100/60, and her temperature is 102. You noted that she was slightly jaundiced and has slight abdominal distension. She had diminished bowel sounds, and on palpation, tender but has no rebound pain and did not guard her abdomen. It was suspected that the patient was suffering from pancreatitis secondary to gallstones. Serum and urinary amylase, serum lipase, glucose, calcium levels, WBC, bilirubin - all of which were elevated except for the calcium, which was lowered. In addition, the patient’s CT demonstrated that some pancreatic tissue did not enhance with IV contrast indicative of necrotizing pancreatitis The patient was referred to a surgeon and taken to the O.R. for surgical debridement and placed on antibiotics. Blood supply to the pancreas is by all the following except?", "options": [{"label": "A", "text": "Gastroduodenal Artery", "correct": false}, {"label": "B", "text": "Splenic Artery", "correct": false}, {"label": "C", "text": "Superior Mesenteric Artery", "correct": false}, {"label": "D", "text": "Left Colic Artery", "correct": true}], "correct_answer": "D. Left Colic Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture24.jpg"], "explanation": "<p><strong>Ans. D) Left Colic Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Gastroduodenal artery arises from common hepatic artery , it gives rise to posterior superior and anterior superior pancreaticoduodenal arteries that supplies the head of pancreas .</li><li>• Option A.</li><li>• common hepatic artery</li><li>• rise</li><li>• posterior superior</li><li>• anterior superior pancreaticoduodenal</li><li>• arteries</li><li>• supplies</li><li>• head</li><li>• pancreas</li><li>• Option B. The splenic artery is another major vessel that supplies the pancreas , particularly the body and tail of the organ . It runs along the top of the pancreas and gives off several small branches that penetrate the pancreas .</li><li>• Option B.</li><li>• another major vessel</li><li>• supplies</li><li>• pancreas</li><li>• body</li><li>• tail</li><li>• organ</li><li>• top</li><li>• pancreas</li><li>• small branches</li><li>• penetrate</li><li>• pancreas</li><li>• Option C. While the superior mesenteric artery primarily supplies the intestine , it also contributes to the blood supply of the pancreas through its smaller branches . These branches help supply blood to the lower part of the head of the pancreas and a portion of the uncinate process , which is a part of the pancreas that hooks around the superior mesenteric artery and vein .</li><li>• Option C.</li><li>• superior mesenteric artery</li><li>• supplies</li><li>• intestine</li><li>• contributes</li><li>• blood supply</li><li>• pancreas</li><li>• smaller branches</li><li>• supply blood</li><li>• lower part</li><li>• head</li><li>• pancreas</li><li>• portion</li><li>• uncinate process</li><li>• part</li><li>• pancreas</li><li>• hooks around</li><li>• superior mesenteric artery</li><li>• vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left colic artery primarily supplies the descending colon and is not directly involved in supplying blood to the pancreas. It's a branch of the inferior mesenteric artery and is concerned with the large intestine , rather than the pancreas.</li><li>➤ The left colic artery primarily supplies the descending colon and is not directly involved in supplying blood to the pancreas.</li><li>➤ The left colic artery primarily supplies the descending colon and is not directly involved in supplying blood to the pancreas.</li><li>➤ supplies</li><li>➤ descending colon</li><li>➤ It's a branch of the inferior mesenteric artery and is concerned with the large intestine , rather than the pancreas.</li><li>➤ It's a branch of the inferior mesenteric artery and is concerned with the large intestine , rather than the pancreas.</li><li>➤ branch</li><li>➤ inferior mesenteric artery</li><li>➤ concerned</li><li>➤ large intestine</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 131</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old male, chronic alcoholic presented to the ER with severe epigastric pain and hematemesis. On physical examination, the patient was found to be jaundiced and tachycardic with low blood pressure. Other physical findings included spider naevi on the cheeks, neck, upper extremities, and torso; ascites; splenomegaly; and tortuous dilated veins radiating from the umbilicus (caput medusae). The patient also complained that he often had bloody stools. Per rectal examination showed internal hemorrhoids. Patient was diagnosed with alcoholic cirrhosis of the liver. Which of the following is not a portal tributary?", "options": [{"label": "A", "text": "Right Gastric Vein", "correct": false}, {"label": "B", "text": "Cystic Vein", "correct": false}, {"label": "C", "text": "Middle Rectal Vein", "correct": true}, {"label": "D", "text": "Paraumbilical vein", "correct": false}], "correct_answer": "C. Middle Rectal Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture22_C9CrlRq.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture27.jpg"], "explanation": "<p><strong>Ans. C) Middle Rectal Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Right Gastric Vein is one of the tributaries of the portal vein . It drains blood from the lesser curvature of the stomach into the portal vein . In conditions like cirrhosis , where portal hypertension occurs, the increase in pressure can lead to the formation of esophageal varices due to the backup of blood in these veins.</li><li>• Option A. Right Gastric Vein</li><li>• portal vein</li><li>• drains blood</li><li>• lesser curvature</li><li>• stomach</li><li>• portal vein</li><li>• cirrhosis</li><li>• portal hypertension</li><li>• increase</li><li>• pressure</li><li>• lead</li><li>• formation</li><li>• esophageal varices</li><li>• backup</li><li>• blood</li><li>• Option B. The cystic vein drains blood from the gallbladder . It usually empties directly into the right branch of portal vein , though it can sometimes drain into one of the hepatic veins .</li><li>• Option B.</li><li>• drains blood</li><li>• gallbladder</li><li>• empties directly</li><li>• right branch</li><li>• portal vein</li><li>• sometimes drain</li><li>• one</li><li>• hepatic veins</li><li>• Option D. The paraumbilical veins are small veins that run along the ligamentum teres in the falciform ligament . They connect the portal vein with veins of the anterior abdominal wall . These veins can become prominent in conditions like cirrhosis , leading to the formation of caput medusae - the dilated veins radiating from the umbilicus observed in the patient . Paraumbilical vein also terminates into portal vein</li><li>• Option D.</li><li>• small veins</li><li>• run</li><li>• ligamentum teres</li><li>• falciform ligament</li><li>• connect</li><li>• portal vein</li><li>• veins</li><li>• anterior abdominal wall</li><li>• prominent</li><li>• cirrhosis</li><li>• leading</li><li>• formation</li><li>• caput medusae</li><li>• dilated veins</li><li>• radiating</li><li>• umbilicus</li><li>• patient</li><li>• Paraumbilical vein</li><li>• terminates</li><li>• portal vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle rectal vein is not typically a tributary of the portal vein. Instead, it drains into the internal iliac vein , which is part of the systemic venous circulation , not the portal venous system.</li><li>➤ The middle rectal vein is not typically a tributary of the portal vein.</li><li>➤ Instead, it drains into the internal iliac vein , which is part of the systemic venous circulation , not the portal venous system.</li><li>➤ drains</li><li>➤ internal iliac vein</li><li>➤ part</li><li>➤ systemic venous circulation</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 135</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 135</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old slightly obese female presented to E.R. with spasmodic, colicky pain in her right upper quadrant, with some right shoulder discomfort and accompanying nausea and vomiting. She reports that she has been running a fever over the past twenty-four hours. On physical examination, you note heart rate 110, blood pressure 110/70, respiratory rate 20, and temperature 102. She is noticeably uncomfortable on deep inspiration, and palpation reveals an increase in pain while palpating the right upper quadrant. The physician suspects that the patient is suffering from an acute episode of cholecystitis and orders an ultrasound study. The study reveals a large stone lodged within the cystic duct. The patient is prepped for a laparoscopic cholecystectomy. Which of the following statements pertaining to the above case is true?", "options": [{"label": "A", "text": "The Lumen of Cystic Duct is kept patent by Circular Valves of Heister.", "correct": false}, {"label": "B", "text": "The Cystic Artery lies Above and Medial to Cystic Duct.", "correct": false}, {"label": "C", "text": "The Common Hepatic Duct lies Lateral to Cystic Duct.", "correct": false}, {"label": "D", "text": "Cystic Duct forms the Inferolateral Boundary for Calot’s Triangle.", "correct": true}], "correct_answer": "D. Cystic Duct forms the Inferolateral Boundary for Calot’s Triangle.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-123807.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture28.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture30.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture29.jpg"], "explanation": "<p><strong>Ans. D) Cystic Duct forms the Inferolateral Boundary for Calot’s Triangle.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The cystic duct, which connects the gallbladder to the common bile duct , contains a series of mucosal folds known as the valves of Heister . These folds help maintain the duct's patency , allowing bile to flow into and out of the gallbladder . However, these valves can sometimes complicate the passage of gallstones through the cystic duct , as seen in this case.</li><li>• Option A</li><li>• connects</li><li>• gallbladder</li><li>• common bile duct</li><li>• mucosal folds</li><li>• valves of Heister</li><li>• maintain</li><li>• duct's patency</li><li>• bile</li><li>• flow</li><li>• gallbladder</li><li>• gallstones</li><li>• cystic duct</li><li>• Option B. Generally, the cystic artery arises from the right hepatic artery and passes posterior to the common hepatic duct to reach the gallbladder . The relationship of the cystic artery to the cystic duct is variable, but it typically lies superior and slightly posterior (not medial) to the cystic duct . This anatomical relation is crucial during cholecystectomy to prevent accidental injury.</li><li>• Option B.</li><li>• right hepatic artery</li><li>• posterior</li><li>• common hepatic duct</li><li>• gallbladder</li><li>• cystic artery</li><li>• lies superior</li><li>• posterior</li><li>• cystic duct</li><li>• cholecystectomy</li><li>• prevent accidental injury.</li><li>• Option C . The common hepatic duct lies medial to the cystic duct . The cystic duct joins the common hepatic duct to form the common bile duct .</li><li>• Option C</li><li>• medial</li><li>• cystic duct</li><li>• common hepatic duct</li><li>• common bile duct</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Calot’s triangle , also known as the cystohepatic triangle , is an anatomical space bordered by the cystic duct inferolaterally , the common hepatic duct medially , and the cystic duct superiorly . This triangle is a key landmark in laparoscopic cholecystectomy , as it contains the cystic artery and the cystic lymph node , which need to be identified and managed carefully during the surgery .</li><li>➤ Calot’s triangle , also known as the cystohepatic triangle , is an anatomical space bordered by the cystic duct inferolaterally , the common hepatic duct medially , and the cystic duct superiorly .</li><li>➤ Calot’s triangle</li><li>➤ cystohepatic triangle</li><li>➤ anatomical space</li><li>➤ cystic duct inferolaterally</li><li>➤ medially</li><li>➤ superiorly</li><li>➤ This triangle is a key landmark in laparoscopic cholecystectomy , as it contains the cystic artery and the cystic lymph node , which need to be identified and managed carefully during the surgery .</li><li>➤ laparoscopic cholecystectomy</li><li>➤ cystic artery</li><li>➤ cystic lymph node</li><li>➤ identified</li><li>➤ surgery</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 118</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol.II, Abdomen, Pg. 118</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with a history of hypertension, uncontrolled by multiple antihypertensive medications, and recent onset of episodic headaches, palpitations, and diaphoresis. Her blood tests show markedly elevated levels of catecholamines. A CT scan is ordered to evaluate her adrenal glands for a possible pheochromocytoma. The radiologist plans to focus on the typical location of the adrenal glands. Where is the hilum for the right adrenal gland typically located?", "options": [{"label": "A", "text": "Lower End", "correct": false}, {"label": "B", "text": "Anterior Surface Close to Apex", "correct": true}, {"label": "C", "text": "Posterior Surface", "correct": false}, {"label": "D", "text": "Posterior Surface Lower End", "correct": false}], "correct_answer": "B. Anterior Surface Close to Apex", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-130952.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture31.jpg"], "explanation": "<p><strong>Ans. B) Anterior Surface Close to Apex</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The hilum of the adrenal gland is not typically located at the lower end. The adrenal glands are more or less encapsulated and don't have a distinct hilum like organs such as the kidneys. Their blood vessels and nerves generally enter the gland at various points. Base is directed below and overlaps the upper end of the right kidney .</li><li>• Option A</li><li>• adrenal glands</li><li>• more</li><li>• less encapsulated</li><li>• enter</li><li>• gland</li><li>• Base</li><li>• below</li><li>• overlaps</li><li>• upper end</li><li>• right kidney</li><li>• Option C. The posterior surface of the adrenal gland is not the primary location for the entry of the main blood vessels and nerves. However, the adrenal glands do have an extensive blood supply , and some smaller vessels may approach from different directions. Posterior surface is related to diaphragm and right kidney .</li><li>• Option C.</li><li>• adrenal glands</li><li>• extensive blood supply</li><li>• approach</li><li>• Posterior surface</li><li>• diaphragm</li><li>• right kidney</li><li>• Option D . The upper end of the adrenal gland , especially on the right side , is closely related to the inferior vena cava. While some blood vessels and nerves may be in this area, it is not considered the main hilum for the adrenal gland. Apex of the right adrenal gland is overlapped by IVC .</li><li>• Option D</li><li>• upper end</li><li>• adrenal gland</li><li>• right side</li><li>• Apex</li><li>• right adrenal gland</li><li>• overlapped by IVC</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The blood vessels and nerve supply to the right adrenal gland primarily approach and enter the gland at the anterior surface , close to the apex . This area is the main point where these structures enter the gland .</li><li>➤ The blood vessels and nerve supply to the right adrenal gland primarily approach and enter the gland at the anterior surface , close to the apex . This area is the main point where these structures enter the gland .</li><li>➤ blood vessels</li><li>➤ nerve supply</li><li>➤ right adrenal</li><li>➤ gland</li><li>➤ approach</li><li>➤ enter</li><li>➤ gland</li><li>➤ anterior surface</li><li>➤ close</li><li>➤ apex</li><li>➤ enter</li><li>➤ gland</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 176</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-1, B-4, C-3, D-2", "correct": true}, {"label": "B", "text": "A-2, B-1, C-4, D-3", "correct": false}, {"label": "C", "text": "A-4, B-3, C-1, D-2", "correct": false}, {"label": "D", "text": "A-3, B-2, C-1, D-4", "correct": false}], "correct_answer": "A. A-1, B-4, C-3, D-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-131656.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/01/image_s3HwIV5.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture34.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-132418.jpg"], "explanation": "<p><strong>Ans. A) A-1, B-4, C-3, D-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Inferior Epigastric Artery is a branch of the external iliac artery (4). It ascends in the abdominal wall and supplies the lower anterior abdominal wall . It is often mentioned in the context of abdominal wall hernias due to its anatomical path .</li><li>• Option B.</li><li>• external iliac artery</li><li>• ascends</li><li>• abdominal wall</li><li>• supplies</li><li>• lower anterior abdominal wall</li><li>• anatomical path</li><li>• Option C. The inferior gluteal artery is a branch of the internal iliac artery (3). It exits the pelvis and supplies the gluteal region , which includes the large muscles of the buttock .</li><li>• Option C.</li><li>• internal iliac artery</li><li>• exits</li><li>• pelvis</li><li>• supplies</li><li>• gluteal region</li><li>• large muscles</li><li>• buttock</li><li>• Option D. Superior Rectal Artery originates from the internal pudendal artery , which is a branch of the internal iliac artery (3). However, the inferior rectal artery is often considered a direct branch of the internal iliac artery in many anatomical descriptions. It supplies the lower part of the rectum and the anal canal .</li><li>• Option D.</li><li>• internal pudendal artery</li><li>• internal iliac artery</li><li>• direct branch</li><li>• internal iliac artery</li><li>• supplies</li><li>• lower part</li><li>• rectum</li><li>• anal canal</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Branches:</li><li>➤ Branches:</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol. II, Abdomen, Pg. 184</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3rd Edition, Vol. II, Abdomen, Pg. 184</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-7, B-5, C-6, D-3", "correct": false}, {"label": "B", "text": "A-4, B-1, C-6, D-7", "correct": true}, {"label": "C", "text": "A-5, B-4, C-1, D-7", "correct": false}, {"label": "D", "text": "A-3, B-2, C-4, D-6", "correct": false}], "correct_answer": "B. A-4, B-1, C-6, D-7", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-132855.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture35.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/26/screenshot-2024-02-26-134836.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture36.jpg"], "explanation": "<p><strong>Ans. B) A-4, B-1, C-6, D-7</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The portal vein is formed by the union of the superior mesenteric and splenic veins . It doesn't directly receive any of the veins listed in the options. However, it's closely associated with the left gastric vein ( 4), which drains into it. The portal vein is a key vessel in the hepatic portal system , which carries blood from the gastrointestinal tract and spleen to the liver .</li><li>• Option A.</li><li>• union</li><li>• superior mesenteric</li><li>• splenic veins</li><li>• closely</li><li>• left gastric vein (</li><li>• drains</li><li>• portal vein</li><li>• key vessel</li><li>• hepatic portal system</li><li>• carries blood</li><li>• gastrointestinal tract</li><li>• spleen</li><li>• liver</li><li>• Option C. The external iliac vein is a major vein that drains blood from the lower limb . The deep circumflex vein (6) is a branch of the external iliac vein .</li><li>• Option C.</li><li>• major vein</li><li>• drains</li><li>• blood</li><li>• lower limb</li><li>• deep circumflex vein</li><li>• branch</li><li>• external iliac vein</li><li>• Option D. The internal iliac vein drains the pelvis . The deep dorsal vein of the penis (3) eventually drains into the internal pudendal vein , which is a branch of the internal iliac vein . The obturator veins (7) are also branches of the internal iliac vein .</li><li>• Option D.</li><li>• drains</li><li>• pelvis</li><li>• penis</li><li>• internal pudendal vein</li><li>• branch</li><li>• internal iliac vein</li><li>• obturator veins</li><li>• internal iliac vein</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 187</li><li>• Ref</li><li>• : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 187</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following blood supply will be impaired by the ligation of the common hepatic artery?", "options": [{"label": "A", "text": "Right Gastric and Right Gastroepiploic Artery", "correct": true}, {"label": "B", "text": "Right Gastric and Left Gastric Artery", "correct": false}, {"label": "C", "text": "Right Gastroepiploic Artery and Short Gastric Vessels", "correct": false}, {"label": "D", "text": "Right Gastric and Short Gastric Vessels", "correct": false}], "correct_answer": "A. Right Gastric and Right Gastroepiploic Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture40.jpg"], "explanation": "<p><strong>Ans. A) Right Gastric and Right Gastroepiploic Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The left gastric artery is actually a branch of the celiac trunk , not the common hepatic artery. Thus, ligation of the common hepatic artery would not directly affect the left gastric artery.</li><li>• Option B.</li><li>• left gastric artery</li><li>• branch</li><li>• celiac trunk</li><li>• Option C. The short gastric vessels arise from the splenic artery , another branch of the celiac trunk , and supply the fundus of the stomach . Therefore, ligation of the common hepatic artery would not directly affect the short gastric vessels.</li><li>• Option C.</li><li>• short gastric vessels</li><li>• splenic artery</li><li>• celiac trunk</li><li>• fundus</li><li>• stomach</li><li>• Option D. As mentioned earlier, the short gastric vessels are branches of the splenic artery , so they wouldn't be affected by the ligation of the common hepatic artery .</li><li>• Option D.</li><li>• short gastric vessels</li><li>• splenic artery</li><li>• affected</li><li>• ligation</li><li>• common hepatic artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The common hepatic artery branches off into the proper hepatic artery and the gastroduodenal artery . The proper hepatic artery further gives rise to the right gastric artery , which supplies the lesser curvature of the stomach . The gastroduodenal artery branches into the right gastroepiploic artery , which supplies the greater curvature of the stomach . Ligation of the common hepatic artery would impair blood flow to these arteries.</li><li>➤ The common hepatic artery branches off into the proper hepatic artery and the gastroduodenal artery .</li><li>➤ common hepatic artery</li><li>➤ hepatic artery</li><li>➤ gastroduodenal artery</li><li>➤ The proper hepatic artery further gives rise to the right gastric artery , which supplies the lesser curvature of the stomach .</li><li>➤ right gastric artery</li><li>➤ supplies</li><li>➤ lesser curvature</li><li>➤ stomach</li><li>➤ The gastroduodenal artery branches into the right gastroepiploic artery , which supplies the greater curvature of the stomach . Ligation of the common hepatic artery would impair blood flow to these arteries.</li><li>➤ right gastroepiploic artery</li><li>➤ greater curvature</li><li>➤ stomach</li><li>➤ Ligation</li><li>➤ impair blood flow</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 184</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 184</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male presents to the clinic with a 3-month history of back pain, weight loss, and jaundice. His past medical history includes Type 2 diabetes mellitus, newly diagnosed four months ago. On examination, he is jaundiced with palpable, nontender gallbladder. Laboratory tests reveal elevated liver enzymes and bilirubin. An abdominal CT scan is ordered to investigate a suspected pancreatic pathology. If a tumor is present in the uncinate process of the pancreas, which of the following vessels is most likely to be affected?", "options": [{"label": "A", "text": "Superior Mesenteric Artery", "correct": true}, {"label": "B", "text": "Portal Vein", "correct": false}, {"label": "C", "text": "Common Hepatic Artery", "correct": false}, {"label": "D", "text": "Inferior Mesenteric Artery", "correct": false}], "correct_answer": "A. Superior Mesenteric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture41.jpg"], "explanation": "<p><strong>Ans. A) Superior Mesenteric Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The portal vein is formed by the confluence of the SMV and the splenic vein . While it is in close proximity to the pancreas , it is not as directly related to the uncinate process as the SMA.</li><li>• Option B.</li><li>• confluence</li><li>• SMV</li><li>• splenic vein</li><li>• close proximity</li><li>• pancreas</li><li>• Option C . The common hepatic artery supplies blood to the liver and arises from the celiac trunk . It is located more superiorly in relation to the uncinate process. A tumor in the uncinate process is less likely to directly affect the common hepatic artery compared to the SMA .</li><li>• Option C</li><li>• blood</li><li>• liver</li><li>• arises</li><li>• celiac trunk</li><li>• superiorly</li><li>• uncinate process</li><li>• directly affect</li><li>• common hepatic artery</li><li>• SMA</li><li>• Option D . The Inferior Mesenteric Artery (IMA) supplies the lower part of the large intestine . It is located quite distant from the uncinate process and is unlikely to be affected by a tumor in this part of the pancreas .</li><li>• Option D</li><li>• Inferior Mesenteric Artery (IMA)</li><li>• lower part</li><li>• large intestine</li><li>• quite distant</li><li>• uncinate process</li><li>• affected</li><li>• tumor</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The uncinate process of the pancreas lies posterior to the Superior mesenteric artery and the superior mesenteric vein . A tumor in the uncinate process can potentially compress or involve the SMA , leading to vascular complications or challenges during surgical resection .</li><li>➤ The uncinate process of the pancreas lies posterior to the Superior mesenteric artery and the superior mesenteric vein .</li><li>➤ The uncinate process of the pancreas lies posterior to the Superior mesenteric artery and the superior mesenteric vein .</li><li>➤ uncinate process</li><li>➤ pancreas</li><li>➤ posterior</li><li>➤ Superior mesenteric artery</li><li>➤ superior mesenteric vein</li><li>➤ A tumor in the uncinate process can potentially compress or involve the SMA , leading to vascular complications or challenges during surgical resection .</li><li>➤ A tumor in the uncinate process can potentially compress or involve the SMA , leading to vascular complications or challenges during surgical resection .</li><li>➤ potentially compress</li><li>➤ involve</li><li>➤ SMA</li><li>➤ vascular complications</li><li>➤ challenges</li><li>➤ surgical resection</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 128</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 128</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Based on the Couinaud classification system, Which of the following structure divides liver anatomically?", "options": [{"label": "A", "text": "Portal Veins", "correct": true}, {"label": "B", "text": "Hepatic Artery", "correct": false}, {"label": "C", "text": "Bile Duct", "correct": false}, {"label": "D", "text": "Cystic Duct", "correct": false}], "correct_answer": "A. Portal Veins", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture42.jpg"], "explanation": "<p><strong>Ans. A) Portal veins</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . While the hepatic artery is crucial in supplying oxygenated blood to the liver , it is not the primary structure used in the Couinaud classification. The segmentation of the liver in this system is more closely related to the distribution of the portal veins.</li><li>• Option B</li><li>• supplying oxygenated blood</li><li>• liver</li><li>• segmentation</li><li>• liver</li><li>• Option C. The biliary system , including the bile ducts, is important for the drainage of bile from the liver . However, it does not primarily define the liver's segmentation in the Couinaud classification. The segments do each have their own biliary drainage , but the division is based more on the vascular anatomy than on the bile ducts.</li><li>• Option C.</li><li>• biliary system</li><li>• drainage</li><li>• bile</li><li>• liver</li><li>• biliary drainage</li><li>• division</li><li>• vascular anatomy</li><li>• Option D. The cystic duct connects the gallbladder to the common bile duct and is not directly involved in liver segmentation. It's more related to the storage and flow of bile rather than liver anatomy .</li><li>• Option D.</li><li>• gallbladder</li><li>• common bile duct</li><li>• storage</li><li>• flow</li><li>• bile</li><li>• liver anatomy</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the Couinaud system , the liver is divided into eight segments , each with its own vascular inflow , outflow , and biliary drainage . These segments are defined by the branches of the portal vein , which supply blood to different parts of the liver . The portal veins act as important landmarks for segmental anatomy in liver surgery and imaging .</li><li>➤ In the Couinaud system , the liver is divided into eight segments , each with its own vascular inflow , outflow , and biliary drainage .</li><li>➤ Couinaud system</li><li>➤ eight segments</li><li>➤ vascular inflow</li><li>➤ outflow</li><li>➤ biliary drainage</li><li>➤ These segments are defined by the branches of the portal vein , which supply blood to different parts of the liver .</li><li>➤ branches</li><li>➤ portal vein</li><li>➤ blood</li><li>➤ different parts</li><li>➤ liver</li><li>➤ The portal veins act as important landmarks for segmental anatomy in liver surgery and imaging .</li><li>➤ segmental anatomy</li><li>➤ liver surgery</li><li>➤ imaging</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 108</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 108</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of poorly controlled hypertension presents to the emergency department with acute onset of severe abdominal pain and hematuria. He has no past history of kidney stones or urinary tract infections. A CT scan without contrast shows no signs of kidney stones but reveals renal infarctions. Considering the patient's presentation and the imaging findings, which of the following renal vessels is most likely an end artery and thus, its occlusion would lead to infarction?", "options": [{"label": "A", "text": "Renal Artery", "correct": false}, {"label": "B", "text": "Interlobar Artery", "correct": false}, {"label": "C", "text": "Interlobular Artery", "correct": false}, {"label": "D", "text": "Arcuate Artery", "correct": true}], "correct_answer": "D. Arcuate Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture44.jpg"], "explanation": "<p><strong>Ans. D) Arcuate Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Renal Artery is not typically considered an end artery because within the kidney, its branches have some degree of anastomosis, especially at the level of the smaller arteries and arterioles . Renal artery gives segmental artery which in turn divides into lobar artery which in turn into interlobar artery .</li><li>• Option A.</li><li>• smaller arteries</li><li>• arterioles</li><li>• segmental artery</li><li>• lobar artery</li><li>• interlobar artery</li><li>• Option B. Interlobar Artery are found in the kidneys between the renal pyramids . They branch from the renal artery and extend toward the cortex of the kidney. Like the renal artery, they are not typically considered end arteries because there is some degree of anastomotic flow within the kidney's vascular network.</li><li>• Option B.</li><li>• renal pyramids</li><li>• renal artery</li><li>• extend</li><li>• cortex</li><li>• Option C. Interlobular Artery , also in the kidney, branch off from the arcuate arteries and extend into the renal cortex . While they are small and have limited anastomotic connections , they are not the primary examples of end arteries in the renal circulation.</li><li>• Option C.</li><li>• arcuate arteries</li><li>• extend</li><li>• renal cortex</li><li>• small</li><li>• limited anastomotic connections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Arcuate arteries, found in the kidneys , arch along the border of the renal cortex and medulla . They are often described as end arteries . If an arcuate artery is blocked , the area it supplies is at a higher risk of ischemia because there is limited collateral circulation to compensate for the loss of blood flow .</li><li>➤ Arcuate arteries, found in the kidneys , arch along the border of the renal cortex and medulla . They are often described as end arteries .</li><li>➤ kidneys</li><li>➤ border</li><li>➤ renal cortex</li><li>➤ medulla</li><li>➤ end arteries</li><li>➤ If an arcuate artery is blocked , the area it supplies is at a higher risk of ischemia because there is limited collateral circulation to compensate for the loss of blood flow .</li><li>➤ blocked</li><li>➤ supplies</li><li>➤ higher risk</li><li>➤ ischemia</li><li>➤ limited collateral circulation</li><li>➤ compensate</li><li>➤ loss of blood flow</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 164</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 164</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old woman undergoes a CT scan of the abdomen for evaluation of chronic right upper quadrant pain. The radiologist notes a distinct anatomical line on the scan, which is important for understanding the liver's segmentation and surgical anatomy. This line is crucial in differentiating certain liver structures in surgical planning. Which of the following structures is separated by the line noted by the radiologist, commonly Ref erred to as the CholecystoCaval line?", "options": [{"label": "A", "text": "Caudate and quadrate lobe", "correct": false}, {"label": "B", "text": "Physiological left and right half of liver", "correct": true}, {"label": "C", "text": "IVC and gallbladder", "correct": false}, {"label": "D", "text": "Caudate lobe and IVC", "correct": false}], "correct_answer": "B. Physiological left and right half of liver", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Physiological Left and Right Half of Liver</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male with a history of hypertension and chronic kidney disease presents to the emergency department with acute onset of left flank pain and hematuria. A CT abdomen is performed to rule out renal causes. During the imaging, the radiologist notes a vascular structure crossing anteriorly over the abdominal aorta. The recognition of this anatomical relationship is important for interpreting abdominal imaging and planning vascular or renal surgeries. Which of the following structures is known to cross anteriorly over the abdominal aorta?", "options": [{"label": "A", "text": "Left Renal Vein.", "correct": true}, {"label": "B", "text": "Right Renal Vein", "correct": false}, {"label": "C", "text": "Right Renal Artery", "correct": false}, {"label": "D", "text": "Left Renal Artery.", "correct": false}], "correct_answer": "A. Left Renal Vein.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture45.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture47.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture48.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The right renal vein does not cross the abdominal aorta. It has a shorter course than the left renal vein , draining the right kidney directly into the inferior vena cava without crossing anterior to the aorta.</li><li>• Option B.</li><li>• shorter course</li><li>• left renal vein</li><li>• draining</li><li>• right kidney</li><li>• Option C. The right renal artery does not cross anterior to the abdominal aorta. Instead, it originates from the lateral aspect of the aorta and travels posterior to the inferior vena cava to reach the right kidney .</li><li>• Option C.</li><li>• originates</li><li>• lateral aspect</li><li>• aorta</li><li>• posterior</li><li>• inferior vena cava</li><li>• reach</li><li>• right kidney</li><li>• Option D. Like the right renal artery, the left renal artery also originates from the aorta . However, it does not cross anteriorly over the aorta. It travels directly from the aorta to the left kidney . It passes behind the body of the pancreas and is crossed by an inferior mesenteric vein .</li><li>• Option D.</li><li>• originates</li><li>• aorta</li><li>• aorta</li><li>• left kidney</li><li>• behind</li><li>• body</li><li>• pancreas</li><li>• crossed</li><li>• inferior mesenteric vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left renal vein runs anterior to the abdominal aorta . It drains the left kidney and crosses over the aorta to empty into the inferior vena cava (IVC) . This anatomical feature is significant because the left renal vein can be compressed between the aorta and the superior mesenteric artery , a condition known as the nutcracker syndrome .</li><li>➤ The left renal vein runs anterior to the abdominal aorta . It drains the left kidney and crosses over the aorta to empty into the inferior vena cava (IVC) .</li><li>➤ anterior</li><li>➤ abdominal aorta</li><li>➤ drains</li><li>➤ left kidney</li><li>➤ aorta</li><li>➤ empty</li><li>➤ inferior vena cava (IVC)</li><li>➤ This anatomical feature is significant because the left renal vein can be compressed between the aorta and the superior mesenteric artery , a condition known as the nutcracker syndrome .</li><li>➤ left renal</li><li>➤ vein</li><li>➤ aorta</li><li>➤ superior mesenteric artery</li><li>➤ nutcracker syndrome</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 185</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the emergency department with a two-day history of severe left flank pain and hematuria. She has a past medical history of hypertension and type 2 diabetes mellitus. On examination, her blood pressure is 160/100 mmHg, and she has tenderness over the left costovertebral angle. Laboratory findings show an elevated serum creatinine level. A CT scan of the abdomen reveals a mass in the left adrenal gland, which appears to be compressing adjacent structures. Which of the following veins is most likely to be involved in the drainage of the left suprarenal gland and may be affected by this mass?", "options": [{"label": "A", "text": "Internal Iliac Vein", "correct": false}, {"label": "B", "text": "Left Renal Vein", "correct": true}, {"label": "C", "text": "Common Iliac Vein", "correct": false}, {"label": "D", "text": "Inferior Vena Cava", "correct": false}], "correct_answer": "B. Left Renal Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture49.jpg"], "explanation": "<p><strong>Ans. B) Left Renal Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The internal iliac vein drains blood from the pelvis and lower limbs . It is not involved in the drainage of the suprarenal glands. Therefore, the left suprarenal vein does not drain into the internal iliac vein.</li><li>• Option A.</li><li>• drains blood</li><li>• pelvis</li><li>• lower limbs</li><li>• Option C. Common iliac Vein drains the venous blood from lower limb into the inferior vena cava . It is formed by the union of external and internal iliac vein .</li><li>• Option C.</li><li>• venous blood</li><li>• lower limb</li><li>• inferior vena</li><li>• cava</li><li>• union</li><li>• external</li><li>• internal iliac</li><li>• vein</li><li>• Option D . While the right suprarenal vein drains directly into the Inferior Vena Cava (IVC) , the left suprarenal vein does not. The asymmetry in the drainage patterns of the suprarenal veins is due to the position of the IVC to the right of the midline , making it closer to the right suprarenal gland .</li><li>• Option D</li><li>• right suprarenal vein</li><li>• directly</li><li>• Inferior Vena Cava (IVC)</li><li>• asymmetry</li><li>• drainage patterns</li><li>• suprarenal veins</li><li>• position</li><li>• IVC</li><li>• right</li><li>• midline</li><li>• closer</li><li>• right suprarenal gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left suprarenal vein drains into the left renal vein . The left renal vein runs anterior to the abdominal aorta and receives blood not only from the left kidney but also from the left gonadal ( testicular or ovarian ) vein and the left suprarenal vein . This is in contrast to the right side , where the right suprarenal vein drains directly into the inferior vena cava .</li><li>➤ The left suprarenal vein drains into the left renal vein . The left renal vein runs anterior to the abdominal aorta and receives blood not only from the left kidney but also from the left gonadal ( testicular or ovarian ) vein and the left suprarenal vein . This is in contrast to the right side , where the right suprarenal vein drains directly into the inferior vena cava .</li><li>➤ left suprarenal vein</li><li>➤ left renal vein</li><li>➤ anterior</li><li>➤ abdominal aorta</li><li>➤ receives</li><li>➤ left gonadal</li><li>➤ testicular</li><li>➤ ovarian</li><li>➤ vein</li><li>➤ left suprarenal vein</li><li>➤ right side</li><li>➤ right suprarenal vein</li><li>➤ directly</li><li>➤ inferior vena cava</li><li>➤ Tributaries of IVC :</li><li>➤ Tributaries of IVC :</li><li>➤ Tributaries</li><li>➤ IVC</li><li>➤ Right and Left Common Iliac Vein Lumbar Veins Renal Veins Right Suprarenal Vein Right Gonadal Vein Phrenic Veins Hepatic Veins</li><li>➤ Right and Left Common Iliac Vein</li><li>➤ Lumbar Veins</li><li>➤ Renal Veins</li><li>➤ Right Suprarenal Vein</li><li>➤ Right Gonadal Vein</li><li>➤ Phrenic Veins</li><li>➤ Hepatic Veins</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 187</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 187</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man with a history of chronic alcoholism presents to the emergency department with severe abdominal pain and jaundice. His abdomen is distended and tender to palpation in the right upper quadrant. Laboratory tests reveal elevated liver enzymes and bilirubin levels. An abdominal ultrasound shows ascites and a complex fluid collection. The radiologist is concerned about fluid accumulation in a specific intraperitoneal pouch, which is a common site for fluid accumulation in patients with liver cirrhosis and ascites. This pouch is anatomically located between the liver and right kidney. Which of the following is the correct identification of this pouch?", "options": [{"label": "A", "text": "Right Anterior Intraperitoneal Pouch", "correct": false}, {"label": "B", "text": "Right Posterior Intraperitoneal Pouch", "correct": true}, {"label": "C", "text": "Left Anterior Intraperitoneal Pouch", "correct": false}, {"label": "D", "text": "Left Posterior Intraperitoneal Pouch", "correct": false}], "correct_answer": "B. Right Posterior Intraperitoneal Pouch", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture50.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Right Anterior Intraperitoneal Pouch does not accurately describe the Hepatorenal pouch . While it is located on the right side of the abdominal cavity , the pouch is not situated anteriorly but rather posteriorly between the liver and the right kidney.</li><li>• Option A.</li><li>• does not</li><li>• Hepatorenal pouch</li><li>• right side</li><li>• abdominal cavity</li><li>• Option C . This option is incorrect . The Hepatorenal pouch is specifically located on the right side of the body , not the left, and as previously mentioned, it is a posterior , not anterior, structure .</li><li>• Option C</li><li>• incorrect</li><li>• right side</li><li>• body</li><li>• posterior</li><li>• structure</li><li>• Option D . This option is also incorrect for the same reasons as option C. The Hepatorenal pouch is not located on the left side of the body.</li><li>• Option D</li><li>• also incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Hepatorenal pouch , or Morison's pouch , is a recess between the liver and the right kidney , located posteriorly in the intraperitoneal space . It is the deepest part of the peritoneal cavity when a person is in the supine position and is clinically significant as fluid , such as blood or pus , can accumulate in this space.</li><li>➤ The Hepatorenal pouch , or Morison's pouch , is a recess between the liver and the right kidney , located posteriorly in the intraperitoneal space . It is the deepest part of the peritoneal cavity when a person is in the supine position and is clinically significant as fluid , such as blood or pus , can accumulate in this space.</li><li>➤ Hepatorenal</li><li>➤ pouch</li><li>➤ Morison's pouch</li><li>➤ liver</li><li>➤ right kidney</li><li>➤ posteriorly</li><li>➤ intraperitoneal space</li><li>➤ deepest part</li><li>➤ peritoneal cavity</li><li>➤ person</li><li>➤ supine position</li><li>➤ fluid</li><li>➤ blood</li><li>➤ pus</li><li>➤ accumulate</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 85</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 85</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-4, B-3, C-5, D-2", "correct": true}, {"label": "B", "text": "A-1, B-3, C-5, D-4", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1, D-5", "correct": false}, {"label": "D", "text": "A-4, B-1, C-4,D-1", "correct": false}], "correct_answer": "A. A-4, B-3, C-5, D-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-133538.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-134218.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture38.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-134826.jpg"], "explanation": "<p><strong>Ans. A) A-4, B-3, C-5, D-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Subcostal vessels and nerve run along the inferior border of the 12th rib . They are not directly associated with any of the specific diaphragmatic openings but are related to the area just below the ribcage . The sympathetic trunk runs vertically along the vertebral column . It is located posteriorly in the abdomen and is not directly associated with the diaphragmatic openings but lies behind the medial arcuate ligament. Superior epigastric vessels are continuations of the internal thoracic (mammary) artery and vein . They travel through the space of Larrey , which is a gap between the sternal and costal attachments of the diaphragm on either side. The thoracic duct is the main lymphatic duct of the body . It ascends through the aortic opening of the diaphragm at the level of T12 . The phrenic nerve provides the main motor supply to the diaphragm . The right phrenic nerve enters the thoracic cavity and passes through the caval opening ( IVC opening ) in the diaphragm .</li><li>• Subcostal vessels and nerve run along the inferior border of the 12th rib . They are not directly associated with any of the specific diaphragmatic openings but are related to the area just below the ribcage .</li><li>• inferior border</li><li>• 12th rib</li><li>• below</li><li>• ribcage</li><li>• The sympathetic trunk runs vertically along the vertebral column . It is located posteriorly in the abdomen and is not directly associated with the diaphragmatic openings but lies behind the medial arcuate ligament.</li><li>• vertically</li><li>• vertebral column</li><li>• posteriorly</li><li>• abdomen</li><li>• Superior epigastric vessels are continuations of the internal thoracic (mammary) artery and vein . They travel through the space of Larrey , which is a gap between the sternal and costal attachments of the diaphragm on either side.</li><li>• internal thoracic (mammary) artery</li><li>• vein</li><li>• space of Larrey</li><li>• gap</li><li>• sternal</li><li>• costal attachments</li><li>• diaphragm</li><li>• The thoracic duct is the main lymphatic duct of the body . It ascends through the aortic opening of the diaphragm at the level of T12 .</li><li>• main lymphatic duct</li><li>• body</li><li>• ascends</li><li>• aortic opening</li><li>• diaphragm</li><li>• level</li><li>• T12</li><li>• The phrenic nerve provides the main motor supply to the diaphragm . The right phrenic nerve enters the thoracic cavity and passes through the caval opening ( IVC opening ) in the diaphragm .</li><li>• main motor supply</li><li>• diaphragm</li><li>• thoracic cavity</li><li>• passes</li><li>• caval opening</li><li>• IVC opening</li><li>• diaphragm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Minor openings in Diaphragm:</li><li>➤ Minor openings</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 180</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 180</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female was admitted to hospital with a three-week history of jaundice, pruritus, pale stools and dark urine. She had a history of alcohol abuse, a stable angina and was on medication for hypertension. After a computed tomography (CT) of the abdomen, the diagnosis of pancreas head carcinoma with obstructive jaundice was made. Aorta calcifications were also noted. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "The Common Bile Duct is embedded in the Posterior Surface of the Head of the Pancreas.", "correct": false}, {"label": "B", "text": "Carcinoma Head of Pancreas Compresses CBD leading to stasis of Bile in Biliary Tree.", "correct": false}, {"label": "C", "text": "The Head of the Pancreas lies at a slightly higher level than the Body opposite L2 and L3 Vertebra.", "correct": true}, {"label": "D", "text": "Head is separated from the Neck on its Anterior Surface by a groove for Gastroduodenal Artery.", "correct": false}], "correct_answer": "C. The Head of the Pancreas lies at a slightly higher level than the Body opposite L2 and L3 Vertebra.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-150855.jpg"], "explanation": "<p><strong>Ans. C) The Head of the Pancreas lies at a slightly higher level than the Body opposite L2 and L3 Vertebra.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The common bile duct runs posteriorly through the head of the pancreas . This anatomical relationship is clinically significant, as tumors in the head of the pancreas can compress the common bile duct , leading to obstructive jaundice , as seen in this patient.</li><li>• Option A</li><li>• posteriorly</li><li>• head</li><li>• pancreas</li><li>• tumors</li><li>• compress</li><li>• common bile duct</li><li>• obstructive jaundice</li><li>• Option B. Due to the close anatomical relationship between the head of the pancreas and the common bile duct , a carcinoma in this location can compress the bile duct . This compression leads to obstructive jaundice , characterized by jaundice , pruritus , pale stools , and dark urine due to the accumulation of bile in the liver and its subsequent leakage into the bloodstream and urine .</li><li>• Option B.</li><li>• close anatomical relationship</li><li>• head</li><li>• common bile duct</li><li>• compress</li><li>• bile duct</li><li>• obstructive jaundice</li><li>• jaundice</li><li>• pruritus</li><li>• pale stools</li><li>• dark urine</li><li>• accumulation</li><li>• bile</li><li>• liver</li><li>• bloodstream</li><li>• urine</li><li>• Option D. The anterior surface of the pancreas has a groove where the gastroduodenal artery lies. This groove is one of the landmarks that separate the head of the pancreas from its neck .</li><li>• Option D.</li><li>• anterior surface</li><li>• pancreas</li><li>• groove</li><li>• gastroduodenal artery</li><li>• separate</li><li>• head</li><li>• pancreas</li><li>• neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The head of the pancreas is actually located at the level of the L1 and L2 vertebrae . It nestles into the C-shaped curve of the duodenum . The body of the pancreas extends across the midline of the body , generally at the level of the L1 vertebra , slightly higher than the head of the pancreas . Parts &amp; Relations of head of pancreas :</li><li>➤ The head of the pancreas is actually located at the level of the L1 and L2 vertebrae . It nestles into the C-shaped curve of the duodenum .</li><li>➤ level</li><li>➤ L1</li><li>➤ L2 vertebrae</li><li>➤ nestles</li><li>➤ C-shaped curve</li><li>➤ duodenum</li><li>➤ The body of the pancreas extends across the midline of the body , generally at the level of the L1 vertebra , slightly higher than the head of the pancreas .</li><li>➤ body</li><li>➤ across</li><li>➤ midline</li><li>➤ body</li><li>➤ L1 vertebra</li><li>➤ higher</li><li>➤ head</li><li>➤ pancreas</li><li>➤ Parts &amp; Relations of head of pancreas :</li><li>➤ Parts</li><li>➤ Relations</li><li>➤ head</li><li>➤ pancreas</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1179</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1179</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the clinic with fatigue, weight loss, and a feeling of fullness in her left upper abdomen. She has a history of chronic immune thrombocytopenia. On physical examination, her spleen is palpable below the left costal margin. The enlargement of her spleen is significant but does not extend into the lower abdomen. Which of the following anatomical structures is most likely preventing the downward displacement of her enlarged spleen?", "options": [{"label": "A", "text": "Lienorenal Ligament", "correct": false}, {"label": "B", "text": "Phrenicocolic Ligament", "correct": true}, {"label": "C", "text": "Phrenicosplenic Ligament", "correct": false}, {"label": "D", "text": "Gastrosplenic Ligament", "correct": false}], "correct_answer": "B. Phrenicocolic Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture52.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture53.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Lienorenal ligament connects the anterior surface of left kidney with hilum of spleen and contains splenic vessels , lymphatics and nerves , tail of pancreas . While it does provide support to the spleen, it is not the primary ligament preventing its downward displacement.</li><li>• Option A.</li><li>• anterior surface</li><li>• left kidney</li><li>• hilum</li><li>• spleen</li><li>• splenic vessels</li><li>• lymphatics</li><li>• nerves</li><li>• tail of pancreas</li><li>• Option C. Phrenicosplenic/Lienophrenic ligament is an upward continuation of lienorenal ligament joining hilum of spleen with diaphragm .</li><li>• Option C.</li><li>• Phrenicosplenic/Lienophrenic ligament</li><li>• upward continuation</li><li>• lienorenal ligament</li><li>• hilum</li><li>• spleen</li><li>• diaphragm</li><li>• Option D. The gastrosplenic ligament connects the greater curvature of the stomach to the hilum of spleen . It contains short gastric vessels and is part of the greater omentum . While it helps to hold the spleen in place , it is not the main structure preventing downward displacement of the spleen.</li><li>• Option D.</li><li>• connects</li><li>• greater curvature</li><li>• stomach</li><li>• hilum</li><li>• spleen</li><li>• short gastric vessels</li><li>• greater omentum</li><li>• hold</li><li>• spleen</li><li>• place</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The phrenicocolic ligament extends from the left colic flexure to the diaphragm , near the spleen . It acts as a suspensory ligament for the spleen and is specifically important in preventing the downward displacement of an enlarged spleen , such as in conditions like splenomegaly .</li><li>• The phrenicocolic ligament extends from the left colic flexure to the diaphragm , near the spleen .</li><li>• left colic flexure</li><li>• diaphragm</li><li>• spleen</li><li>• It acts as a suspensory ligament for the spleen and is specifically important in preventing the downward displacement of an enlarged spleen , such as in conditions like splenomegaly .</li><li>• suspensory ligament</li><li>• spleen</li><li>• preventing</li><li>• downward displacement</li><li>• enlarged spleen</li><li>• splenomegaly</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 176</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male with a history of gastritis presents to the emergency department with acute onset of severe left upper quadrant abdominal pain and signs of hypovolemic shock. His blood pressure is 90/60 mmHg, heart rate is 120 bpm, and he appears pale and diaphoretic. An abdominal CT scan reveals a large volume of intraperitoneal free fluid. The attending surgeon suspects a ruptured splenic artery aneurysm and discusses the probable location of the lesion with Ref erence to a specific ligament. Which of the following ligaments most likely contains the splenic artery in this patient?", "options": [{"label": "A", "text": "Lienorenal Ligament", "correct": true}, {"label": "B", "text": "Phrenicocolic Ligament", "correct": false}, {"label": "C", "text": "Gastrosplenic Ligament", "correct": false}, {"label": "D", "text": "Gastrocolic Ligament", "correct": false}], "correct_answer": "A. Lienorenal Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture54.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-154005.jpg"], "explanation": "<p><strong>Ans. A. Lienorenal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Phrenicocolic Ligament extends from the left colic flexure to the diaphragm . It provides support to the spleen , especially in preventing its downward displacement in cases of enlargement , but it does not contain the splenic artery.</li><li>• Option B.</li><li>• left colic flexure</li><li>• diaphragm</li><li>• support</li><li>• spleen</li><li>• downward displacement</li><li>• enlargement</li><li>• Option C. The gastrosplenic ligament connects the greater curvature of the stomach to the spleen. It contains the short gastric arteries and left gastroepiploic artery .</li><li>• Option C. The gastrosplenic ligament</li><li>• short gastric arteries and left gastroepiploic artery</li><li>• Option D. Part of the greater omentum , the gastrocolic ligament extends from the greater curvature of the stomach to the transverse colon . It does not contain the splenic artery.</li><li>• Option D.</li><li>• greater omentum</li><li>• greater curvature</li><li>• stomach</li><li>• transverse colon</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lienorenal ligament, also known as the splenorenal ligament, connects the spleen to the left kidney. It primarily consists of fibrous tissue and contains the splenic vessels and tail of the pancreas.</li><li>➤ The lienorenal ligament, also known as the splenorenal ligament, connects the spleen to the left kidney. It primarily consists of fibrous tissue and contains the splenic vessels and tail of the pancreas.</li><li>➤ splenorenal ligament,</li><li>➤ fibrous tissue</li><li>➤ splenic vessels and tail of the pancreas.</li><li>➤ Ligaments of Spleen:</li><li>➤ Ligaments of Spleen:</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy was brought to the surgery OPD because of swelling over right scrotum. On examination, transillumination revealed fluid accumulation within the scrotum. This boy was diagnosed with hydrocele and was posted for surgery the next day. Which of the following statements is NOT true about hydrocele?", "options": [{"label": "A", "text": "Abnormal Collection of Serous Fluid in a part of Tunica Vaginalis", "correct": false}, {"label": "B", "text": "Scrotal Injury could be a cause for development of Hydrocele in Later Life.", "correct": false}, {"label": "C", "text": "Testis and Spermatic Cord cannot be palpated separately.", "correct": false}, {"label": "D", "text": "Dartos Muscle is supplied by Genital Branch of Genitofemoral Nerve.", "correct": true}], "correct_answer": "D. Dartos Muscle is supplied by Genital Branch of Genitofemoral Nerve.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-154418.jpg"], "explanation": "<p><strong>Ans. D) Dartos Muscle is supplied by Genital Branch of Genitofemoral Nerve.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A hydrocele is characterized by the accumulation of fluid in the tunica vaginalis , a pouch of serous membrane that covers the testes . This can lead to swelling in the scrotum , as seen in the patient.</li><li>• Option A.</li><li>• accumulation</li><li>• fluid</li><li>• tunica vaginalis</li><li>• pouch</li><li>• serous membrane</li><li>• covers</li><li>• testes</li><li>• swelling</li><li>• scrotum</li><li>• Option B. Hydrocele can be caused by scrotal injury , inflammation , or other underlying conditions affecting the scrotum . It can develop immediately after the injury or later in life as a result of scarring or blockage in the drainage of fluid .</li><li>• Option B.</li><li>• scrotal injury</li><li>• inflammation</li><li>• affecting</li><li>• scrotum</li><li>• after</li><li>• injury</li><li>• later</li><li>• life</li><li>• scarring</li><li>• blockage</li><li>• drainage</li><li>• fluid</li><li>• Option C. In most cases of hydrocele, the testis and the spermatic cord can still be palpated separately from the fluid collection . This is an important clinical sign in distinguishing hydrocele from other scrotal swellings, such as a hernia .</li><li>• Option C.</li><li>• testis</li><li>• spermatic cord</li><li>• palpated</li><li>• fluid collection</li><li>• clinical sign</li><li>• hydrocele</li><li>• hernia</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The dartos muscle , a layer of smooth muscle in the subcutaneous tissue of the scrotum , is actually innervated by sympathetic fibers from the genital branch of the genitofemoral nerve .</li><li>• The dartos muscle , a layer of smooth muscle in the subcutaneous tissue of the scrotum , is actually innervated by sympathetic fibers from the genital branch of the genitofemoral nerve .</li><li>• dartos muscle</li><li>• smooth muscle</li><li>• subcutaneous tissue</li><li>• scrotum</li><li>• innervated</li><li>• sympathetic fibers</li><li>• genital branch</li><li>• genitofemoral nerve</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1286</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1286</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male was brought to ER with complaints of right sided scrotal pain and swelling that gradually worsened over the past 5 days. He complained of raised body temperature and chills. On examination, his right hemiscrotum is warm, tender and erythematous. Cremasteric Ref lex is present. Scrotal ultrasound confirmed the diagnosis of scrotal abscess. Which of the following statements pertaining to the above case is correct?", "options": [{"label": "A", "text": "Lymphatics from Scrotum Drain into Internal Iliac Nodes", "correct": false}, {"label": "B", "text": "Anterior Third of the Scrotum is supplied by Ilioinguinal and Genitofemoral Nerves", "correct": true}, {"label": "C", "text": "Layers of the Scrotum from Outer to Inner are Skin, Dartos, External Spermatic Fascia, Internal Spermatic Fascia, Cremaster, Parietal Layer of Tunica Vaginalis", "correct": false}, {"label": "D", "text": "Right Half of the Scrotum is lower than the Left Side", "correct": false}], "correct_answer": "B. Anterior Third of the Scrotum is supplied by Ilioinguinal and Genitofemoral Nerves", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture55.jpg"], "explanation": "<p><strong>Ans. B) Anterior Third of the Scrotum is supplied by Ilioinguinal and Genitofemoral Nerves</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The lymphatic drainage of the scrotum is primarily to the superficial inguinal lymph nodes , not the internal iliac nodes. The internal iliac nodes are involved in the lymphatic drainage of the deeper structures of the pelvis .</li><li>• Option A.</li><li>• superficial inguinal lymph nodes</li><li>• internal iliac nodes</li><li>• lymphatic drainage</li><li>• deeper structures</li><li>• pelvis</li><li>• Option C. The correct order of scrotal layers from outer to inner is: Skin , Dartos Muscle and Fascia , External Spermatic Fascia , Cremasteric Muscle and Fascia , Internal Spermatic Fascia , and finally the Parietal Layer of the Tunica Vaginalis . The order presented in this option is mixed up.</li><li>• Option C.</li><li>• correct order</li><li>• Skin</li><li>• Dartos Muscle</li><li>• Fascia</li><li>• External Spermatic Fascia</li><li>• Cremasteric Muscle</li><li>• Fascia</li><li>• Internal Spermatic Fascia</li><li>• Parietal Layer</li><li>• Tunica Vaginalis</li><li>• Option D. While there can be individual variations in the level of the testicles, with one testicle often hanging slightly lower than the other, it is mostly seen that the right half of the scrotum is always lower than the left .</li><li>• Option D.</li><li>• one testicle</li><li>• hanging slightly lower</li><li>• right half</li><li>• scrotum</li><li>• always lower</li><li>• left</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The anterior part of the scrotum is innervated by the ilioinguinal nerve (a branch of the first lumbar nerve ) and the genital branch of the genitofemoral nerve (which originates from the lumbar plexus ). This innervation is important for sensory perception in the scrotal area .</li><li>➤ The anterior part of the scrotum is innervated by the ilioinguinal nerve (a branch of the first lumbar nerve ) and the genital branch of the genitofemoral nerve (which originates from the lumbar plexus ).</li><li>➤ anterior part</li><li>➤ scrotum</li><li>➤ ilioinguinal nerve</li><li>➤ branch</li><li>➤ first lumbar nerve</li><li>➤ genital branch</li><li>➤ genitofemoral nerve</li><li>➤ lumbar plexus</li><li>➤ This innervation is important for sensory perception in the scrotal area .</li><li>➤ sensory perception</li><li>➤ scrotal area</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 1286</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 1286</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old male with a history of cirrhosis secondary to chronic hepatitis C infection presents with esophageal varices and rectal bleeding. His recent endoscopies have shown the presence of enlarged veins in both the lower esophagus and the anorectal region. The patient is concerned about the risks of bleeding from these areas and asks about the potential sites where his portal hypertension might cause portosystemic shunting. Which of the following structures is least likely to be a site of portosystemic shunt formation in this patient?", "options": [{"label": "A", "text": "Gastroesophageal", "correct": false}, {"label": "B", "text": "Spleen", "correct": true}, {"label": "C", "text": "Liver", "correct": false}, {"label": "D", "text": "Anorectum", "correct": false}], "correct_answer": "B. Spleen", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture56.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-155145.jpg"], "explanation": "<p><strong>Ans. B) Spleen</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. In conditions of portal hypertension , gastroesophageal portosystemic shunts are commonly seen. These collaterals form between the portal venous system (via the left gastric vein) and the systemic venous system (via the esophageal veins). This can lead to the development of esophageal varices , which are a significant clinical concern due to their potential for life-threatening bleeding .</li><li>• Option A.</li><li>• portal hypertension</li><li>• gastroesophageal portosystemic shunts</li><li>• collaterals</li><li>• portal venous system</li><li>• systemic venous system</li><li>• esophageal varices</li><li>• significant clinical concern</li><li>• potential</li><li>• life-threatening bleeding</li><li>• Option C. The liver is the primary site affected in conditions leading to portal hypertension , which in turn leads to the formation of portosystemic shunts . However, the liver itself does not form these shunts; rather, they form in other locations as a result of the increased pressure in the portal venous system due to liver pathology .</li><li>• Option C.</li><li>• affected</li><li>• portal hypertension</li><li>• formation</li><li>• portosystemic shunts</li><li>• result</li><li>• increased pressure</li><li>• portal venous system</li><li>• liver pathology</li><li>• Option D. Portosystemic shunts can form in the anorectal area , where the superior rectal veins anastomose with the middle and inferior rectal veins . This can lead to the formation of hemorrhoids , which are essentially varicosities in the anorectal region .</li><li>• Option D.</li><li>• Portosystemic shunts</li><li>• anorectal area</li><li>• superior rectal</li><li>• veins</li><li>• middle</li><li>• inferior rectal veins</li><li>• hemorrhoids</li><li>• varicosities</li><li>• anorectal region</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The spleen itself does not form portosystemic shunts . While the spleen can be involved in conditions leading to portal hypertension (as it is part of the portal system), the spleen itself does not directly form these shunts.</li><li>• The spleen itself does not form portosystemic shunts . While the spleen can be involved in conditions leading to portal hypertension (as it is part of the portal system), the spleen itself does not directly form these shunts.</li><li>• does not</li><li>• portosystemic shunts</li><li>• portal hypertension</li><li>• Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 89</li><li>• Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old man presents to the clinic with intermittent right-sided abdominal pain. His medical history is significant for peptic ulcer disease and cholelithiasis. On physical examination, tenderness is noted in the right flank region. An abdominal CT scan is ordered to assess the patient's kidneys and surrounding structures. The radiologist is discussing the anatomy of the right kidney with the medical team. Which of the following structures is not typically found in the anterior relation of the right kidney?", "options": [{"label": "A", "text": "Liver", "correct": false}, {"label": "B", "text": "Hepatic Flexure", "correct": false}, {"label": "C", "text": "Adrenal", "correct": false}, {"label": "D", "text": "Duodenum 4 th Part", "correct": true}], "correct_answer": "D. Duodenum 4 th Part", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture57.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-155728.png"], "explanation": "<p><strong>Ans. D) Duodenum 4thPart</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The liver is indeed an anterior relation of the right kidney , particularly its right lobe . The right kidney lies inferior and posterior to the liver , making it a key structure in the anterior aspect of the kidney .</li><li>• Option A.</li><li>• anterior relation</li><li>• right kidney</li><li>• right lobe</li><li>• inferior</li><li>• posterior</li><li>• liver</li><li>• anterior aspect</li><li>• kidney</li><li>• Option B. The hepatic flexure of the colon is also an anterior relation of the right kidney . It is the part of the colon that turns downwards from the right side of the abdomen towards the transverse colon .</li><li>• Option B.</li><li>• hepatic flexure</li><li>• colon</li><li>• anterior relation</li><li>• right kidney</li><li>• colon</li><li>• downwards</li><li>• right side</li><li>• abdomen</li><li>• transverse colon</li><li>• Option C. The right adrenal gland is located superior to the right kidney , but it is not considered an anterior relation. Instead, it lies at the superior pole of the kidney and more posteriorly . Therefore, this is not an anterior relation.</li><li>• Option C.</li><li>• right adrenal gland</li><li>• superior</li><li>• right kidney</li><li>• superior pole</li><li>• kidney</li><li>• posteriorly</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The second part of the duodenum , not the fourth part, is an anterior relation of the right kidney . The fourth part of the duodenum runs upwards to the level of the duodenojejunal flexure and is not in close relation to the right kidney.</li><li>➤ The second part of the duodenum , not the fourth part, is an anterior relation of the right kidney . The fourth part of the duodenum runs upwards to the level of the duodenojejunal flexure and is not in close relation to the right kidney.</li><li>➤ second part</li><li>➤ duodenum</li><li>➤ anterior relation</li><li>➤ right kidney</li><li>➤ fourth part</li><li>➤ duodenum</li><li>➤ upwards</li><li>➤ level</li><li>➤ duodenojejunal flexure</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 161</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 161</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female with a history of chronic abdominal pain undergoes exploratory laparotomy. During the surgery, the surgeon notes the anatomical relationship of the root of the mesentery with various retroperitoneal structures. Understanding these relationships is important to avoid vascular or ureteral injury during the procedure. Root of the mesentery crosses anterior to all the following, except:", "options": [{"label": "A", "text": "IVC", "correct": false}, {"label": "B", "text": "Fourth Part of Duodenum", "correct": true}, {"label": "C", "text": "Right Ureter", "correct": false}, {"label": "D", "text": "Right Gonadal Vessels", "correct": false}], "correct_answer": "B. Fourth Part of Duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture58.jpg"], "explanation": "<p><strong>Ans. B) Fourth Part of Duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The root of the mesentery crosses anterior to the IVC (Inferior Vena Cava). This is an important anatomical relationship, as the Superior Mesenteric Vein (SMV) crosses anterior to the IVC just to the right of the midline and joins the splenic vein to form the portal vein .</li><li>• Option A.</li><li>• anterior</li><li>• IVC</li><li>• Superior Mesenteric Vein (SMV)</li><li>• anterior</li><li>• IVC</li><li>• right</li><li>• midline</li><li>• splenic vein</li><li>• form</li><li>• portal vein</li><li>• Option C. The right ureter typically crosses anterior to the root of the mesentery. This is relevant in cases of surgical procedures involving the ureters or the small intestine .</li><li>• Option C.</li><li>• crosses anterior</li><li>• root</li><li>• ureters</li><li>• small intestine</li><li>• Option D. The right gonadal vessels, which include the right testicular (or ovarian ) artery and vein , usually cross anterior to the root of the mesentery .</li><li>• Option D.</li><li>• include</li><li>• right testicular</li><li>• ovarian</li><li>• artery</li><li>• vein</li><li>• cross anterior</li><li>• root</li><li>• mesentery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The root of the mesentery does not typically cross anterior to the fourth part of the duodenum; instead, fourth part of the duodenum is crossing it.</li><li>• The root of the mesentery does not typically cross anterior to the fourth part of the duodenum; instead, fourth part of the duodenum is crossing it.</li><li>• fourth part</li><li>• duodenum</li><li>• crossing</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 79</li><li>• Ref</li><li>• : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 79</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 31-year-old woman presents to the emergency department with acute onset lower abdominal pain and fever. She reports a history of pelvic inflammatory disease. On physical examination, she has tenderness in the lower abdomen, particularly in the pelvic region. A pelvic ultrasound is performed, which shows fluid accumulation in the pelvis. The attending physician explains to the resident that in women, fluid in the abdomen tends to collect in the most dependent area in the standing position. Which of the following is the most dependent area in a standing female where fluid is likely to accumulate?", "options": [{"label": "A", "text": "Right Subhepatic", "correct": false}, {"label": "B", "text": "Left Subhepatic", "correct": false}, {"label": "C", "text": "Pouch of Douglas", "correct": true}, {"label": "D", "text": "Right Suprahepatic", "correct": false}], "correct_answer": "C. Pouch of Douglas", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-161807.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture59.jpg"], "explanation": "<p><strong>Ans. C) Pouch of Douglas</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Right Subhepatic refers to the space below the right lobe of the liver . In a standing position, the liver occupies the upper part of the abdominal cavity , and the right subhepatic space is not the most dependent space because it is located above the liver .</li><li>• Option A.</li><li>• below</li><li>• right lobe</li><li>• liver</li><li>• upper part</li><li>• abdominal cavity</li><li>• right subhepatic space</li><li>• above</li><li>• liver</li><li>• Option B. Similar to the right subhepatic space, the left subhepatic space is below the left lobe of the liver . It is also situated above the liver and is not the most dependent space in a standing position.</li><li>• Option B.</li><li>• below</li><li>• left lobe</li><li>• liver</li><li>• above</li><li>• liver</li><li>• Option D. Right Suprahepatic refers to the space above the right lobe of the liver . Like the subhepatic spaces, the right suprahepatic space is not the most dependent space because it is located above the liver.</li><li>• Option D.</li><li>• above</li><li>• right lobe</li><li>• liver</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• \"Pouch of Douglas\" represents the most dependent space in the standing position within the pelvic cavity in females . This anatomical feature is important in clinical medicine , especially in gynecology and obstetrics .</li><li>• \"Pouch of Douglas\" represents the most dependent space in the standing position within the pelvic cavity in females .</li><li>• most dependent space</li><li>• standing</li><li>• pelvic cavity</li><li>• females</li><li>• This anatomical feature is important in clinical medicine , especially in gynecology and obstetrics .</li><li>• clinical medicine</li><li>• gynecology</li><li>• obstetrics</li><li>• Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 87</li><li>• Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol II, Abdomen, Pg. 87</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male with a history of hepatocellular carcinoma is being evaluated for potential liver resection. The surgeon explains to the medical team that certain segments of the liver have independent vascular and biliary structures, making them suitable for isolated resection. Identifying these segments is crucial for planning surgical interventions while preserving liver function. Which of the following liver segments is known for its physiological independence and is often considered in surgical strategies for liver diseases?", "options": [{"label": "A", "text": "Segment I", "correct": true}, {"label": "B", "text": "Segment II", "correct": false}, {"label": "C", "text": "Segment IV", "correct": false}, {"label": "D", "text": "Segment VIII", "correct": false}], "correct_answer": "A. Segment I", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Segment I</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Segment II ( Left Lateral Segment ) is part of the left lateral lobe of the liver and is not as physiologically independent as Segment I. It shares blood supply and drainage with other parts of the left lateral lobe .</li><li>• Option B.</li><li>• Left Lateral Segment</li><li>• left lateral lobe</li><li>• liver</li><li>• shares blood supply</li><li>• drainage</li><li>• left lateral lobe</li><li>• Option C. Segment IV (Left Medial Segment) is also part of the left lateral lobe of the liver and is not considered physiologically independent. Like Segment II, it shares blood supply and drainage with other segments of the left lateral lobe .</li><li>• Option C.</li><li>• (Left Medial Segment)</li><li>• left lateral lobe</li><li>• liver</li><li>• blood supply</li><li>• drainage</li><li>• left lateral lobe</li><li>• Option D. Segment VIII (Right Anterior Inferior Segment) is located in the right lobe of the liver and is not considered physiologically independent. It shares blood supply and drainage with other parts of the right lobe .</li><li>• Option D.</li><li>• (Right Anterior Inferior Segment)</li><li>• right lobe</li><li>• liver</li><li>• blood supply</li><li>• drainage</li><li>• right lobe</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Segment I of the liver, also known as the caudate lobe , is unique in that it has independent vascular inflow and outflow , as well as biliary drainage . This independence makes it physiologically distinct from the rest of the liver , which is divided into left, right , and quadrate lobes based on the distribution of the portal vein , hepatic artery , and bile ducts . Caudate lobe is segment 1 and belongs to the physiological left lobe of liver but it independently drains into inferior vena cava , receiving blood from right and left hepatic artery . Bile duct from this segment drains to either the left or right duct .</li><li>➤ Segment I of the liver, also known as the caudate lobe , is unique in that it has independent vascular inflow and outflow , as well as biliary drainage .</li><li>➤ caudate lobe</li><li>➤ independent vascular inflow</li><li>➤ outflow</li><li>➤ biliary</li><li>➤ drainage</li><li>➤ This independence makes it physiologically distinct from the rest of the liver , which is divided into left, right , and quadrate lobes based on the distribution of the portal vein , hepatic artery , and bile ducts .</li><li>➤ physiologically distinct</li><li>➤ rest</li><li>➤ liver</li><li>➤ left, right</li><li>➤ quadrate lobes</li><li>➤ distribution</li><li>➤ portal vein</li><li>➤ hepatic artery</li><li>➤ bile ducts</li><li>➤ Caudate lobe is segment 1 and belongs to the physiological left lobe of liver but it independently drains into inferior vena cava , receiving blood from right and left hepatic artery . Bile duct from this segment drains to either the left or right duct .</li><li>➤ Caudate lobe</li><li>➤ segment 1</li><li>➤ physiological left lobe</li><li>➤ liver</li><li>➤ independently drains</li><li>➤ inferior vena cava</li><li>➤ blood</li><li>➤ right</li><li>➤ left hepatic artery</li><li>➤ Bile duct</li><li>➤ drains</li><li>➤ either</li><li>➤ left</li><li>➤ right duct</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 109</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 109</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the clinic with rectal bleeding. During the examination and history-taking, the physician explains to the medical student the importance of understanding the anatomy of the rectum, particularly the pectinate line, for diagnosing conditions like hemorrhoids and rectal cancer. Which of the following statements is true regarding the pectinate line?", "options": [{"label": "A", "text": "Blood Supply above Pectinate Line is through Superior Rectal Artery.", "correct": true}, {"label": "B", "text": "Lymphatic Drainage above Pectinate Line is through Superficial Inguinal Nodes.", "correct": false}, {"label": "C", "text": "Part above Pectinate Line develops from Proctodeum", "correct": false}, {"label": "D", "text": "Part above Pectinate line is supplied by Somatic Nerves.", "correct": false}], "correct_answer": "A. Blood Supply above Pectinate Line is through Superior Rectal Artery.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture60.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-162624.jpg"], "explanation": "<p><strong>Ans. A) Blood Supply above Pectinate Line is through Superior Rectal Artery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. This statement is incorrect . Lymphatic drainage from the region above the pectinate line typically drains to the internal illiac lymph nodes . This is in contrast to the region below the pectinate line , which drains to the superficial inguinal lymph nodes .</li><li>• Option B.</li><li>• incorrect</li><li>• above</li><li>• pectinate line</li><li>• internal illiac lymph nodes</li><li>• below</li><li>• pectinate line</li><li>• superficial inguinal lymph nodes</li><li>• Option C. This statement is incorrect . The part above the pectinate line, known as the \" hindgut-derived \" part of the anal canal , develops from the endodermal cloaca during embryogenesis . It is not derived from the proctodeum.</li><li>• Option C.</li><li>• incorrect</li><li>• hindgut-derived</li><li>• anal canal</li><li>• endodermal cloaca</li><li>• embryogenesis</li><li>• Option D. This statement is incorrect . The part above the pectinate line , also known as the \" visceral \" or \" autonomic \" part, is supplied by visceral nerves , which are part of the autonomic nervous system . It is insensitive to pain and temperature . In contrast, the part below the pectinate line is supplied by somatic nerves and is sensitive to pain and temperature .</li><li>• Option D.</li><li>• incorrect</li><li>• above</li><li>• pectinate line</li><li>• visceral</li><li>• autonomic</li><li>• visceral nerves</li><li>• autonomic nervous system</li><li>• insensitive</li><li>• pain</li><li>• temperature</li><li>• below</li><li>• pectinate line</li><li>• somatic nerves</li><li>• sensitive</li><li>• pain</li><li>• temperature</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Above the pectinate line , the blood supply to the anal canal is primarily through the superior rectal artery is the continuation of the inferior mesenteric artery . This arterial supply is part of the systemic circulation .</li><li>➤ pectinate line</li><li>➤ blood supply</li><li>➤ anal canal</li><li>➤ superior rectal artery</li><li>➤ continuation of the inferior mesenteric artery</li><li>➤ systemic circulation</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old male with a history of hepatocellular carcinoma is scheduled for a right hepatectomy. The surgical team discusses the extent of the resection required. The surgeon explains that the resection will involve specific segments of the liver to ensure complete removal of the tumor while preserving as much healthy liver tissue as possible. Which of the following sets of segments constitute the right lobe of the liver, which is the target of the planned hepatectomy in this patient?", "options": [{"label": "A", "text": "V, VI, VII and VIII", "correct": true}, {"label": "B", "text": "IV, V, VI, VII, VIII", "correct": false}, {"label": "C", "text": "I, V, VI, VII, VIII", "correct": false}, {"label": "D", "text": "I, IV, V, VI, VII, VIII", "correct": false}], "correct_answer": "A. V, VI, VII and VIII", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture61.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. While segments V, VI, VII, and VIII are indeed part of the right lobe of the liver, including segment IV in the right lobe would not be accurate. Segment IV is part of the left hepatic lobe .</li><li>• Option B.</li><li>• Segment IV</li><li>• left hepatic lobe</li><li>• Option C. Including segment I (caudate lobe) in the right lobe is not correct. Segment I is located posteriorly and is considered part of the caudate lobe , which is separate from the right and left lobes.</li><li>• Option C.</li><li>• Segment I</li><li>• posteriorly</li><li>• caudate lobe</li><li>• Option D. This option includes segments I (caudate lobe) and IV (quadrate lobe) in the right lobe, which is not accurate. The right lobe primarily consists of segments V, VI, VII , and VIII .</li><li>• Option D.</li><li>• right lobe</li><li>• segments V, VI, VII</li><li>• VIII</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Liver is divided into segments by means of three major fissures and three minor fissures present on the surface . The major fissures harbor the three hepatic veins . The liver is anatomically divided into segments, and the right lobe of the liver consists of specific segments . The right lobe of the liver consists of segments V, VI, VII , and VIII . These segments are located on the right side of the liver and are collectively referred to as the right hepatic lobe .</li><li>➤ Liver is divided into segments by means of three major fissures and three minor fissures present on the surface . The major fissures harbor the three hepatic veins .</li><li>➤ three major fissures</li><li>➤ three minor fissures</li><li>➤ surface</li><li>➤ harbor</li><li>➤ three hepatic veins</li><li>➤ The liver is anatomically divided into segments, and the right lobe of the liver consists of specific segments .</li><li>➤ right lobe</li><li>➤ liver</li><li>➤ specific segments</li><li>➤ The right lobe of the liver consists of segments V, VI, VII , and VIII . These segments are located on the right side of the liver and are collectively referred to as the right hepatic lobe .</li><li>➤ right lobe</li><li>➤ liver</li><li>➤ segments V, VI, VII</li><li>➤ VIII</li><li>➤ right side</li><li>➤ liver</li><li>➤ right hepatic lobe</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 109</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 109</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents with recurrent episodes of epigastric pain radiating to the back. She has a history of chronic pancreatitis. During an endoscopic retrograde cholangiopancreatography (ERCP), the gastroenterologist points out a structure to the medical residents and explains its significance in some patients with pancreatitis. This structure, known as the minor duodenal papilla, is the opening of which of the following?", "options": [{"label": "A", "text": "Hepatic Duct", "correct": false}, {"label": "B", "text": "Hepatopancreatic Ampulla", "correct": false}, {"label": "C", "text": "Accessory Pancreatic Duct", "correct": true}, {"label": "D", "text": "Bile Duct", "correct": false}], "correct_answer": "C. Accessory Pancreatic Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture62.jpg"], "explanation": "<p><strong>Ans. C) Accessory Pancreatic Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The right and left hepatic duct unite to form a common hepatic duct that runs downwards for 2.5cm and then joined by cystic duct to form common bile duct .</li><li>• Option A.</li><li>• right</li><li>• left hepatic duct</li><li>• common hepatic</li><li>• duct</li><li>• downwards</li><li>• 2.5cm</li><li>• joined</li><li>• cystic duct</li><li>• common bile duct</li><li>• Option B. The Hepatopancreatic Ampulla (Ampulla of Vater) is a small , funnel-shaped dilation where the common bile duct and the main pancreatic duct ( duct of Wirsung ) join together. Sphincter choledochus surrounds pre-ampullary part of bile duct , sphincter pancreaticus surrounds pre ampullary part of pancreatic duct . Sphincter of Oddi surrounds termination of ampulla .</li><li>• Option B.</li><li>• (Ampulla of Vater)</li><li>• small</li><li>• funnel-shaped dilation</li><li>• common bile duct</li><li>• main pancreatic duct</li><li>• duct of Wirsung</li><li>• pre-ampullary part</li><li>• bile duct</li><li>• sphincter pancreaticus</li><li>• pre ampullary part</li><li>• pancreatic duct</li><li>• Sphincter</li><li>• Oddi</li><li>• termination</li><li>• ampulla</li><li>• Option D. Bile Duct, specifically the common bile duct , is formed by the convergence of the common hepatic duct and the cystic duct . The end of the common bile duct combines with the main pancreatic duct and empties into the duodenum at the major duodenal papilla . Common bile duct is 7.5cm long and lies in the right free margin of lesser omentum anterior to portal vein and to right of common hepatic artery .</li><li>• Option D.</li><li>• common bile duct</li><li>• convergence</li><li>• common hepatic duct</li><li>• cystic duct</li><li>• main pancreatic duct</li><li>• duodenum</li><li>• major duodenal papilla</li><li>• 7.5cm long</li><li>• right free margin</li><li>• lesser omentum</li><li>• portal vein</li><li>• right</li><li>• common hepatic artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Accessory Pancreatic Duct (Duct of Santorini) is a smaller duct in the pancreas . It usually drains a portion of the pancreas independent of the main pancreatic duct . The minor duodenal papilla is the opening of this duct into the duodenum , which is less prominent than the major duodenal papilla.</li><li>➤ The Accessory Pancreatic Duct (Duct of Santorini) is a smaller duct in the pancreas .</li><li>➤ (Duct of Santorini)</li><li>➤ smaller duct</li><li>➤ pancreas</li><li>➤ It usually drains a portion of the pancreas independent of the main pancreatic duct .</li><li>➤ drains</li><li>➤ pancreas independent</li><li>➤ main pancreatic duct</li><li>➤ The minor duodenal papilla is the opening of this duct into the duodenum , which is less prominent than the major duodenal papilla.</li><li>➤ minor duodenal papilla</li><li>➤ opening</li><li>➤ duodenum</li><li>➤ less prominent</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 117</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 117</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents with symptoms of malabsorption, including weight loss, diarrhea, and abdominal discomfort. A small bowel follow-through study is performed, which shows prominent mucosal folds in the proximal small intestine. The attending physician explains to the medical student that these folds, known as valvulae conniventes, are most prominent in which part of the gastrointestinal tract?", "options": [{"label": "A", "text": "Ileum", "correct": true}, {"label": "B", "text": "Stomach", "correct": false}, {"label": "C", "text": "Colon", "correct": false}, {"label": "D", "text": "Appendix", "correct": false}], "correct_answer": "A. Ileum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture63.jpg"], "explanation": "<p><strong>Ans. A) Ileum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Stomach:</li><li>• Option B. Stomach:</li><li>• The stomach has rugae , not valvulae conniventes. Rugae are folds in the stomach lining that allow for expansion as the stomach fills . These folds are different in structure and function from the valvulae conniventes found in the small intestine .</li><li>• The stomach has rugae , not valvulae conniventes. Rugae are folds in the stomach lining that allow for expansion as the stomach fills .</li><li>• rugae</li><li>• folds</li><li>• stomach</li><li>• allow</li><li>• expansion</li><li>• stomach fills</li><li>• These folds are different in structure and function from the valvulae conniventes found in the small intestine .</li><li>• folds</li><li>• structure</li><li>• function</li><li>• valvulae conniventes</li><li>• small intestine</li><li>• Option C. Colon:</li><li>• Option C. Colon:</li><li>• The colon , or large intestine , does not have valvulae conniventes. Instead, it has haustra , which are small pouches caused by sacculation ( sac formation ), giving the colon its segmented appearance . The colon's primary function is to absorb water and electrolytes from the remaining indigestible food matter .</li><li>• The colon , or large intestine , does not have valvulae conniventes.</li><li>• colon</li><li>• large intestine</li><li>• Instead, it has haustra , which are small pouches caused by sacculation ( sac formation ), giving the colon its segmented appearance .</li><li>• haustra</li><li>• small pouches</li><li>• sacculation</li><li>• sac formation</li><li>• colon</li><li>• segmented appearance</li><li>• The colon's primary function is to absorb water and electrolytes from the remaining indigestible food matter .</li><li>• absorb water</li><li>• electrolytes</li><li>• remaining indigestible</li><li>• food matter</li><li>• Option D. Appendix:</li><li>• Option D. Appendix:</li><li>• The appendix is a small, tube-like sac attached to the lower end of the large intestine . It does not contain valvulae conniventes. The appendix's function is still a topic of research, but it is believed to play a role in the immune system . The appendix is mostly known for its tendency to become inflamed , leading to appendicitis .</li><li>• The appendix is a small, tube-like sac attached to the lower end of the large intestine .</li><li>• small,</li><li>• tube-like sac</li><li>• lower end</li><li>• large intestine</li><li>• It does not contain valvulae conniventes. The appendix's function is still a topic of research, but it is believed to play a role in the immune system .</li><li>• play</li><li>• role</li><li>• immune system</li><li>• The appendix is mostly known for its tendency to become inflamed , leading to appendicitis .</li><li>• tendency</li><li>• inflamed</li><li>• appendicitis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ileum:</li><li>➤ Ileum:</li><li>➤ The ileum is the final and longest segment of the small intestine . Valvulae conniventes are numerous and highly developed in the ileum (as well as the jejunum ).</li><li>➤ The ileum is the final and longest segment of the small intestine .</li><li>➤ ileum</li><li>➤ final</li><li>➤ longest segment</li><li>➤ small intestine</li><li>➤ Valvulae conniventes are numerous and highly developed in the ileum (as well as the jejunum ).</li><li>➤ Valvulae conniventes</li><li>➤ numerous</li><li>➤ highly</li><li>➤ ileum</li><li>➤ jejunum</li><li>➤ These are deep , circular folds of the mucous membrane that line the small intestine . Their function is to increase the surface area for absorption and to slow down the passage of food , allowing more time for nutrients to be absorbed .Top of Form Valvulae conniventes are characteristic features of the small intestine , particularly the ileum and jejunum , and are not found in the stomach, colon, or appendix. Their primary function is to increase the surface area for nutrient absorption .</li><li>➤ These are deep , circular folds of the mucous membrane that line the small intestine . Their function is to increase the surface area for absorption and to slow down the passage of food , allowing more time for nutrients to be absorbed .Top of Form</li><li>➤ deep</li><li>➤ circular folds</li><li>➤ mucous membrane</li><li>➤ line</li><li>➤ small intestine</li><li>➤ increase</li><li>➤ surface area</li><li>➤ absorption</li><li>➤ slow down</li><li>➤ passage</li><li>➤ food</li><li>➤ nutrients</li><li>➤ absorbed</li><li>➤ Valvulae conniventes are characteristic features of the small intestine , particularly the ileum and jejunum , and are not found in the stomach, colon, or appendix.</li><li>➤ Valvulae conniventes</li><li>➤ small intestine</li><li>➤ ileum</li><li>➤ jejunum</li><li>➤ Their primary function is to increase the surface area for nutrient absorption .</li><li>➤ increase</li><li>➤ surface area</li><li>➤ nutrient absorption</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 150</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a colonoscopy in a 56-year-old man with a history of chronic constipation, the gastroenterologist points out the Valves of Houston to a group of medical residents. He describes their anatomical features and function in maintaining fecal continence. He then poses a question about a common misconception regarding these structures. Which of the following statements is FALSE about the Valves of Houston?", "options": [{"label": "A", "text": "Anteriorly correlates with Peritoneal Reflection.", "correct": true}, {"label": "B", "text": "Are placed Transversely.", "correct": false}, {"label": "C", "text": "Contain all Layers of Intestine.", "correct": false}, {"label": "D", "text": "Prominent on Relax Rectum.", "correct": false}], "correct_answer": "A. Anteriorly correlates with Peritoneal Reflection.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture64.jpg"], "explanation": "<p><strong>Ans. A) Anteriorly correlates with Peritoneal Reflection</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Are placed transversely:</li><li>• Option B. Are placed transversely:</li><li>• This statement is true . The Valves of Houston are transversely oriented folds in the rectum . There are usually two or three such folds , and they are positioned horizontally within the rectum .</li><li>• This statement is true . The Valves of Houston are transversely oriented folds in the rectum .</li><li>• true</li><li>• transversely</li><li>• folds</li><li>• rectum</li><li>• There are usually two or three such folds , and they are positioned horizontally within the rectum .</li><li>• two</li><li>• three</li><li>• folds</li><li>• positioned horizontally</li><li>• rectum</li><li>• Option C. Contain all layers of intestine:</li><li>• Option C. Contain all layers of intestine:</li><li>• This statement is generally considered true . The Valves of Houston contain all the layers of the intestinal wall , as they are folds of the rectal wall itself . These layers include the mucosa , submucosa , muscularis , and serosa/adventitia .</li><li>• This statement is generally considered true . The Valves of Houston contain all the layers of the intestinal wall , as they are folds of the rectal wall itself .</li><li>• true</li><li>• layers</li><li>• intestinal wall</li><li>• folds</li><li>• rectal wall itself</li><li>• These layers include the mucosa , submucosa , muscularis , and serosa/adventitia .</li><li>• mucosa</li><li>• submucosa</li><li>• muscularis</li><li>• serosa/adventitia</li><li>• Option D. Prominent on relax rectum :</li><li>• Option D.</li><li>• Prominent on relax rectum</li><li>• :</li><li>• This statement is true . The Valves of Houston are actually less prominent on distension . When the rectum is empty or not distended, these folds are more noticeable . They can flatten out and become less distinct when the rectum is distended .</li><li>• This statement is true . The Valves of Houston are actually less prominent on distension .</li><li>• true</li><li>• less prominent</li><li>• distension</li><li>• When the rectum is empty or not distended, these folds are more noticeable . They can flatten out and become less distinct when the rectum is distended .</li><li>• rectum</li><li>• empty</li><li>• more noticeable</li><li>• flatten out</li><li>• less distinct</li><li>• rectum</li><li>• distended</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Valves of Houston do not correlate with the peritoneal Reflection.</li><li>➤ The peritoneal reflection is where the rectum transitions from being covered by peritoneum (the serous membrane lining the abdominal cavity ) to being below the peritoneum . This point of reflection is not directly related to the transverse rectal folds. The Valves of Houston are mucosal folds within the rectum and are not determined by the peritoneal covering.</li><li>➤ The peritoneal reflection is where the rectum transitions from being covered by peritoneum (the serous membrane lining the abdominal cavity ) to being below the peritoneum . This point of reflection is not directly related to the transverse rectal folds.</li><li>➤ rectum</li><li>➤ peritoneum</li><li>➤ serous membrane</li><li>➤ abdominal cavity</li><li>➤ below</li><li>➤ peritoneum</li><li>➤ The Valves of Houston are mucosal folds within the rectum and are not determined by the peritoneal covering.</li><li>➤ Valves of Houston</li><li>➤ mucosal folds</li><li>➤ rectum</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 87, 274.</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 87, 274.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old female undergoes a pre-operative assessment for a planned colectomy due to extensive diverticular disease. During a surgical planning meeting, the attending surgeon discusses the importance of understanding the variability in colonic blood supply for avoiding ischemic complications post-surgery. He mentions that one of the most common anatomical variants in colonic blood supply involves a specific artery. Which of the following arteries is most commonly absent as a variant in the blood supply of the colon?", "options": [{"label": "A", "text": "Absent Right Colic Artery", "correct": false}, {"label": "B", "text": "Absent Middle Colic Artery", "correct": true}, {"label": "C", "text": "Absent Left Colic Artery", "correct": false}, {"label": "D", "text": "Absent Superior Rectal Artery", "correct": false}], "correct_answer": "B. Absent Middle Colic Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture65.jpg"], "explanation": "<p><strong>Ans. B) Absent Middle Colic Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The right colic artery supplies the ascending colon . The ascending branch of the right colic artery anastomoses with the right branch of middle colic artery . The blood supply to the ascending colon is usually compensated by branches of the ileocolic or middle colic arteries .</li><li>• Option A.</li><li>• right colic artery</li><li>• ascending colon</li><li>• ascending branch</li><li>• right colic artery</li><li>• right branch</li><li>• middle colic artery</li><li>• blood supply</li><li>• ascending colon</li><li>• compensated</li><li>• branches</li><li>• ileocolic</li><li>• middle colic arteries</li><li>• Option C. The left colic artery , a branch of the inferior mesenteric artery , supplies the descending colon . Left colic artery arises from an inferior mesenteric artery, its ascending branch anastomose with the left branch of the middle colic artery . The absence of the left colic artery is less common than the absence of the middle colic artery.</li><li>• Option C.</li><li>• left colic artery</li><li>• inferior mesenteric artery</li><li>• supplies</li><li>• descending colon</li><li>• ascending branch</li><li>• left branch</li><li>• middle colic artery</li><li>• Option D. The inferior mesenteric artery continues as the superior rectal artery which runs along the descending limb of the root of sigmoid mesocolon . In the rare instances where it is absent , blood supply to the upper rectum would have to come from middle and inferior rectal arteries , but such a scenario is quite unusual .</li><li>• Option D.</li><li>• inferior mesenteric artery</li><li>• superior rectal artery</li><li>• descending limb</li><li>• root</li><li>• sigmoid mesocolon</li><li>• rare instances</li><li>• absent</li><li>• blood supply</li><li>• upper rectum</li><li>• middle</li><li>• inferior rectal arteries</li><li>• quite unusual</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle colic artery is a branch of the superior mesenteric artery and supplies the transverse colon . The absence of the middle colic artery is the most common variant in the blood supply of the colon . In situations where the middle colic artery is absent , collateral circulation from the right and left colic arteries typically compensates for its absence .</li><li>➤ The middle colic artery is a branch of the superior mesenteric artery and supplies the transverse colon .</li><li>➤ middle colic artery</li><li>➤ superior mesenteric artery</li><li>➤ supplies</li><li>➤ transverse colon</li><li>➤ The absence of the middle colic artery is the most common variant in the blood supply of the colon .</li><li>➤ absence</li><li>➤ middle colic artery</li><li>➤ blood supply</li><li>➤ colon</li><li>➤ In situations where the middle colic artery is absent , collateral circulation from the right and left colic arteries typically compensates for its absence .</li><li>➤ middle colic artery</li><li>➤ absent</li><li>➤ collateral circulation</li><li>➤ right</li><li>➤ left colic arteries</li><li>➤ compensates</li><li>➤ absence</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 179</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 179</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a teaching session with medical students, a hepatobiliary surgeon discusses the anatomy of the portal vein and its surrounding structures. He emphasizes the importance of understanding these relationships for surgical procedures involving the liver and pancreas. He then challenges the students to identify an incorrect statement about the portal vein. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Formed behind Neck of Pancreas.", "correct": false}, {"label": "B", "text": "Bile Duct lies Anterior and Right to it.", "correct": false}, {"label": "C", "text": "Gastroduodenal Artery lies to Left and Anterior to it.", "correct": false}, {"label": "D", "text": "Ascends behind 2 nd Part of Duodenum.", "correct": true}], "correct_answer": "D. Ascends behind 2 nd Part of Duodenum.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture66.jpg"], "explanation": "<p><strong>Ans. D) Ascends behind 2ndPart of Duodenum.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . The portal vein is formed by the union of the superior mesenteric vein and the splenic vein behind the neck of the pancreas at level of L2 vertebra . This is a key anatomical landmark in understanding the relationships of the portal vein .</li><li>• Option A.</li><li>• correct</li><li>• union</li><li>• superior mesenteric</li><li>• vein</li><li>• splenic vein</li><li>• neck</li><li>• pancreas</li><li>• L2 vertebra</li><li>• relationships</li><li>• portal vein</li><li>• Option B. This statement is also correct . The common bile duct is positioned anteriorly and to the right of the portal vein . Right branch of the portal vein is shorter , vertical and receives a cystic vein .</li><li>• Option B.</li><li>• correct</li><li>• positioned anteriorly</li><li>• right</li><li>• portal vein</li><li>• Right branch</li><li>• portal vein</li><li>• shorter</li><li>• vertical</li><li>• receives</li><li>• cystic vein</li><li>• Option C. This statement is correct . The gastroduodenal artery runs anteriorly and to the left of the portal vein . Left branch is longer , oblique and receives paraumbilical vein and is connected with ligamentum teres from below and ligamentum venosum from above .</li><li>• Option C.</li><li>• correct</li><li>• gastroduodenal artery</li><li>• anteriorly</li><li>• left</li><li>• portal vein</li><li>• Left branch</li><li>• longer</li><li>• oblique</li><li>• paraumbilical vein</li><li>• ligamentum teres</li><li>• below</li><li>• ligamentum venosum</li><li>• above</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The portal vein does not ascend behind the second part of the duodenum. Instead, it ascends in the hepatoduodenal ligament , which is part of the lesser omentum , and enters the liver at the porta hepatis . The second part of the duodenum is actually anterior to the portal vein .Top of Form</li><li>➤ The portal vein does not ascend behind the second part of the duodenum. Instead, it ascends in the hepatoduodenal ligament , which is part of the lesser omentum , and enters the liver at the porta hepatis .</li><li>➤ ascends</li><li>➤ hepatoduodenal ligament</li><li>➤ part</li><li>➤ lesser omentum</li><li>➤ enters</li><li>➤ liver</li><li>➤ porta hepatis</li><li>➤ The second part of the duodenum is actually anterior to the portal vein .Top of Form</li><li>➤ second part</li><li>➤ duodenum</li><li>➤ actually anterior</li><li>➤ portal vein</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 134</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 134</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of chronic pancreatitis undergoes an abdominal CT scan. The radiologist, while discussing the scan with medical residents, highlights the importance of understanding the anatomical relationships of the pancreas for diagnostic and surgical planning. He asks the residents to identify which of the following structures is not a posterior relation of the head of the pancreas.", "options": [{"label": "A", "text": "Common Bile Duct", "correct": false}, {"label": "B", "text": "First Part of Duodenum", "correct": true}, {"label": "C", "text": "Aorta", "correct": false}, {"label": "D", "text": "Inferior Vena Cava", "correct": false}], "correct_answer": "B. First Part of Duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture67.jpg"], "explanation": "<p><strong>Ans. B) First Part of Duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The common bile duct is indeed a posterior relation of the head of the pancreas . Anterior relations of head of pancreas : Gastroduodenal Artery , Transverse Colon , Root of Transverse Mesocolon , Jejunum .</li><li>• Option A.</li><li>• posterior relation</li><li>• head</li><li>• pancreas</li><li>• Anterior relations</li><li>• head</li><li>• pancreas</li><li>• Gastroduodenal Artery</li><li>• Transverse Colon</li><li>• Root of Transverse Mesocolon</li><li>• Jejunum</li><li>• Option C. The aorta is indeed a posterior relation of the head of the pancreas . The pancreas lies anterior to the aorta as it passes through the abdomen . Superior border of head of pancreas related to the first part of duodenum , and superior pancreaticoduodenal artery .</li><li>• Option C.</li><li>• posterior</li><li>• head</li><li>• pancreas</li><li>• anterior</li><li>• aorta</li><li>• abdomen</li><li>• Superior border</li><li>• head</li><li>• pancreas</li><li>• first part</li><li>• duodenum</li><li>• superior pancreaticoduodenal artery</li><li>• Option D. The inferior vena cava is also a posterior relation of the head of the pancreas . It lies posteriorly to the pancreas , and the head of the pancreas is often closely related to the inferior vena cava . Inferior border related to the third part of duodenum , and inferior pancreaticoduodenal artery .</li><li>• Option D.</li><li>• posterior</li><li>• head</li><li>• pancreas</li><li>• posteriorly</li><li>• pancreas</li><li>• head</li><li>• pancreas</li><li>• closely</li><li>• inferior vena cava</li><li>• third part</li><li>• duodenum</li><li>• inferior pancreaticoduodenal artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ First Part of Duodenum is correct and represents the exception . The first part of the duodenum is not a posterior relation of the head of the pancreas . Instead, it is located anteriorly and laterally to the head of the pancreas . The head of the pancreas nestles into the curve of the duodenum , making this part of the duodenum an anterior , not posterior, relation.</li><li>➤ First Part of Duodenum is correct and represents the exception . The first part of the duodenum is not a posterior relation of the head of the pancreas .</li><li>➤ correct</li><li>➤ represents</li><li>➤ exception</li><li>➤ first part</li><li>➤ duodenum</li><li>➤ not</li><li>➤ posterior</li><li>➤ head</li><li>➤ pancreas</li><li>➤ Instead, it is located anteriorly and laterally to the head of the pancreas . The head of the pancreas nestles into the curve of the duodenum , making this part of the duodenum an anterior , not posterior, relation.</li><li>➤ anteriorly</li><li>➤ laterally</li><li>➤ head</li><li>➤ pancreas</li><li>➤ head</li><li>➤ pancreas</li><li>➤ nestles</li><li>➤ curve</li><li>➤ duodenum</li><li>➤ duodenum</li><li>➤ anterior</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 128</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 128</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What lies between cystic duct and common hepatic duct?", "options": [{"label": "A", "text": "Lymph Node", "correct": true}, {"label": "B", "text": "Portal Vein", "correct": false}, {"label": "C", "text": "Hepatic Artery", "correct": false}, {"label": "D", "text": "Cystic Artery", "correct": false}], "correct_answer": "A. Lymph Node", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture68.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-165941.jpg"], "explanation": "<p><strong>Ans. A) Lymph Node</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Portal Vein:</li><li>• Option B. Portal Vein:</li><li>• The portal vein is not located between the cystic duct and the common hepatic duct. It lies posteriorly to the first part of the duodenum and the head of the pancreas , a bit farther from the location described.</li><li>• The portal vein is not located between the cystic duct and the common hepatic duct.</li><li>• It lies posteriorly to the first part of the duodenum and the head of the pancreas , a bit farther from the location described.</li><li>• posteriorly</li><li>• first part</li><li>• duodenum</li><li>• head</li><li>• pancreas</li><li>• Option C. Hepatic Artery:</li><li>• Option C. Hepatic Artery:</li><li>• The hepatic artery, specifically the right hepatic artery , may sometimes be closely related to this area, but it is not typically found between the cystic duct and the common hepatic duct. Variations in hepatic artery anatomy are common , and in some cases, the right hepatic artery may pass posterior to or through Calot's triangle , but it's not the norm.</li><li>• The hepatic artery, specifically the right hepatic artery , may sometimes be closely related to this area, but it is not typically found between the cystic duct and the common hepatic duct.</li><li>• right hepatic artery</li><li>• Variations in hepatic artery anatomy are common , and in some cases, the right hepatic artery may pass posterior to or through Calot's triangle , but it's not the norm.</li><li>• hepatic artery anatomy</li><li>• common</li><li>• right hepatic artery</li><li>• posterior</li><li>• Calot's triangle</li><li>• Option D. Cystic Artery:</li><li>• Option D. Cystic Artery:</li><li>• The cystic artery typically arises from the right hepatic artery and travels to the gallbladder , passing through Calot's triangle . While it is related to this area, it is not usually positioned between the cystic duct and the common hepatic duct.</li><li>• The cystic artery typically arises from the right hepatic artery and travels to the gallbladder , passing through Calot's triangle .</li><li>• arises</li><li>• right hepatic artery</li><li>• travels</li><li>• gallbladder</li><li>• Calot's triangle</li><li>• While it is related to this area, it is not usually positioned between the cystic duct and the common hepatic duct.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Calot triangle is formed by the cystic duct , the common hepatic duct , and the CYSTIC ARTERY (known as Calot's triangle ), lymph nodes are commonly found . These lymph nodes are significant, especially in gallbladder surgery (like cholecystectomy), as they can be sites of inflammation or metastasis in gallbladder cancer .</li><li>➤ Calot triangle is formed by the cystic duct , the common hepatic duct , and the CYSTIC ARTERY (known as Calot's triangle ), lymph nodes are commonly found .</li><li>➤ Calot</li><li>➤ triangle</li><li>➤ cystic duct</li><li>➤ common hepatic duct</li><li>➤ CYSTIC ARTERY</li><li>➤ Calot's triangle</li><li>➤ lymph nodes</li><li>➤ found</li><li>➤ These lymph nodes are significant, especially in gallbladder surgery (like cholecystectomy), as they can be sites of inflammation or metastasis in gallbladder cancer .</li><li>➤ lymph nodes</li><li>➤ gallbladder surgery</li><li>➤ sites</li><li>➤ inflammation</li><li>➤ metastasis</li><li>➤ gallbladder cancer</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 118</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 118</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old woman presents with recurrent episodes of right upper quadrant pain, jaundice, and elevated liver enzymes. During an endoscopic retrograde cholangiopancreatography (ERCP), the gastroenterologist explains to the medical residents that the dysfunction of a specific sphincter complex might be contributing to the patient's symptoms. This sphincter complex regulates the flow of bile and pancreatic juice into the duodenum. How many sphincters does this complex, known as the Sphincter of Oddi, consist of?", "options": [{"label": "A", "text": "2 sphincters", "correct": false}, {"label": "B", "text": "3 sphincters", "correct": false}, {"label": "C", "text": "4 sphincters", "correct": true}, {"label": "D", "text": "6 sphincters", "correct": false}], "correct_answer": "C. 4 sphincters", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture69.jpg"], "explanation": "<p><strong>Ans. C) 4 Sphincters</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. 2 Sphincters:</li><li>• Option A. 2 Sphincters:</li><li>• This is not correct. The Sphincter of Oddi is more complex than just two sphincters .</li><li>• This is not correct. The Sphincter of Oddi is more complex than just two sphincters .</li><li>• more complex</li><li>• two sphincters</li><li>• Option B. 3 Sphincters:</li><li>• Option B. 3 Sphincters:</li><li>• This is closer but still not entirely accurate. Traditionally, it has been described as having three distinct parts : the sphincter choledochus (controlling the bile duct), the sphincter pancreaticus (controlling the pancreatic duct), and the sphincter ampullae (at the ampulla of Vater). However, more detailed studies have identified additional components.</li><li>• This is closer but still not entirely accurate. Traditionally, it has been described as having three distinct parts : the sphincter choledochus (controlling the bile duct), the sphincter pancreaticus (controlling the pancreatic duct), and the sphincter ampullae (at the ampulla of Vater). However, more detailed studies have identified additional components.</li><li>• three distinct parts</li><li>• sphincter choledochus</li><li>• sphincter pancreaticus</li><li>• sphincter ampullae</li><li>• Option D. 6 Sphincters:</li><li>• Option D. 6 Sphincters:</li><li>• This is not correct. There is no anatomical or physiological basis for describing the Sphincter of Oddi as consisting of six separate sphincters .</li><li>• This is not correct. There is no anatomical or physiological basis for describing the Sphincter of Oddi as consisting of six separate sphincters .</li><li>• six separate sphincters</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Sphincter of Oddi is composed of four distinct sphincters , each contributing to the regulation of bile and pancreatic juice flow into the duodenum . This complex arrangement is crucial for normal digestive processes and for preventing the reflux of duodenal contents into the pancreaticobiliary system .</li><li>➤ The Sphincter of Oddi is composed of four distinct sphincters , each contributing to the regulation of bile and pancreatic juice flow into the duodenum .</li><li>➤ four distinct sphincters</li><li>➤ regulation</li><li>➤ bile</li><li>➤ pancreatic juice</li><li>➤ duodenum</li><li>➤ This complex arrangement is crucial for normal digestive processes and for preventing the reflux of duodenal contents into the pancreaticobiliary system .</li><li>➤ normal digestive processes</li><li>➤ reflux</li><li>➤ duodenal contents</li><li>➤ pancreaticobiliary system</li><li>➤ Ref : Bailey &amp; Love’s Surgery Text Book Page no- 1214;</li><li>➤ Ref</li><li>➤ : Bailey &amp; Love’s Surgery Text Book Page no- 1214;</li><li>➤ Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 118</li><li>➤ Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen, Pg. 118</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman, who regularly completes her lunch combo with a bowl full of French fries, visited her family physician with complaints of pain over the upper belly, on the right side, and under the ribs. She also complained of an upset stomach and vomiting. The pain radiated to the right shoulder. She said that she had experienced the pain on several occasions before and that when she ate fatty foods, it seemed to make the pain worse. Ultrasound demonstrated the presence of gallstones. Which of the following statement is incorrect?", "options": [{"label": "A", "text": "The Body of Gall Bladder is related to the Pylorus of the Stomach on its Left Side.", "correct": false}, {"label": "B", "text": "Fundus of Gallbladder is located over the Tip of Right 9 th Costal Cartilage in Midclavicular Line.", "correct": false}, {"label": "C", "text": "Cystic Vein opens into the Right Hepatic Vein.", "correct": true}, {"label": "D", "text": "The Right Phrenic Nerve reaches the Gallbladder through Phrenic and Hepatic Plexus, hence Pain is referred to Tip of Right Shoulder in Gallbladder Inflammation", "correct": false}], "correct_answer": "C. Cystic Vein opens into the Right Hepatic Vein.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture70.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-170737.jpg"], "explanation": "<p><strong>Ans. C) Cystic Vein opens into the Right Hepatic Vein.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• This statement is correct . The body of the gallbladder is indeed positioned close to the pylorus of the stomach on its left side . The close anatomical relationship between these structures is clinically significant.</li><li>• This statement is correct . The body of the gallbladder is indeed positioned close to the pylorus of the stomach on its left side . The close anatomical relationship between these structures is clinically significant.</li><li>• correct</li><li>• body</li><li>• gallbladder</li><li>• positioned</li><li>• pylorus</li><li>• stomach</li><li>• left side</li><li>• Option B.</li><li>• Option B.</li><li>• This statement is also correct . The fundus of the gallbladder is typically located at the tip of the right 9th costal cartilage in the midclavicular line . This anatomical landmark is often used in clinical examinations to locate the gallbladder .</li><li>• This statement is also correct . The fundus of the gallbladder is typically located at the tip of the right 9th costal cartilage in the midclavicular line . This anatomical landmark is often used in clinical examinations to locate the gallbladder .</li><li>• correct</li><li>• fundus</li><li>• gallbladder</li><li>• located</li><li>• tip</li><li>• right 9th costal cartilage</li><li>• midclavicular line</li><li>• locate</li><li>• gallbladder</li><li>• Option D.</li><li>• Option D.</li><li>• This statement is correct . The right phrenic nerve innervates the diaphragm and carries sensory fibers from the gallbladder area . Inflammation of the gallbladder can irritate these fibers, leading to referred pain at the tip of the right shoulder , a phenomenon known as Kehr's sign . Kehr Sign is not seen in Cholecystitis. It is seen in the Spleenic Rupture.</li><li>• This statement is correct . The right phrenic nerve innervates the diaphragm and carries sensory fibers from the gallbladder area . Inflammation of the gallbladder can irritate these fibers, leading to referred pain at the tip of the right shoulder , a phenomenon known as Kehr's sign . Kehr Sign is not seen in Cholecystitis. It is seen in the Spleenic Rupture.</li><li>• correct</li><li>• right phrenic nerve</li><li>• diaphragm</li><li>• carries sensory fibers</li><li>• gallbladder area</li><li>• Inflammation</li><li>• gallbladder</li><li>• referred pain</li><li>• tip</li><li>• right shoulder</li><li>• Kehr's sign</li><li>• Spleenic Rupture.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objectives:</li><li>➤ The Cystic Vein typically drains into the Portal Vein , not the right hepatic vein.</li><li>➤ Cystic Vein</li><li>➤ drains</li><li>➤ Portal Vein</li><li>➤ The cystic vein drains the gallbladder and typically opens into the portal vein , not the right hepatic vein. The portal vein is formed by the union of the superior mesenteric vein and the splenic vein and is a key vessel in the hepatic portal system , carrying blood from the gastrointestinal tract and spleen to the liver .</li><li>➤ The cystic vein drains the gallbladder and typically opens into the portal vein , not the right hepatic vein. The portal vein is formed by the union of the superior mesenteric vein and the splenic vein and is a key vessel in the hepatic portal system , carrying blood from the gastrointestinal tract and spleen to the liver .</li><li>➤ gallbladder</li><li>➤ opens</li><li>➤ portal vein</li><li>➤ union</li><li>➤ superior mesenteric vein</li><li>➤ splenic</li><li>➤ vein</li><li>➤ hepatic portal system</li><li>➤ carrying blood</li><li>➤ gastrointestinal tract</li><li>➤ spleen</li><li>➤ liver</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1175</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1175</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy with a temperature of 102°F and pain over the lower abdomen on right side got admitted. On examination, the skin on the right lower quadrant was tender to the touch, and the abdominal muscles were contracted and rigid. Ultrasound abdomen suggested features suggestive of acute appendicitis.Which of the following statements does not explain the signs and symptoms experienced by this patient?", "options": [{"label": "A", "text": "The Pain in the Right Lower Quadrant and the Regional Contraction of the Abdominal Muscles is to limit the Inflammatory Process.", "correct": false}, {"label": "B", "text": "The Nerve Supply of Appendix is T10.", "correct": false}, {"label": "C", "text": "Rupture of the Appendix, the Parietal Peritoneum would become involved.", "correct": false}, {"label": "D", "text": "The Tip of the Appendix is Rich in Vascularity.", "correct": true}], "correct_answer": "D. The Tip of the Appendix is Rich in Vascularity.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-171729.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture71.jpg"], "explanation": "<p><strong>Ans. D) The Tip of the Appendix is Rich in Vascularity.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . Pain in the right lower quadrant , along with contraction and rigidity of the abdominal muscles (a sign known as \" guarding \"), is a typical response to localize and limit the spread of inflammation in cases of acute appendicitis .</li><li>• Option A.</li><li>• correct</li><li>• Pain</li><li>• right lower quadrant</li><li>• contraction</li><li>• rigidity</li><li>• abdominal muscles</li><li>• guarding</li><li>• localize</li><li>• limit</li><li>• spread</li><li>• inflammation</li><li>• acute appendicitis</li><li>• Option B. This statement is correct regarding the primary innervation involved in appendicitis . The initial , vague pain of appendicitis is usually felt around the umbilicus and is mediated by the visceral afferent fibers which accompany the sympathetic nerves back to the spinal cord segments T10 .</li><li>• Option B.</li><li>• correct</li><li>• primary innervation</li><li>• appendicitis</li><li>• initial</li><li>• vague pain</li><li>• appendicitis</li><li>• felt</li><li>• umbilicus</li><li>• mediated</li><li>• visceral afferent fibers</li><li>• sympathetic nerves</li><li>• spinal cord segments T10</li><li>• Option C. This statement is correct . If the appendix ruptures , the infection and inflammation spread to the parietal peritoneum , intensifying the pain and potentially leading to a more widespread abdominal infection ( peritonitis ).</li><li>• Option C.</li><li>• correct</li><li>• appendix ruptures</li><li>• infection</li><li>• inflammation spread</li><li>• parietal peritoneum</li><li>• pain</li><li>• widespread abdominal infection</li><li>• peritonitis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The tip of the appendix is rich in vascularity:</li><li>➤ The tip of the appendix is rich in vascularity:</li><li>➤ The appendix, including its tip , does have blood supply (primarily from the appendicular artery , a branch of the ileocolic artery ), but it is not particularly noted for being \"rich in vascularity\" compared to other organs or parts of the gastrointestinal tract. The primary concern in appendicitis is not related to the vascularity of the appendix but to the inflammation and potential for infection and rupture. Appendix is supplied by an end artery , specifically the appendicular artery , which is a branch of the ileocolic artery (itself a branch of the superior mesenteric artery ).</li><li>➤ The appendix, including its tip , does have blood supply (primarily from the appendicular artery , a branch of the ileocolic artery ), but it is not particularly noted for being \"rich in vascularity\" compared to other organs or parts of the gastrointestinal tract. The primary concern in appendicitis is not related to the vascularity of the appendix but to the inflammation and potential for infection and rupture.</li><li>➤ tip</li><li>➤ blood supply</li><li>➤ appendicular artery</li><li>➤ ileocolic artery</li><li>➤ Appendix is supplied by an end artery , specifically the appendicular artery , which is a branch of the ileocolic artery (itself a branch of the superior mesenteric artery ).</li><li>➤ Appendix</li><li>➤ end artery</li><li>➤ appendicular artery</li><li>➤ branch</li><li>➤ ileocolic artery</li><li>➤ branch</li><li>➤ superior mesenteric artery</li><li>➤ An end artery is one that does not have any significant anastomoses or connections with other arteries. This means that if the appendicular artery becomes occluded or blocked , there isn't an alternative blood supply to the appendix, making it vulnerable to ischemia (lack of blood supply) and necrosis .</li><li>➤ An end artery is one that does not have any significant anastomoses or connections with other arteries. This means that if the appendicular artery becomes occluded or blocked , there isn't an alternative blood supply to the appendix, making it vulnerable to ischemia (lack of blood supply) and necrosis .</li><li>➤ appendicular artery</li><li>➤ occluded</li><li>➤ blocked</li><li>➤ necrosis</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1142</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In an intercollege sports meet, a 20-year-old boy was representing his college team for football. During the match, he sustained a kick on his left flank. On examination in the emergency department, his left flank was severely bruised, and his left costovertebral angle was extremely tender on palpation. A specimen of urine showed microscopic hematuria. A diagnosis of damage to the left kidney was made. Which of the following is incorrect?", "options": [{"label": "A", "text": "The Kidney can be injured by Fractures of the 12 th Rib (Right Kidney) or 11 th and 12 th Ribs (Left Kidney)", "correct": false}, {"label": "B", "text": "Renal Angle is the Angulation between the Upper Border of 12 th Rib and Erector Spinae Muscle.", "correct": true}, {"label": "C", "text": "Renal Angle is not encroached by Costodiaphragmatic Recess of Pleura.", "correct": false}, {"label": "D", "text": "During Surgery Kidney is exposed Retroperitoneally by an Oblique Incision commencing from Renal Angle", "correct": false}], "correct_answer": "B. Renal Angle is the Angulation between the Upper Border of 12 th Rib and Erector Spinae Muscle.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture72.jpg"], "explanation": "<p><strong>Ans. B) Renal Angle is the Angulation between the Upper Border of 12thRib and Erector Spinae Muscle.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The kidneys are retroperitoneal organs located relatively high in the abdominal cavity . The right kidney is slightly lower than the left due to the presence of the liver . Because of their location, the kidneys can be injured by trauma to the lower ribs , particularly the 11th and 12th ribs .</li><li>• Option A.</li><li>• retroperitoneal organs</li><li>• high</li><li>• abdominal cavity</li><li>• slightly lower</li><li>• left</li><li>• presence</li><li>• liver</li><li>• trauma</li><li>• lower ribs</li><li>• 11th</li><li>• 12th ribs</li><li>• Option C. Considering the \" costovertebral angle \" (assuming \" renal angle \" refers to this). The costodiaphragmatic recess of the pleura extends only to approximately the level of the 10th rib in the midaxillary line when the lung is fully inflated , which is above the location of the kidneys and the costovertebral angle .</li><li>• Option C.</li><li>• costovertebral angle</li><li>• renal angle</li><li>• costodiaphragmatic recess</li><li>• pleura</li><li>• approximately</li><li>• level</li><li>• 10th rib</li><li>• midaxillary line</li><li>• lung</li><li>• fully inflated</li><li>• above</li><li>• location</li><li>• kidneys</li><li>• costovertebral angle</li><li>• Option D. In surgeries involving the kidney , a retroperitoneal approach is often used. An oblique incision starting near the costovertebral angle (again, assuming \" renal angle \" refers to this) provides access to the kidney while avoiding the peritoneal cavity .</li><li>• Option D.</li><li>• kidney</li><li>• retroperitoneal approach</li><li>• oblique incision</li><li>• costovertebral angle</li><li>• renal angle</li><li>• access</li><li>• kidney</li><li>• avoiding</li><li>• peritoneal cavity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The term \"renal angle\" is not commonly used to describe an anatomical angle between the 12th rib and the erector spinae muscle. The \" costovertebral angle ,\" which is formed by the lower border of the 12th rib and the vertebral column . This angle is clinically significant as tenderness in this area, known as costovertebral angle tenderness , is a sign of kidney pathology .Top of Form</li><li>➤ The term \"renal angle\" is not commonly used to describe an anatomical angle between the 12th rib and the erector spinae muscle.</li><li>➤ The \" costovertebral angle ,\" which is formed by the lower border of the 12th rib and the vertebral column . This angle is clinically significant as tenderness in this area, known as costovertebral angle tenderness , is a sign of kidney pathology .Top of Form</li><li>➤ costovertebral angle</li><li>➤ formed</li><li>➤ lower border</li><li>➤ 12th rib</li><li>➤ vertebral column</li><li>➤ clinically significant</li><li>➤ tenderness</li><li>➤ costovertebral angle</li><li>➤ tenderness</li><li>➤ kidney pathology</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1237</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1237</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male who was apparently alright, two days back had tooth extraction following which he complained of bleeding from gum. He also had complaints of abdominal distension and pedal edema. He was a known case of alcoholic liver disease. On examination, hepatomegaly was present. USG abdomen showed cirrhosis of liver with portal hypertension as evidenced by splenomegaly and gross tense ascites. Which of the following statements pertaining to the above case is incorrect?", "options": [{"label": "A", "text": "The Liver produces most of the Coagulation Factors, hence Bleeding Manifestations occur in Progressive Liver Disease.", "correct": false}, {"label": "B", "text": "Liver Biopsy is approached through the Right 7 th or 8 th Intercostal Space.", "correct": true}, {"label": "C", "text": "Cirrhosis of Liver causes Obstruction in Intrahepatic Portal Radicles leading to Portal Hypertension", "correct": false}, {"label": "D", "text": "Stasis of Blood in Portal Circulation results in Massive Enlargement of Spleen and Fatal Hematemesis", "correct": false}], "correct_answer": "B. Liver Biopsy is approached through the Right 7 th or 8 th Intercostal Space.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture73.jpg"], "explanation": "<p><strong>Ans. B) Liver Biopsy is approached through the Right 7thor 8thIntercostal Space.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . The liver is responsible for the production of all coagulation factors (Except Factor VIII) . In liver diseases like cirrhosis , this function can be impaired , leading to bleeding tendencies due to decreased synthesis of these factors.</li><li>• Option A.</li><li>• correct</li><li>• production</li><li>• coagulation factors (Except Factor VIII)</li><li>• cirrhosis</li><li>• impaired</li><li>• bleeding tendencies</li><li>• decreased synthesis</li><li>• Option C. This statement is correct . In cirrhosis , the normal liver architecture is disrupted by fibrosis and nodular regeneration , leading to increased resistance to portal blood flow and subsequently portal hypertension . This condition can lead to complications like ascites and splenomegaly.</li><li>• Option C.</li><li>• correct</li><li>• cirrhosis</li><li>• fibrosis</li><li>• nodular regeneration</li><li>• increased resistance</li><li>• portal blood flow</li><li>• portal hypertension</li><li>• Option D. This statement is mostly correct . Portal hypertension can lead to splenomegaly due to congestion in the portal system . It can also cause the formation of varices in the esophagus and stomach , which can rupture , leading to potentially fatal hematemesis .</li><li>• Option D.</li><li>• correct</li><li>• Portal hypertension</li><li>• splenomegaly</li><li>• congestion</li><li>• portal system</li><li>• formation</li><li>• varices</li><li>• esophagus</li><li>• stomach</li><li>• rupture</li><li>• potentially</li><li>• fatal</li><li>• hematemesis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While liver biopsies are typically performed on the right side due to the liver's location , the approach is usually through the 9th or 10th intercostal space in the midaxillary line . Using the 7th or 8th intercostal space for a liver biopsy would be unusually high and could risk injury to the lungs and other structures.</li><li>➤ While liver biopsies are typically performed on the right side due to the liver's location , the approach is usually through the 9th or 10th intercostal space in the midaxillary line .</li><li>➤ liver</li><li>➤ biopsies</li><li>➤ performed</li><li>➤ right side</li><li>➤ liver's location</li><li>➤ approach</li><li>➤ 9th</li><li>➤ 10th</li><li>➤ intercostal space</li><li>➤ midaxillary line</li><li>➤ Using the 7th or 8th intercostal space for a liver biopsy would be unusually high and could risk injury to the lungs and other structures.</li><li>➤ 7th</li><li>➤ 8th intercostal space</li><li>➤ liver biopsy</li><li>➤ unusually high</li><li>➤ risk injury</li><li>➤ lungs</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg no. 1160</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg no. 1160</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon transplants a donor kidney into a 45-year-old female patient with end stage renal disease. The upper 1/3rd of the ureter of the transplanted kidney is retained and attached to the recipient patient's bladder. However, soon after transplantation, the ureter becomes necrotic. All the following arteries supply the ureter except:", "options": [{"label": "A", "text": "Renal Artery", "correct": false}, {"label": "B", "text": "Inferior Vesical Artery", "correct": false}, {"label": "C", "text": "Uterine Artery", "correct": false}, {"label": "D", "text": "Inferior Mesenteric Artery", "correct": true}], "correct_answer": "D. Inferior Mesenteric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture74.jpg"], "explanation": "<p><strong>Ans. D) Inferior Mesenteric Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The renal artery does indeed supply the upper part of the ureter . The upper third of the ureter, which includes the part retained in the kidney transplant as mentioned in the scenario , receives blood from branches of the renal artery .</li><li>• Option A.</li><li>• supply</li><li>• upper part</li><li>• ureter</li><li>• upper third</li><li>• retained</li><li>• kidney transplant</li><li>• scenario</li><li>• blood</li><li>• branches</li><li>• renal artery</li><li>• Option B. In males, the ureter receives some blood supply from the inferior vesical artery , a branch of the internal iliac artery . In females, the vaginal provides part of the blood supply to the ureter , particularly its lower portion near the bladder .</li><li>• Option B.</li><li>• inferior vesical artery</li><li>• internal iliac artery</li><li>• vaginal</li><li>• blood supply</li><li>• ureter</li><li>• lower portion</li><li>• bladder</li><li>• Option C. In females, the ureter is indeed supplied in part by branches of the uterine artery . The uterine artery crosses over the ureter , and this anatomical relationship is famously remembered by the phrase \" water under the bridge \", referring to the ureter running underneath the uterine artery .</li><li>• Option C.</li><li>• branches</li><li>• uterine artery</li><li>• crosses</li><li>• ureter</li><li>• water under the bridge</li><li>• underneath</li><li>• uterine</li><li>• artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior mesenteric artery primarily supplies the left colon and rectum and is not a significant source of blood supply for the ureter. This artery's area of distribution does not typically include the ureter, making it the correct answer for the artery that does not supply the ureter in this context.</li><li>➤ The inferior mesenteric artery primarily supplies the left colon and rectum and is not a significant source of blood supply for the ureter.</li><li>➤ supplies</li><li>➤ left colon</li><li>➤ rectum</li><li>➤ This artery's area of distribution does not typically include the ureter, making it the correct answer for the artery that does not supply the ureter in this context.</li><li>➤ correct answer</li><li>➤ artery</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1251</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1251</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old male presents with dull aching pain of upper abdomen, poorly localized. CT imaging of the abdomen is given below. Which of the following labelled organs is supplied by an artery of the foregut though it is not a derivative of foregut?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture75.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B- spleen</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Liver:</li><li>• Option A: Liver:</li><li>• Hepatic Artery is the branch of the celiac trunk . The hepatic artery proper, a further branch, supplies oxygenated blood to the liver . Portal Vein - Provides the majority ( about 75%) of blood to the liver . The hepatic artery and portal vein enter the liver at the porta hepatis and branch extensively to supply the entire organ .</li><li>• Hepatic Artery is the branch of the celiac trunk . The hepatic artery proper, a further branch, supplies oxygenated blood to the liver .</li><li>• celiac trunk</li><li>• oxygenated blood</li><li>• liver</li><li>• Portal Vein - Provides the majority ( about 75%) of blood to the liver .</li><li>• Portal Vein</li><li>• about 75%)</li><li>• blood</li><li>• liver</li><li>• The hepatic artery and portal vein enter the liver at the porta hepatis and branch extensively to supply the entire organ .</li><li>• hepatic artery</li><li>• portal vein</li><li>• liver</li><li>• porta hepatis</li><li>• supply</li><li>• entire organ</li><li>• Option C: The stomach receives its blood supply primarily from branches of the celiac trunk .</li><li>• Option C:</li><li>• blood supply</li><li>• branches</li><li>• celiac trunk</li><li>• Left Gastric Artery a rises directly from the celiac trunk and supplies the lesser curvature of the stomach . Right Gastric Artery , branch of the proper hepatic artery supplies the lesser curvature . Left Gastroepiploic Artery : Arises from the splenic artery (a branch of the celiac trunk ) and supplies the greater curvature . Right Gastroepiploic Artery : Comes from the gastroduodenal artery (a branch of the common hepatic artery ) and also supplies the greater curvature . Short Gastric Arteries : These arise from the splenic artery and supply the fundus and upper part of the greater curvature .</li><li>• Left Gastric Artery a rises directly from the celiac trunk and supplies the lesser curvature of the stomach .</li><li>• Left Gastric Artery</li><li>• directly</li><li>• celiac trunk</li><li>• supplies</li><li>• lesser curvature</li><li>• stomach</li><li>• Right Gastric Artery , branch of the proper hepatic artery supplies the lesser curvature .</li><li>• Right Gastric Artery</li><li>• proper hepatic artery</li><li>• lesser curvature</li><li>• Left Gastroepiploic Artery : Arises from the splenic artery (a branch of the celiac trunk ) and supplies the greater curvature .</li><li>• Left Gastroepiploic Artery</li><li>• splenic artery</li><li>• celiac trunk</li><li>• supplies</li><li>• greater curvature</li><li>• Right Gastroepiploic Artery : Comes from the gastroduodenal artery (a branch of the common hepatic artery ) and also supplies the greater curvature .</li><li>• Right Gastroepiploic Artery</li><li>• gastroduodenal artery</li><li>• common hepatic artery</li><li>• greater curvature</li><li>• Short Gastric Arteries : These arise from the splenic artery and supply the fundus and upper part of the greater curvature .</li><li>• Short Gastric Arteries</li><li>• splenic artery</li><li>• fundus</li><li>• upper part</li><li>• greater curvature</li><li>• Option D:Pancreas:</li><li>• Option D:Pancreas:</li><li>• The pancreas develops from caudal part of foregut and is supplied by superior pancreaticoduodenal artery ( gastroduodenal artery - common hepatic artery - coeliac trunk ) and inferior pancreatico-duodenal artery (branch from superior mesenteric artery ).</li><li>• The pancreas develops from caudal part of foregut and is supplied by superior pancreaticoduodenal artery ( gastroduodenal artery - common hepatic artery - coeliac trunk ) and inferior pancreatico-duodenal artery (branch from superior mesenteric artery ).</li><li>• caudal part</li><li>• foregut</li><li>• superior pancreaticoduodenal artery</li><li>• gastroduodenal artery</li><li>• common hepatic artery</li><li>• coeliac trunk</li><li>• inferior pancreatico-duodenal artery</li><li>• superior mesenteric artery</li><li>• Pancreaticoduodenal Arteries: These come from both the celiac trunk (via the gastroduodenal artery ) and the superior mesenteric artery , supplying the head of the pancreas . Dorsal Pancreatic Artery: A branch of the splenic artery , supplies the body of the pancreas . Great Pancreatic Artery: Also a branch of the splenic artery , supplies the tail of the pancreas . Inferior Pancreatic Artery: Usually branches from the splenic artery or the left gastroepiploic artery to supply the lower part of the pancreas .</li><li>• Pancreaticoduodenal Arteries: These come from both the celiac trunk (via the gastroduodenal artery ) and the superior mesenteric artery , supplying the head of the pancreas .</li><li>• Pancreaticoduodenal Arteries:</li><li>• both</li><li>• celiac trunk</li><li>• gastroduodenal artery</li><li>• superior mesenteric artery</li><li>• head</li><li>• pancreas</li><li>• Dorsal Pancreatic Artery: A branch of the splenic artery , supplies the body of the pancreas .</li><li>• Dorsal Pancreatic Artery:</li><li>• splenic artery</li><li>• body</li><li>• pancreas</li><li>• Great Pancreatic Artery: Also a branch of the splenic artery , supplies the tail of the pancreas .</li><li>• Great Pancreatic Artery:</li><li>• splenic artery</li><li>• tail</li><li>• pancreas</li><li>• Inferior Pancreatic Artery: Usually branches from the splenic artery or the left gastroepiploic artery to supply the lower part of the pancreas .</li><li>• Inferior Pancreatic Artery:</li><li>• splenic artery</li><li>• left gastroepiploic artery</li><li>• lower part</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The splenic artery is one of the three major branches of the celiac trunk , which is the first major branch of the abdominal aorta . After originating from the celiac trunk , the splenic artery runs along the top of the pancreas towards the spleen . It is known for its tortuous course along the pancreas . These branches include the short gastric arteries , which supply the fundus of the stomach , and the left gastroepiploic artery , which supplies the greater curvature of the stomach . Within the spleen , the splenic artery further divides into smaller branches , ultimately forming trabecular arteries and then penicillar arteries , ensuring the delivery of oxygenated blood throughout the splenic tissue .</li><li>➤ The splenic artery is one of the three major branches of the celiac trunk , which is the first major branch of the abdominal aorta .</li><li>➤ three major branches</li><li>➤ celiac trunk</li><li>➤ first major branch</li><li>➤ abdominal aorta</li><li>➤ After originating from the celiac trunk , the splenic artery runs along the top of the pancreas towards the spleen . It is known for its tortuous course along the pancreas .</li><li>➤ celiac trunk</li><li>➤ splenic artery</li><li>➤ top</li><li>➤ pancreas</li><li>➤ spleen</li><li>➤ tortuous course</li><li>➤ pancreas</li><li>➤ These branches include the short gastric arteries , which supply the fundus of the stomach , and the left gastroepiploic artery , which supplies the greater curvature of the stomach .</li><li>➤ short gastric arteries</li><li>➤ fundus</li><li>➤ stomach</li><li>➤ left gastroepiploic artery</li><li>➤ greater curvature</li><li>➤ stomach</li><li>➤ Within the spleen , the splenic artery further divides into smaller branches , ultimately forming trabecular arteries and then penicillar arteries , ensuring the delivery of oxygenated blood throughout the splenic tissue .</li><li>➤ spleen</li><li>➤ smaller branches</li><li>➤ trabecular arteries</li><li>➤ penicillar arteries</li><li>➤ delivery</li><li>➤ oxygenated blood</li><li>➤ splenic tissue</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1190</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1190</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old woman complained of burning abdominal pain, bloated abdomen, feeling full after eating a small amount of food. She was diagnosed with gastric ulcer and started on proton pump inhibitors. But her symptoms continued to persist in spite of medication. Finally, she was operated on for the treatment of a chronic gastric ulcer that had not responded to medical treatment. At an operation for partial gastrectomy, it was found that the posterior wall of the stomach was stuck down to the posterior abdominal wall. The surgeon had to proceed with great care to avoid damaging important structures lying on the posterior abdominal wall. Which of the following structures are not related to the posterior surface of the stomach?", "options": [{"label": "A", "text": "Left Suprarenal Gland", "correct": false}, {"label": "B", "text": "Splenic Artery", "correct": false}, {"label": "C", "text": "Pancreas", "correct": false}, {"label": "D", "text": "Inferior Vena Cava", "correct": true}], "correct_answer": "D. Inferior Vena Cava", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture76.jpg"], "explanation": "<p><strong>Ans. D) Inferior Vena Cava</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• Option A. The left suprarenal (adrenal) gland is located superior to the left kidney and close to the stomach . However, it is not directly related to the posterior surface of the stomach. It lies somewhat superior and lateral to the upper part of the stomach .</li><li>• Option A.</li><li>• superior</li><li>• left kidney</li><li>• stomach</li><li>• superior</li><li>• lateral</li><li>• upper part</li><li>• stomach</li><li>• Option B. The splenic artery is indeed related to the posterior surface of the stomach. It runs along the superior border of the pancreas and gives off short gastric arteries , which supply the upper part of the stomach . This artery is a significant structure surgeons need to be aware of during gastric surgeries.</li><li>• Option B.</li><li>• posterior surface</li><li>• superior border</li><li>• pancreas</li><li>• gives off short gastric arteries</li><li>• upper part</li><li>• stomach</li><li>• Option C. The pancreas is directly related to the posterior surface of the stomach. The stomach overlies the pancreas , especially the body and tail of the pancreas . In cases of gastric ulcers penetrating the posterior wall , there's a risk of involving the pancreas , which can lead to complications like pancreatitis.</li><li>• Option C.</li><li>• posterior surface</li><li>• pancreas</li><li>• body</li><li>• tail</li><li>• pancreas</li><li>• gastric ulcers</li><li>• posterior wall</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior vena cava is not related to the posterior surface of the stomach, while the splenic artery and pancreas are directly related, and the left suprarenal gland is in close proximity but not in immediate relation. This knowledge is essential for surgical planning and avoiding complications during procedures like partial gastrectomy . The Inferior Vena Cava (IVC) runs posterior to the liver , to the right of the vertebral column , and is not directly related to the stomach. It is not in the immediate vicinity of the posterior wall of the stomach, and thus, is less likely to be injured during a gastrectomy unless the dissection is extended far to the right or if there are unusual anatomical variations.</li><li>➤ The inferior vena cava is not related to the posterior surface of the stomach, while the splenic artery and pancreas are directly related, and the left suprarenal gland is in close proximity but not in immediate relation.</li><li>➤ The inferior vena cava is not related to the posterior surface of the stomach, while the splenic artery and pancreas are directly related, and the left suprarenal gland is in close proximity but not in immediate relation.</li><li>➤ splenic artery</li><li>➤ pancreas</li><li>➤ directly</li><li>➤ left suprarenal gland</li><li>➤ close proximity</li><li>➤ This knowledge is essential for surgical planning and avoiding complications during procedures like partial gastrectomy .</li><li>➤ This knowledge is essential for surgical planning and avoiding complications during procedures like partial gastrectomy .</li><li>➤ surgical planning</li><li>➤ avoiding</li><li>➤ partial gastrectomy</li><li>➤ The Inferior Vena Cava (IVC) runs posterior to the liver , to the right of the vertebral column , and is not directly related to the stomach. It is not in the immediate vicinity of the posterior wall of the stomach, and thus, is less likely to be injured during a gastrectomy unless the dissection is extended far to the right or if there are unusual anatomical variations.</li><li>➤ The Inferior Vena Cava (IVC) runs posterior to the liver , to the right of the vertebral column , and is not directly related to the stomach. It is not in the immediate vicinity of the posterior wall of the stomach, and thus, is less likely to be injured during a gastrectomy unless the dissection is extended far to the right or if there are unusual anatomical variations.</li><li>➤ Inferior Vena Cava (IVC)</li><li>➤ posterior</li><li>➤ liver</li><li>➤ right</li><li>➤ vertebral column</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg no 1112</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg no 1112</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-1, B-2, C-6, D-5", "correct": false}, {"label": "B", "text": "A-2, B-3, C-6, D-5", "correct": false}, {"label": "C", "text": "A-1, B-4, C-3, D-2", "correct": false}, {"label": "D", "text": "A-2, B-1, C-4, D-5", "correct": true}], "correct_answer": "D. A-2, B-1, C-4, D-5", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-115847.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture1_Rq9t1Lo.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture2_r3ZnVEw.jpg"], "explanation": "<p><strong>Ans. D) A-2, B-1, C-4, D-5</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Subcostal Plane (L3) corresponds to the level of the upper border of 3 rd lumbar vertebra (L3) .</li><li>• Option A.</li><li>• Subcostal Plane (L3)</li><li>• level</li><li>• upper border</li><li>• 3 rd lumbar vertebra (L3)</li><li>• Option B. Transpyloric Plane (L1) , located halfway between the xiphoid process and the umbilicus , this plane typically aligns with the first lumbar vertebra (L1) lower border . It is clinically significant as it passes through several important structures including the pylorus of the stomach , the duodenojejunal junction , the neck of the pancreas , the hilum of the kidneys , and the origin of the superior mesenteric artery .</li><li>• Option B.</li><li>• Transpyloric Plane (L1)</li><li>• halfway</li><li>• xiphoid process</li><li>• umbilicus</li><li>• aligns</li><li>• first lumbar vertebra (L1)</li><li>• lower border</li><li>• pylorus</li><li>• stomach</li><li>• duodenojejunal junction</li><li>• neck</li><li>• pancreas</li><li>• hilum</li><li>• kidneys</li><li>• origin</li><li>• superior mesenteric artery</li><li>• Option C. Supracristal Plane (L4) , Also known as the intertubercular plane , it runs across the highest points of the iliac crests and corresponds to the body of the fourth lumbar vertebra (L4) . This plane is important for identifying the location of the lumbar puncture site and is a landmark for the division between the abdomen and the pelvis .</li><li>• Option C.</li><li>• Supracristal Plane (L4)</li><li>• intertubercular plane</li><li>• across</li><li>• highest points</li><li>• iliac crests</li><li>• body</li><li>• fourth lumbar vertebra</li><li>• (L4)</li><li>• location</li><li>• lumbar puncture</li><li>• site</li><li>• landmark</li><li>• abdomen</li><li>• pelvis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Correct matching:</li><li>➤ Correct matching:</li><li>➤ Subcostal Plane: L2 Transpyloric Plane: Lower Border of L1 Transtubercular Plane: L5 Xiphisternal Joint: T9 Supracristal Plane: Upper Part of L4</li><li>➤ Subcostal Plane: L2</li><li>➤ Transpyloric Plane: Lower Border of L1</li><li>➤ Transtubercular Plane: L5</li><li>➤ Xiphisternal Joint: T9</li><li>➤ Supracristal Plane: Upper Part of L4</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents to the clinic with chronic lower back pain. He has a history of heavy lifting in his job. On examination, his pain is localized to the lower back without radiation. The physician explains to a medical student that the thoracolumbar fascia plays a significant role in various back conditions due to its attachments and structural importance. Which of the following statements best describes the clinical significance of the thoracolumbar fascia in this patient's condition?", "options": [{"label": "A", "text": "It primarily provides Vascular Supply to the Lumbar Vertebrae.", "correct": false}, {"label": "B", "text": "It serves as a major insertion point for Abdominal Muscles.", "correct": false}, {"label": "C", "text": "It is the primary source of Innervation for the Lower Back Muscles.", "correct": false}, {"label": "D", "text": "It acts as a Mechanical Stabilizer for the Lower Back and Spine.", "correct": true}], "correct_answer": "D. It acts as a Mechanical Stabilizer for the Lower Back and Spine.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture3_Fwp37ZO.jpg"], "explanation": "<p><strong>Ans. D) It acts as a Mechanical Stabilizer for the Lower Back and Spine.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The thoracolumbar fascia does not primarily provide vascular supply to the lumbar vertebrae. The blood supply to the lumbar spine is through the segmental lumbar arteries . Therefore, this option is incorrect.</li><li>• Option A.</li><li>• blood supply</li><li>• lumbar spine</li><li>• segmental lumbar</li><li>• arteries</li><li>• Option B. While the thoracolumbar fascia does serve as an attachment point for some abdominal muscles , including the transversus abdominis and the internal oblique , it is not its primary clinical significance in the context of lower back pain.</li><li>• Option B.</li><li>• thoracolumbar fascia</li><li>• serve</li><li>• attachment</li><li>• abdominal muscles</li><li>• transversus abdominis</li><li>• internal oblique</li><li>• Option C. The thoracolumbar fascia is not a source of innervation. Innervation of the lower back muscles is provided by the branches of the lumbar spinal nerves . This option does not directly relate to the clinical scenario of chronic lower back pain associated with mechanical stress.</li><li>• Option C.</li><li>• Innervation</li><li>• lower back muscles</li><li>• branches</li><li>• lumbar spinal nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thoracolumbar fascia is a deep investing membrane that covers the deep muscles of the back and the lumbar region . It provides mechanical support and stability to the lower back and spine , especially during heavy lifting or movements that put stress on the lower back . In patients with chronic lower back pain , especially those with a history of physical strain, the role of the thoracolumbar fascia as a stabilizer is particularly relevant. The thoracolumbar fascia acts as a mechanical stabilizer for the lower back and spine , which is particularly important in the context of chronic lower back pain related to physical stress and strain .</li><li>➤ The thoracolumbar fascia is a deep investing membrane that covers the deep muscles of the back and the lumbar region . It provides mechanical support and stability to the lower back and spine , especially during heavy lifting or movements that put stress on the lower back . In patients with chronic lower back pain , especially those with a history of physical strain, the role of the thoracolumbar fascia as a stabilizer is particularly relevant.</li><li>➤ deep investing membrane</li><li>➤ covers</li><li>➤ deep muscles</li><li>➤ back</li><li>➤ lumbar region</li><li>➤ mechanical support</li><li>➤ stability</li><li>➤ lower back</li><li>➤ spine</li><li>➤ heavy lifting</li><li>➤ movements</li><li>➤ stress</li><li>➤ lower back</li><li>➤ chronic lower back pain</li><li>➤ role</li><li>➤ thoracolumbar fascia</li><li>➤ stabilizer</li><li>➤ The thoracolumbar fascia acts as a mechanical stabilizer for the lower back and spine , which is particularly important in the context of chronic lower back pain related to physical stress and strain .</li><li>➤ mechanical stabilizer</li><li>➤ lower back</li><li>➤ spine</li><li>➤ chronic lower back pain</li><li>➤ physical stress</li><li>➤ strain</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 169</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 169</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-1, B-4, C-7, D-2", "correct": false}, {"label": "B", "text": "A-1, B-7, C-4, D-3", "correct": true}, {"label": "C", "text": "A-7, B-1, C-4, D-5", "correct": false}, {"label": "D", "text": "A-3, B-2, C-7, D-4", "correct": false}], "correct_answer": "B. A-1, B-7, C-4, D-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-103151.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-103228.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture4_W5Q8jtt.jpg"], "explanation": "<p><strong>Ans. B) A-1, B-7, C-4, D-3</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The superficial inguinal ring is an anatomical structure in the inguinal region . It is a triangular opening in the external oblique aponeurosis , located just above and medial to the pubic tubercle . It serves as an exit for the spermatic cord in males and the round ligament of the uterus in females . Clinically, it is a site where inguinal hernias may protrude .</li><li>• Option A.</li><li>• inguinal region</li><li>• triangular opening</li><li>• external oblique aponeurosis</li><li>• above</li><li>• medial</li><li>• pubic tubercle</li><li>• exit</li><li>• spermatic cord</li><li>• males</li><li>• round ligament</li><li>• uterus</li><li>• females</li><li>• inguinal hernias</li><li>• protrude</li><li>• Option C. The cremaster muscle is a muscle that arises from the internal oblique muscle . It is found in the spermatic cord and functions to raise and lower the testis in response to temperature changes and physical or emotional stimuli. The cremasteric reflex is a clinical sign used to assess the integrity of the L1 and L2 segments of the spinal cord .</li><li>• Option C.</li><li>• arises</li><li>• internal oblique muscle</li><li>• spermatic cord</li><li>• raise</li><li>• lower</li><li>• testis</li><li>• temperature changes</li><li>• cremasteric reflex</li><li>• assess</li><li>• integrity</li><li>• L1</li><li>• L2 segments</li><li>• spinal cord</li><li>• Option D. The fundiform ligament is a supportive structure of the penis or clitoris . It is a condensation of superficial fascia that extends from the linea alba and wraps around the base of the penis or clitoris . It provides support and helps maintain an erect position . The fundiform ligament is not as well-defined as the other penile suspensory structures but plays a role in the overall support and positioning of the genitalia .</li><li>• Option D.</li><li>• supportive structure</li><li>• penis</li><li>• clitoris</li><li>• condensation</li><li>• superficial fascia</li><li>• extends</li><li>• linea alba</li><li>• wraps</li><li>• base</li><li>• penis</li><li>• clitoris</li><li>• support</li><li>• maintain</li><li>• erect position</li><li>• plays</li><li>• role</li><li>• overall support</li><li>• positioning</li><li>• genitalia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superficial Inguinal Ring: An opening in the external oblique aponeurosis Deep Inguinal Ring: An aperture in the transversalis fascia Cremaster Muscle: A muscle originating from the internal oblique Fundiform Ligament: A supportive structure arising from the lineaalba</li><li>➤ Superficial Inguinal Ring: An opening in the external oblique aponeurosis</li><li>➤ Superficial Inguinal Ring: An opening in the external oblique aponeurosis</li><li>➤ Deep Inguinal Ring: An aperture in the transversalis fascia</li><li>➤ Deep Inguinal Ring: An aperture in the transversalis fascia</li><li>➤ Cremaster Muscle: A muscle originating from the internal oblique</li><li>➤ Cremaster Muscle: A muscle originating from the internal oblique</li><li>➤ Fundiform Ligament: A supportive structure arising from the lineaalba</li><li>➤ Fundiform Ligament: A supportive structure arising from the lineaalba</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 25</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 25</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the foll owing:", "options": [{"label": "A", "text": "A-1, B-2, C-6, D-7", "correct": false}, {"label": "B", "text": "A-1, B-4, C-7, D-8", "correct": true}, {"label": "C", "text": "A-6, B-4, C-6, D-1", "correct": false}, {"label": "D", "text": "A-2, B-5, C-7, D-4", "correct": false}], "correct_answer": "B. A-1, B-4, C-7, D-8", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-103828.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-103912.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture5_qI9kpel.jpg"], "explanation": "<p><strong>Ans. B) A-1, B-4, C-7, D-8</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Colles' Fascia is a layer of superficial fascia found in the perineum . It's part of the superficial perineal pouch and plays a role in the structure of the urogenital triangle .</li><li>• Option A.</li><li>• superficial fascia</li><li>• perineum</li><li>• superficial perineal pouch</li><li>• urogenital triangle</li><li>• Option C. Buck's Fascia surrounds the corpus cavernosum penis and corpus spongiosum , contributing to the structure of the penis . It is a deep fascia layer and is important in the clinical understanding of the spread of certain infections and malignancies .</li><li>• Option C.</li><li>• corpus cavernosum penis</li><li>• corpus spongiosum</li><li>• penis</li><li>• deep fascia layer</li><li>• spread</li><li>• infections</li><li>• malignancies</li><li>• Option D. Fascia of Told is associated with the colon . During surgical procedures like a colectomy , this fascia is often dissected . It is important in defining the anatomical planes in the abdominal cavity , particularly along the colon .</li><li>• Option D.</li><li>• colon</li><li>• colectomy</li><li>• dissected</li><li>• anatomical planes</li><li>• abdominal cavity</li><li>• colon</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fascia is a band or sheet of connective tissue , primarily collagen , beneath the skin that attaches , stabilizes , encloses , and separates muscles and other internal organs .</li><li>➤ Fascia</li><li>➤ band</li><li>➤ sheet</li><li>➤ connective tissue</li><li>➤ collagen</li><li>➤ beneath</li><li>➤ skin</li><li>➤ attaches</li><li>➤ stabilizes</li><li>➤ encloses</li><li>➤ separates muscles</li><li>➤ internal organs</li><li>➤ Each of these fasciae has a specific anatomical and functional significance in the body .</li><li>➤ specific anatomical</li><li>➤ functional significance</li><li>➤ body</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 55</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 55</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old male presents to the outpatient clinic with complaints of a dull ache and a sensation of fullness in the right groin, especially noticeable during physical activities such as running or lifting heavy objects. He denies any sharp or sudden onset pain, and there is no history of trauma. On examination, you observe a slight bulge in the right inguinal region that accentuates when the patient coughs but is easily reducible. The patient's history and physical examination suggest a diagnosis of an inguinal hernia. The integrity of which of the following anatomical structures is most crucial in preventing the formation of an inguinal hernia in this patient?", "options": [{"label": "A", "text": "External Oblique, Internal Oblique", "correct": false}, {"label": "B", "text": "Internal Oblique, Transverse Abdominis", "correct": true}, {"label": "C", "text": "Transverse Abdominis, External Oblique", "correct": false}, {"label": "D", "text": "External Oblique, Internal Oblique, Transverse Abdominis", "correct": false}], "correct_answer": "B. Internal Oblique, Transverse Abdominis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture6_eIX8Muu.jpg"], "explanation": "<p><strong>Ans. B) Internal Oblique, Transverse Abdominis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. External Oblique &amp; Internal Oblique , both of these muscles contribute to the abdominal wall's strength , but focusing solely on these two overlooks the importance of the transverse abdominis . The external oblique muscle forms the most superficial layer , and its aponeurosis contributes to the inguinal ligament and the anterior wall of the inguinal canal . The internal oblique lies just beneath and also contributes to the inguinal canal's structure , particularly at the superficial inguinal ring . However, the transverse abdominis, which is not included in this option, plays a significant role as well, especially in the deep part of the inguinal canal.</li><li>• Option A.</li><li>• ,</li><li>• abdominal wall's strength</li><li>• two overlooks</li><li>• importance</li><li>• transverse abdominis</li><li>• most superficial layer</li><li>• aponeurosis</li><li>• inguinal ligament</li><li>• anterior wall</li><li>• inguinal canal</li><li>• inguinal canal's structure</li><li>• superficial inguinal ring</li><li>• Option C. Transverse Abdominis, External Oblique, while both muscles are important, this combination omits the internal oblique , which is a key player in the structure and integrity of the inguinal canal . The external oblique provides superficial strength and forms part of the anterior wall of the inguinal canal , but the absence of the internal oblique in this option misses its critical contribution to the conjoint tendon and the reinforcement of the inguinal canal's posterior wall .</li><li>• Option C.</li><li>• both muscles</li><li>• omits</li><li>• internal oblique</li><li>• key player</li><li>• structure</li><li>• integrity</li><li>• inguinal canal</li><li>• superficial strength</li><li>• anterior wall</li><li>• inguinal canal</li><li>• absence</li><li>• internal oblique</li><li>• conjoint tendon</li><li>• reinforcement</li><li>• inguinal canal's posterior wall</li><li>• Option D. External Oblique, Internal Oblique, Transverse Abdominis, includes all three muscles of the anterior-lateral abdominal wall . While all three contribute to the overall strength and integrity of the abdominal wall and the inguinal region , it's more specific to consider the roles of the internal oblique and transverse abdominis together , as they directly contribute to the inguinal canal's posterior wall reinforcement . Therefore, while this option is not incorrect, option B more precisely targets the key muscular contributions relevant to the prevention of inguinal hernias.</li><li>• Option D.</li><li>• three muscles</li><li>• anterior-lateral abdominal wall</li><li>• three contribute</li><li>• overall strength</li><li>• integrity</li><li>• abdominal wall</li><li>• inguinal region</li><li>• roles</li><li>• internal oblique</li><li>• transverse abdominis together</li><li>• directly</li><li>• inguinal canal's posterior wall reinforcement</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Internal Oblique, Transverse Abdominis :</li><li>➤ Internal Oblique, Transverse Abdominis</li><li>➤ This pair is crucial in the context of inguinal hernia prevention . The internal oblique muscle not only contributes to the inguinal canal's walls but also forms part of the conjoint tendon, which reinforces the posterior wall of the inguinal canal . The transverse abdominis , the deepest abdominal muscle , also contributes to the conjoint tendon and the deep inguinal ring's reinforcement . The combined action and integrity of these muscles are vital in maintaining the strength of the inguinal canal's posterior wall , which is a common site for indirect inguinal hernias .</li><li>➤ This pair is crucial in the context of inguinal hernia prevention . The internal oblique muscle not only contributes to the inguinal canal's walls but also forms part of the conjoint tendon, which reinforces the posterior wall of the inguinal canal .</li><li>➤ This pair is crucial in the context of inguinal hernia prevention . The internal oblique muscle not only contributes to the inguinal canal's walls but also forms part of the conjoint tendon, which reinforces the posterior wall of the inguinal canal .</li><li>➤ inguinal hernia prevention</li><li>➤ reinforces</li><li>➤ posterior wall</li><li>➤ inguinal canal</li><li>➤ The transverse abdominis , the deepest abdominal muscle , also contributes to the conjoint tendon and the deep inguinal ring's reinforcement .</li><li>➤ The transverse abdominis , the deepest abdominal muscle , also contributes to the conjoint tendon and the deep inguinal ring's reinforcement .</li><li>➤ transverse abdominis</li><li>➤ deepest abdominal muscle</li><li>➤ conjoint tendon</li><li>➤ deep inguinal ring's reinforcement</li><li>➤ The combined action and integrity of these muscles are vital in maintaining the strength of the inguinal canal's posterior wall , which is a common site for indirect inguinal hernias .</li><li>➤ The combined action and integrity of these muscles are vital in maintaining the strength of the inguinal canal's posterior wall , which is a common site for indirect inguinal hernias .</li><li>➤ combined action</li><li>➤ integrity</li><li>➤ vital</li><li>➤ strength</li><li>➤ inguinal canal's posterior</li><li>➤ wall</li><li>➤ common site</li><li>➤ indirect inguinal hernias</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 34</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 34</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old male presents to the emergency department with severe epigastric pain radiating to the back, nausea, and vomiting for the past 6 hours. His medical history is significant for chronic alcoholism and type 2 diabetes mellitus. On examination, his vital signs reveal tachycardia and a low-grade fever. Abdominal examination shows marked tenderness in the epigastric region with some guarding. Laboratory tests reveal elevated amylase and lipase levels. An abdominal CT scan is ordered to assess the extent of inflammation and potential complications. Considering the patient's clinical presentation and the need to evaluate potential complications of pancreatitis, such as fluid collections, which anatomical space connected by a specific foramen is most relevant in the spread of pancreatic fluids in this patient?", "options": [{"label": "A", "text": "Pelvic Cavity with Greater Sac", "correct": false}, {"label": "B", "text": "Lesser Sac with Pouch of Morrison", "correct": true}, {"label": "C", "text": "Greater Sac with Pouch of Morrison", "correct": false}, {"label": "D", "text": "Morrison’s Pouch to Pelvic Space", "correct": false}], "correct_answer": "B. Lesser Sac with Pouch of Morrison", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture7_OdSu4ya.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture8_OYnKU9N.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-104137.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture9_DNu5z43.jpg"], "explanation": "<p><strong>Ans. B) Lesser Sac with Pouch of Morrison</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The pelvic cavity is a space in the lower abdomen bounded by the pelvic bones , and the greater sac is the main part of the peritoneal cavity. While fluids from the abdominal cavity can indeed move into the pelvic cavity due to gravity , especially when a patient is lying down , this option does not directly relate to the specific spread of pancreatic fluids. The greater sac is not the primary space involved in the initial spread of pancreatic fluids.</li><li>• Option A.</li><li>• lower abdomen</li><li>• pelvic bones</li><li>• greater sac</li><li>• fluids</li><li>• abdominal cavity</li><li>• pelvic cavity</li><li>• gravity</li><li>• lying down</li><li>• Option C. The greater sac is the main and larger part of the peritoneal cavity . While the pouch of Morrison is a part of the greater sac , this option does not accurately represent the primary route for the spread of pancreatic fluids. The lesser sac is more directly involved in the initial spread of fluids from the pancreas .</li><li>• Option C.</li><li>• main</li><li>• larger part</li><li>• peritoneal cavity</li><li>• pouch of Morrison</li><li>• greater sac</li><li>• lesser sac</li><li>• initial spread</li><li>• fluids</li><li>• pancreas</li><li>• Option D. Morrison's pouch, or the hepatorenal recess, can collect fluids that may then move into other parts of the peritoneal cavity , including the pelvic space , due to the effects of gravity . However, this option does not highlight the initial pathway of pancreatic fluid spread from the pancreas to the lesser sac, which is crucial in understanding the early stages and potential complications of pancreatitis.</li><li>• Option D.</li><li>• fluids</li><li>• move</li><li>• peritoneal cavity</li><li>• pelvic space</li><li>• effects</li><li>• gravity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lesser sac , also known as the omental bursa , is a smaller division of the peritoneal cavity situated posterior to the stomach and the lesser omentum . The pouch of Morrison, or the hepatorenal recess , is the deepest part of the peritoneal cavity when a person is lying down and is located between the liver and the right kidney . Pancreatic fluids , in the case of pancreatitis , can spread from the pancreas into the lesser sac due to its anatomical proximity . From there, fluids can also extend into other peritoneal recesses, including the pouch of Morrison , especially in severe cases.</li><li>➤ lesser sac</li><li>➤ omental bursa</li><li>➤ smaller division</li><li>➤ peritoneal cavity</li><li>➤ posterior</li><li>➤ stomach</li><li>➤ lesser omentum</li><li>➤ hepatorenal recess</li><li>➤ deepest</li><li>➤ peritoneal cavity</li><li>➤ lying down</li><li>➤ between</li><li>➤ liver</li><li>➤ right kidney</li><li>➤ Pancreatic fluids</li><li>➤ pancreatitis</li><li>➤ pancreas</li><li>➤ lesser sac</li><li>➤ anatomical proximity</li><li>➤ extend</li><li>➤ pouch of Morrison</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 86</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 86</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old female presents to the clinic with a complaint of a visible bulge in her lower abdominal wall, which becomes more pronounced on straining or coughing. She mentions that the bulge has been gradually increasing in size over the past year. She has a history of two cesarean sections. On physical examination, a midline protrusion is noted below the umbilicus, which is consistent with a ventral hernia. This type of hernia is often associated with a weakness in the abdominal wall structures. In the context of this patient's presentation and the anatomical location of her hernia, which of the following best describes the composition of the anterior wall of the rectus sheath in the area where her hernia is most likely to have developed?", "options": [{"label": "A", "text": "External Oblique, Internal Oblique, Transversus Abdominis", "correct": true}, {"label": "B", "text": "Internal Oblique and Transverse Abdominis", "correct": false}, {"label": "C", "text": "Both Obliques only", "correct": false}, {"label": "D", "text": "Transversus Abdominis and Pyramidalis", "correct": false}], "correct_answer": "A. External Oblique, Internal Oblique, Transversus Abdominis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture10_eFGNZmF.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-104251.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture11_IymhxMB.jpg"], "explanation": "<p><strong>Ans. A) External Oblique, Internal Oblique, Transversus Abdominis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. This option only includes the internal oblique and transversus abdominis muscles . While these muscles are indeed part of the abdominal wall , the external oblique is also an important contributor to the anterior wall of the rectus sheath . Therefore, this option does not fully describe the composition of the rectus sheath in the lower abdomen.</li><li>• Option B.</li><li>• only</li><li>• internal oblique</li><li>• transversus abdominis</li><li>• muscles</li><li>• part</li><li>• abdominal wall</li><li>• external oblique</li><li>• anterior wall</li><li>• rectus sheath</li><li>• Option C. This option suggests that only the oblique muscles ( internal and external oblique ) contribute to the anterior wall of the rectus sheath . However, the transversus abdominis is also a critical component of this structure, so this option is not accurate.</li><li>• Option C.</li><li>• only</li><li>• oblique muscles</li><li>• internal</li><li>• external oblique</li><li>• anterior wall</li><li>• rectus sheath</li><li>• transversus abdominis</li><li>• Option D. The pyramidalis muscle is a small , triangular muscle located in the lower abdomen , and it does not play a significant role in the formation of the anterior wall of the rectus sheath. The transversus abdominis , on the other hand, is an important contributor to the rectus sheath , especially in its lower part .</li><li>• Option D.</li><li>• small</li><li>• triangular muscle</li><li>• lower abdomen</li><li>• transversus abdominis</li><li>• rectus sheath</li><li>• lower part</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the anterior wall of the rectus sheath , especially in the lower abdomen , you have contributions from all three flat muscles of the anterolateral abdominal wall : the external oblique , the internal oblique , and the transversus abdominis . These muscles contribute their aponeuroses to form the rectus sheath , which encloses the rectus abdominis muscle . Weakness or defects in this layered structure can lead to the development of a ventral hernia .</li><li>➤ anterior wall</li><li>➤ rectus sheath</li><li>➤ lower abdomen</li><li>➤ all three flat muscles</li><li>➤ anterolateral abdominal wall</li><li>➤ external</li><li>➤ oblique</li><li>➤ internal oblique</li><li>➤ transversus abdominis</li><li>➤ aponeuroses</li><li>➤ rectus sheath</li><li>➤ encloses</li><li>➤ rectus abdominis muscle</li><li>➤ Weakness</li><li>➤ defects</li><li>➤ ventral hernia</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 36</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 36</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male presents to the emergency department with acute onset of lower abdominal pain following a strenuous workout involving heavy lifting. The pain is localized to the lower midline of the abdomen, just superior to the pubic symphysis. There is no history of trauma, and the patient denies any urinary or gastrointestinal symptoms. On examination, there is tenderness on palpation in the lower midline of the abdomen, and a small, localized swelling is noted in the same area. There are no signs of hernia on examination. The patient's history and clinical findings suggest a strain of a small abdominal muscle. Which nerve is most likely involved in innervating the strained muscle in this patient?", "options": [{"label": "A", "text": "Subcostal Nerve", "correct": true}, {"label": "B", "text": "Ilioinguinal Nerve", "correct": false}, {"label": "C", "text": "Iliohypogastric Nerve", "correct": false}, {"label": "D", "text": "Genitofemoral Nerve", "correct": false}], "correct_answer": "A. Subcostal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture12_XtlbVtx.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/whatsapp-image-2024-02-15-at-105945-am.jpeg"], "explanation": "<p><strong>Ans. A) Subcostal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Ilioinguinal nerve from lumbar plexus supplies skin over upper and medial side of ring , root of penis and scrotum in male . It also innervates internal oblique and transversus abdominis muscles .</li><li>• Option B.</li><li>• Ilioinguinal nerve</li><li>• lumbar plexus</li><li>• skin</li><li>• upper</li><li>• medial side</li><li>• ring</li><li>• root</li><li>• penis</li><li>• scrotum</li><li>• male</li><li>• internal oblique</li><li>• transversus abdominis muscles</li><li>• Option C. Iliohypogastric nerve innervates the flat muscles of anterior abdominal wall and innervates skin over anterior abdominal wall over the inguinal region .</li><li>• Option C. Iliohypogastric nerve</li><li>• flat muscles</li><li>• anterior abdominal wall</li><li>• innervates</li><li>• skin</li><li>• anterior abdominal wall</li><li>• inguinal region</li><li>• Option D. Genital branch of genitofemoral nerve supplies cremaster and scrotal skin , content of spermatic cord .</li><li>• Option D.</li><li>• Genital branch</li><li>• genitofemoral nerve</li><li>• cremaster</li><li>• scrotal skin</li><li>• spermatic cord</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Subcostal nerve is the ventral ramus of T12 , it innervates the rectus abdominis , pyramidalis . Its lateral cutaneous branch supplies skin of the anterior part of the gluteal region .</li><li>➤ Subcostal nerve</li><li>➤ ventral ramus</li><li>➤ T12</li><li>➤ innervates</li><li>➤ rectus abdominis</li><li>➤ pyramidalis</li><li>➤ lateral cutaneous</li><li>➤ branch</li><li>➤ skin</li><li>➤ anterior part</li><li>➤ gluteal region</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 179</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 179</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old male with a known history of chronic liver disease presents to the clinic with new-onset swelling of his lower extremities and abdomen. He also reports experiencing significant difficulty breathing, especially when lying flat. On examination, you note marked distension of the veins over his chest and upper abdomen, in addition to ascites and bilateral lower extremity edema. The patient's history and clinical findings suggest impaired venous return to the heart. In the context of this patient's presentation, which of the following is most likely to be observed due to obstruction of a major venous structure?", "options": [{"label": "A", "text": "Paraumbilical Dilation", "correct": false}, {"label": "B", "text": "Thoracoepigastric Dilatation", "correct": true}, {"label": "C", "text": "Esophageal Varices", "correct": false}, {"label": "D", "text": "Hemorrhoids", "correct": false}], "correct_answer": "B. Thoracoepigastric Dilatation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture13_mHtLmJU.jpg"], "explanation": "<p><strong>Ans. B) Thoracoepigastric Dilatation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Paraumbilical dilatation seen in portal vein obstruction around umbilicus. Here, the left branch of the portal vein communicates with superficial veins of anterior abdominal wall through paraumbilical veins of Sappey .</li><li>• Option A.</li><li>• left branch</li><li>• portal vein</li><li>• superficial veins</li><li>• anterior abdominal wall</li><li>• paraumbilical veins</li><li>• Sappey</li><li>• Option C. Esophageal varices seen in portal vein obstruction around lower end of oesophagus between left gastric vein and esophageal tributaries of accessory hemiazygos vein .</li><li>• Option C. Esophageal varices</li><li>• portal vein obstruction</li><li>• lower end</li><li>• oesophagus</li><li>• left gastric vein</li><li>• esophageal tributaries</li><li>• accessory hemiazygos vein</li><li>• Option D. Hemorrhoids result due to distension and dilatation of the anastomosis between superior rectal vein and middle and inferior rectal vein tributaries in the anal canal .</li><li>• Option D.</li><li>• distension</li><li>• dilatation</li><li>• anastomosis</li><li>• superior rectal vein</li><li>• middle</li><li>• inferior rectal vein</li><li>• anal canal</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ IVC obstruction results in dilatation of anastomotic channel between IVC and SVC , the thoracoabdominal vein / thoracoepigastric vein formed between lateral thoracic vein ( axillary vein tributary ) and superficial epigastric vein ( tributary of Femoral vein ).</li><li>➤ IVC obstruction</li><li>➤ dilatation</li><li>➤ anastomotic channel</li><li>➤ IVC</li><li>➤ SVC</li><li>➤ thoracoabdominal vein</li><li>➤ thoracoepigastric vein</li><li>➤ lateral thoracic vein</li><li>➤ axillary vein tributary</li><li>➤ superficial epigastric vein</li><li>➤ tributary</li><li>➤ Femoral vein</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 136</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen, Pg. 136</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male, construction workercarrying a load on his head lost his balance and fell astride a rafter on the floor below. Immediately, he was taken to a nearby hospital. The medical practitioner on examination of the patient found that there was extensive swelling of the perineum, scrotum and penis. The lower part of his anterior abdominal wall was also swollen. The patient complained that he was not able to pass his urine normally and was passing only a few drops of blood-stained urine. Which of the following statements is incorrect regarding the above scenario?", "options": [{"label": "A", "text": "The patient’s Urethra had been injured inside the Perineum because of the Fall Sustained.", "correct": false}, {"label": "B", "text": "The patient’s fall ruptured the Penile Urethra.", "correct": false}, {"label": "C", "text": "The Urine passed upward beneath the Membranous Layer of Superficial Fascia on the Anterior Abdominal Wall.", "correct": false}, {"label": "D", "text": "The Urine could not extend posteriorly because of the attachment of Colles’ Fascia to the Anococcygeal Raphe.", "correct": true}], "correct_answer": "D. The Urine could not extend posteriorly because of the attachment of Colles’ Fascia to the Anococcygeal Raphe.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture14_IwXY8JN.jpg"], "explanation": "<p><strong>Ans. D) The Urine could not extend posteriorly because of the attachment of Colles’ Fascia to the Anococcygeal Raphe.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is likely true . A fall astride with such a mechanism of injury commonly results in a straddle injury , which can cause trauma to the urethra , especially the bulbous and membranous parts that are located in the perineum .</li><li>• Option A.</li><li>• true</li><li>• fall astride</li><li>• mechanism</li><li>• injury</li><li>• straddle injury</li><li>• trauma</li><li>• urethra</li><li>• bulbous</li><li>• membranous parts</li><li>• perineum</li><li>• Option B. The mechanism of injury described could lead to a rupture of the penile urethra . The swelling of the scrotum and penis suggests involvement of the spongy (penile) urethra .</li><li>• Option B.</li><li>• mechanism</li><li>• injury</li><li>• lead</li><li>• rupture</li><li>• penile urethra</li><li>• swelling</li><li>• scrotum</li><li>• penis</li><li>• spongy (penile) urethra</li><li>• Option C. This statement is true . In the case of urethral injury , urine can extravasate and track along fascial planes . Due to the attachments of Colles’ fascia in the perineum , urine can pass upward beneath the membranous layer of the superficial fascia ( Scarpa's fascia ) on the anterior abdominal wall , leading to swelling in this area.</li><li>• Option C.</li><li>• true</li><li>• urethral injury</li><li>• urine</li><li>• extravasate</li><li>• track along fascial planes</li><li>• Colles’ fascia</li><li>• perineum</li><li>• upward</li><li>• membranous</li><li>• layer</li><li>• superficial fascia</li><li>• Scarpa's fascia</li><li>• anterior abdominal wall</li><li>• swelling</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In reality, Colles' fascia in the perineum is attached laterally to the ischiopubic rami and posteriorly to the perineal body , but it does not attach to the anococcygeal raphe. Therefore, in the case of a urethral rupture , urine and blood can indeed extend into the superficial perineal space but are prevented from extending into the thigh or posteriorly into the anal region due to these attachments. Scarpa’s fascia of anterior abdominal wall when traced below it is continuous with the: Fundiform Ligament of Penis Dartos Muscle of the Scrotum Colles Fascia of Perineum</li><li>➤ In reality, Colles' fascia in the perineum is attached laterally to the ischiopubic rami and posteriorly to the perineal body , but it does not attach to the anococcygeal raphe. Therefore, in the case of a urethral rupture , urine and blood can indeed extend into the superficial perineal space but are prevented from extending into the thigh or posteriorly into the anal region due to these attachments.</li><li>➤ Colles' fascia</li><li>➤ perineum</li><li>➤ laterally</li><li>➤ ischiopubic rami</li><li>➤ posteriorly</li><li>➤ perineal body</li><li>➤ urethral rupture</li><li>➤ urine</li><li>➤ blood</li><li>➤ superficial perineal space</li><li>➤ extending</li><li>➤ thigh</li><li>➤ posteriorly</li><li>➤ anal region</li><li>➤ Scarpa’s fascia of anterior abdominal wall when traced below it is continuous with the: Fundiform Ligament of Penis Dartos Muscle of the Scrotum Colles Fascia of Perineum</li><li>➤ Scarpa’s fascia</li><li>➤ anterior abdominal wall</li><li>➤ continuous</li><li>➤ Fundiform Ligament of Penis Dartos Muscle of the Scrotum Colles Fascia of Perineum</li><li>➤ Fundiform Ligament of Penis</li><li>➤ Dartos Muscle of the Scrotum</li><li>➤ Colles Fascia of Perineum</li><li>➤ Over the inguinal ligament, it blends with the fascia lata of the thigh along Holden’s line (extends laterally from pubic tubercle above the saphenous opening of the thigh ).</li><li>➤ blends</li><li>➤ fascia lata</li><li>➤ thigh</li><li>➤ Holden’s line</li><li>➤ laterally</li><li>➤ pubic tubercle</li><li>➤ above</li><li>➤ saphenous opening</li><li>➤ thigh</li><li>➤ Injury to the male (bulbar) urethra inside the perineum due to trauma will result in the extravasation of urine from superficial perineal pouch to the scrotum , penis and lower anterior abdominal wall , but not into the thigh because of attachment to Holden’s line. The urine could not extend posteriorly because of the attachment of the Colles’ fascia to the posterior edge of the perineal membrane.</li><li>➤ Injury</li><li>➤ male</li><li>➤ urethra</li><li>➤ perineum</li><li>➤ trauma</li><li>➤ extravasation</li><li>➤ urine</li><li>➤ superficial perineal pouch</li><li>➤ scrotum</li><li>➤ penis</li><li>➤ lower anterior abdominal wall</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1069</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1069</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old man, known diabetic for the past 10 years and a chronic smoker, had severe pain in both legs when taking long walks for the past three weeks. He noticed recently that the cramp-like pain occurs after walking only a few metres. His family physician examined him. On questioning, he said that the pain quickly disappears on rest only to return after he walks the same distance. When the physician asked about his sex life, the patient admitted that he was experiencing difficulty with erection for the past one month. Which of the following statements does not explain the signs and symptoms experienced by this patient?", "options": [{"label": "A", "text": "Arteriography of the Abdominal Aorta revealed Blockage in the Region of the Bifurcation.", "correct": false}, {"label": "B", "text": "The Aorta Bifurcates into Right and Left Common Iliac Arteries opposite the Transtubercular Plane.", "correct": true}, {"label": "C", "text": "The Blockage of the Aorta in the region of the Bifurcation had effectively blocked the entrances into Both Common Iliac Arteries.", "correct": false}, {"label": "D", "text": "The Lack of Blood entering Both Internal Iliac Arteries was responsible for the difficulty with Erection.", "correct": false}], "correct_answer": "B. The Aorta Bifurcates into Right and Left Common Iliac Arteries opposite the Transtubercular Plane.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture15_05SrRk7.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-105002.jpg"], "explanation": "<p><strong>Ans. B) The Aorta Bifurcates into Right and Left Common Iliac Arteries opposite the Transtubercular Plane.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A blockage at the bifurcation of the abdominal aorta into the common iliac arteries can lead to decreased blood flow to the lower limbs , causing pain when walking ( claudication ). This is consistent with the patient's history.</li><li>• Option A.</li><li>• bifurcation</li><li>• abdominal aorta</li><li>• common iliac arteries</li><li>• decreased blood flow</li><li>• lower limbs</li><li>• pain</li><li>• walking</li><li>• claudication</li><li>• Option C. If the blockage is at the aortic bifurcation , it would affect the flow into both common iliac arteries , leading to reduced blood supply to the lower limbs and resulting in pain on exertion .</li><li>• Option C.</li><li>• blockage</li><li>• aortic bifurcation</li><li>• affect</li><li>• flow</li><li>• both common iliac arteries</li><li>• leading</li><li>• reduced blood supply</li><li>• lower limbs</li><li>• resulting</li><li>• pain</li><li>• exertion</li><li>• Option D. The internal iliac arteries supply blood to the pelvic organs , including the structures involved in penile erection . A blockage affecting the flow in these arteries could lead to erectile dysfunction , which aligns with the patient's sexual difficulties .</li><li>• Option D.</li><li>• internal iliac arteries</li><li>• blood</li><li>• pelvic organs</li><li>• penile erection</li><li>• blockage</li><li>• flow</li><li>• erectile dysfunction</li><li>• aligns</li><li>• patient's sexual difficulties</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The aorta typically bifurcates into the right and left common iliac arteries at the level of the fourth lumbar vertebra (L4) , which is higher than the transtubercular plane . The transtubercular plane passes through the body at the level of the iliac tubercles , which is lower than the aortic bifurcation . The aorta bifurcates into right and left common iliac arteries opposite the body of L4 vertebra into right and left common iliac arteries . Each common iliac artery will divide into external and internal iliac arteries .</li><li>➤ The aorta typically bifurcates into the right and left common iliac arteries at the level of the fourth lumbar vertebra (L4) , which is higher than the transtubercular plane . The transtubercular plane passes through the body at the level of the iliac tubercles , which is lower than the aortic bifurcation .</li><li>➤ bifurcates</li><li>➤ right</li><li>➤ left common iliac arteries</li><li>➤ level</li><li>➤ fourth lumbar vertebra (L4)</li><li>➤ higher</li><li>➤ transtubercular plane</li><li>➤ body</li><li>➤ level</li><li>➤ iliac tubercles</li><li>➤ lower</li><li>➤ aortic bifurcation</li><li>➤ The aorta bifurcates into right and left common iliac arteries opposite the body of L4 vertebra into right and left common iliac arteries .</li><li>➤ aorta</li><li>➤ right</li><li>➤ left common iliac</li><li>➤ opposite</li><li>➤ body</li><li>➤ L4 vertebra</li><li>➤ right</li><li>➤ left common iliac arteries</li><li>➤ Each common iliac artery will divide into external and internal iliac arteries .</li><li>➤ divide</li><li>➤ external</li><li>➤ internal iliac arteries</li><li>➤ The gradual blockage of the aorta was caused by advanced arteriosclerosis .</li><li>➤ gradual blockage</li><li>➤ aorta</li><li>➤ advanced arteriosclerosis</li><li>➤ An insufficient amount of blood was reaching both legs , causing pain ( claudication ) on walking .</li><li>➤ insufficient</li><li>➤ blood</li><li>➤ reaching</li><li>➤ legs</li><li>➤ pain</li><li>➤ claudication</li><li>➤ walking</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1087</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1087</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old boy was involved in an argument but quickly worsened into a street brawl with the use of knives. He was examined in the emergency department and found to have a bleeding stab wound in his left flank. A urine specimen revealed frank blood. Of the organs listed below, which one is least likely to be injured?", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Left Suprarenal Gland.", "correct": false}, {"label": "C", "text": "Stomach", "correct": false}, {"label": "D", "text": "Inferior Vena Cava", "correct": true}], "correct_answer": "D. Inferior Vena Cava", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture16_lhmLfCf.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture17_vuV5YOy.jpg"], "explanation": "<p><strong>Ans. D) Inferior Vena Cava</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The spleen is located in the left upper quadrant of the abdomen , just under the rib cage . Given its location, it is a possible organ to be injured in a stab wound to the left flank , particularly if the wound is upward and posterior .</li><li>• Option A.</li><li>• left upper quadrant</li><li>• abdomen</li><li>• under</li><li>• rib cage</li><li>• possible organ</li><li>• injured</li><li>• stab wound</li><li>• left flank</li><li>• upward</li><li>• posterior</li><li>• Option B. The left suprarenal (Adrenal) gland is located atop the left kidney , deep in the upper part of the abdominal cavity . While it is somewhat protected by the ribcage and the position of the kidney , it could potentially be injured in a deep stab wound to the left flank .</li><li>• Option B.</li><li>• atop</li><li>• left kidney</li><li>• deep</li><li>• upper part</li><li>• abdominal cavity</li><li>• protected</li><li>• ribcage</li><li>• position</li><li>• kidney</li><li>• potentially</li><li>• injured</li><li>• deep stab wound</li><li>• left flank</li><li>• Option C. The stomach is primarily located in the upper left part of the abdomen , extending towards the midline . It's plausible for the stomach to be injured in a stab wound to the left flank , especially if the wound is anterior and upward .</li><li>• Option C.</li><li>• upper left part</li><li>• abdomen</li><li>• midline</li><li>• stomach</li><li>• stab wound</li><li>• left flank</li><li>• anterior</li><li>• upward</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior vena cava (IVC) runs along the right side of the vertebral column . It is a major vein that returns blood from the lower body to the heart . Given its location on the right side , it is less likely to be directly injured by a stab wound in the left flank compared to the other organs listed. The inferior vena cava is not present in the left abdominal quadrant. Instead, IVC is seen to the right side of the abdominal aorta . It begins opposite the L5 vertebra by the union of right and left common iliac veins .</li><li>➤ The inferior vena cava (IVC) runs along the right side of the vertebral column . It is a major vein that returns blood from the lower body to the heart . Given its location on the right side , it is less likely to be directly injured by a stab wound in the left flank compared to the other organs listed.</li><li>➤ right side</li><li>➤ vertebral column</li><li>➤ major vein</li><li>➤ returns blood</li><li>➤ lower body</li><li>➤ heart</li><li>➤ right side</li><li>➤ injured</li><li>➤ stab wound</li><li>➤ left flank</li><li>➤ The inferior vena cava is not present in the left abdominal quadrant. Instead, IVC is seen to the right side of the abdominal aorta .</li><li>➤ right side</li><li>➤ abdominal aorta</li><li>➤ It begins opposite the L5 vertebra by the union of right and left common iliac veins .</li><li>➤ opposite</li><li>➤ L5 vertebra</li><li>➤ union</li><li>➤ right</li><li>➤ left common iliac veins</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1090</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1090</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old woman was late to work. She increased the speed of her car. While taking a turn around the corner, she got involved in a head-on automobile accident. She was immediately shifted to a neighboring hospital. She was received in the ER in a state of severe shock, with a rapid pulse and low blood pressure. Examination revealed bruising on the lower part of the anterior abdominal wall. Further examination showed that the abdomen was becoming rapidly distended. Exploratory surgery revealed a ruptured abdominal aorta. Which of the following is true concerning this case?", "options": [{"label": "A", "text": "The Abdominal Aorta pierces the Diaphragm opposite T10 Vertebra.", "correct": false}, {"label": "B", "text": "The Abdominal Aorta passes to the Left of the Vertebral Column.", "correct": false}, {"label": "C", "text": "Anteriorly, it is covered by Parietal Peritoneum and crossed by Root of Mesentery.", "correct": true}, {"label": "D", "text": "It ends by dividing into Right and Left Common Iliac Arteries opposite L5 Vertebra.", "correct": false}], "correct_answer": "C. Anteriorly, it is covered by Parietal Peritoneum and crossed by Root of Mesentery.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture18_GEbGvQU.jpg"], "explanation": "<p><strong>Ans. C) Anteriorly, it is covered by Parietal Peritoneum and crossed by Root of Mesentery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The abdominal aorta actually passes through the diaphragm at the aortic hiatus , which is located at the level of the T12 vertebra , not the T10 vertebra.</li><li>• Option A.</li><li>• abdominal aorta</li><li>• diaphragm</li><li>• aortic hiatus</li><li>• level</li><li>• T12 vertebra</li><li>• Option B. The abdominal aorta runs anterior to the vertebral column and is positioned centrally rather than to the left or right . It runs down from the thoracic aorta and is in line with the vertebral column until it bifurcates .</li><li>• Option B.</li><li>• abdominal aorta</li><li>• anterior</li><li>• vertebral column</li><li>• positioned centrally</li><li>• left</li><li>• right</li><li>• thoracic aorta</li><li>• line</li><li>• vertebral column</li><li>• bifurcates</li><li>• Option D. The abdominal aorta typically bifurcates into the right and left common iliac arteries at the level of the fourth lumbar vertebra ( L4 ), not L5.</li><li>• Option D.</li><li>• abdominal aorta</li><li>• bifurcates</li><li>• right</li><li>• left common iliac</li><li>• arteries</li><li>• fourth lumbar vertebra</li><li>• L4</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The abdominal aorta is retroperitoneal , meaning it lies behind the parietal peritoneum . The root of the mesentery of the small intestine crosses in front of the abdominal aorta . This anatomical relationship is important for understanding abdominal structures and their potential involvement in trauma or surgical procedures . Aortic opening of the diaphragm lies opposite the lower border of the T12 vertebra . Aorta passes downwards in front of the vertebral column to the left side of Inferior vena cava . It ends by dividing into right and left common iliac arteries opposite L5 vertebrae .</li><li>• The abdominal aorta is retroperitoneal , meaning it lies behind the parietal peritoneum . The root of the mesentery of the small intestine crosses in front of the abdominal aorta . This anatomical relationship is important for understanding abdominal structures and their potential involvement in trauma or surgical procedures .</li><li>• abdominal aorta</li><li>• retroperitoneal</li><li>• behind</li><li>• parietal peritoneum</li><li>• root</li><li>• mesentery</li><li>• small intestine</li><li>• front</li><li>• abdominal aorta</li><li>• understanding abdominal structures</li><li>• potential involvement</li><li>• trauma</li><li>• surgical procedures</li><li>• Aortic opening of the diaphragm lies opposite the lower border of the T12 vertebra . Aorta passes downwards in front of the vertebral column to the left side of Inferior vena cava . It ends by dividing into right and left common iliac arteries opposite L5 vertebrae .</li><li>• Aortic opening</li><li>• diaphragm</li><li>• opposite</li><li>• lower border</li><li>• T12 vertebra</li><li>• downwards</li><li>• front</li><li>• vertebral column</li><li>• left side</li><li>• Inferior vena cava</li><li>• ends</li><li>• dividing</li><li>• right</li><li>• left common iliac</li><li>• opposite L5 vertebrae</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1087</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg No. 1087</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old male, asthmatic for the past 15 years and known smoker, visited the surgery OPD after he noticed a swelling in the right groin that gradually increased in size. On examination, the surgeon noticed a 4 cm sized swelling above and medial to the pubic tubercle. When the patient coughed the size of the swelling increased and it was reducible manually. Which of the following statements is not true in the above scenario?", "options": [{"label": "A", "text": "This is a case of Direct Inguinal Hernia.", "correct": false}, {"label": "B", "text": "This case occurred through the Hesselbach's Triangle.", "correct": false}, {"label": "C", "text": "Inferior Epigastric Artery is located Medial to Neck of Hernial Sac.", "correct": true}, {"label": "D", "text": "Conjoint Tendon forms the Medial Half of the Posterior Wall of Inguinal Canal.", "correct": false}], "correct_answer": "C. Inferior Epigastric Artery is located Medial to Neck of Hernial Sac.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-105142.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture19.jpg"], "explanation": "<p><strong>Ans. C) Inferior Epigastric Artery is located Medial to Neck of Hernial Sac.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is true . The description of the swelling in the right groin , above and medial to the pubic tubercle , and its characteristics ( increasing in size with coughing and reducible ) are consistent with a direct inguinal hernia . Direct inguinal hernias typically occur in older males and protrude through a weakened area in the abdominal wall in Hesselbach's triangle .</li><li>• Option A.</li><li>• true</li><li>• right groin</li><li>• above</li><li>• medial</li><li>• pubic tubercle</li><li>• increasing</li><li>• size</li><li>• coughing</li><li>• reducible</li><li>• direct inguinal hernia</li><li>• older males</li><li>• protrude</li><li>• weakened area</li><li>• abdominal wall</li><li>• Hesselbach's triangle</li><li>• Option B. This statement is true . This is case of direct inguinal hernia which occurs through Hesselbach’s triangle while indirect inguinal hernia occurs outside Hesselbach’s triangle .</li><li>• Option B.</li><li>• true</li><li>• direct inguinal hernia</li><li>• Hesselbach’s triangle</li><li>• indirect inguinal hernia</li><li>• outside</li><li>• Hesselbach’s triangle</li><li>• Option D. This statement is true . The conjoint tendon , formed by the fusion of the aponeuroses of the internal oblique and transversus abdominis muscles , forms the medial part of the posterior wall of the inguinal canal , reinforcing this region.</li><li>• Option D.</li><li>• true</li><li>• conjoint tendon</li><li>• fusion</li><li>• aponeuroses</li><li>• internal oblique</li><li>• transversus abdominis muscles</li><li>• medial part</li><li>• posterior wall</li><li>• inguinal canal</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior epigastric artery is located lateral to the neck of hernial sac in direct inguinal hernia . In the case of a direct inguinal hernia , the inferior epigastric artery is located lateral to the neck of the hernial sac . In indirect inguinal hernias , the inferior epigastric artery is medial to the neck of the hernial sac .</li><li>➤ Inferior epigastric artery is located lateral to the neck of hernial sac in direct inguinal hernia . In the case of a direct inguinal hernia , the inferior epigastric artery is located lateral to the neck of the hernial sac .</li><li>➤ Inferior epigastric artery is located lateral to the neck of hernial sac in direct inguinal hernia . In the case of a direct inguinal hernia , the inferior epigastric artery is located lateral to the neck of the hernial sac .</li><li>➤ Inferior epigastric artery</li><li>➤ lateral</li><li>➤ neck</li><li>➤ hernial sac</li><li>➤ direct inguinal hernia</li><li>➤ direct inguinal hernia</li><li>➤ inferior epigastric artery</li><li>➤ lateral</li><li>➤ neck</li><li>➤ hernial sac</li><li>➤ In indirect inguinal hernias , the inferior epigastric artery is medial to the neck of the hernial sac .</li><li>➤ In indirect inguinal hernias , the inferior epigastric artery is medial to the neck of the hernial sac .</li><li>➤ indirect inguinal hernias</li><li>➤ inferior epigastric artery</li><li>➤ medial</li><li>➤ neck</li><li>➤ hernial sac</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1081</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1081</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old male presented to his physician with subacute low back pain. The patient reported an intermittent history of low back pain over the past 3 months. All low back movements were reported as painful. He also describes a dull aching sensation in the lumbar region. Physical examination revealed a pulsatile mass and tenderness over abdomen. The arterial pulses in the lower limbs appeared diminished. CT scan confirmed the diagnosis of aneurysm of infrarenal abdominal aorta and narrowing of common iliac arteries. Which of the following statements regarding the above case is incorrect?", "options": [{"label": "A", "text": "Abdominal Aortic Aneurysm is due to Weakening of Tunica Adventitia.", "correct": false}, {"label": "B", "text": "Pseudoaneurysm the Blood collects between Tunica Media and Intima", "correct": true}, {"label": "C", "text": "95% of Aneurysms are Infrarenal.", "correct": false}, {"label": "D", "text": "Infrarenal Aneurysms can cause Lower Extremity Ischaemia.", "correct": false}], "correct_answer": "B. Pseudoaneurysm the Blood collects between Tunica Media and Intima", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture20_BDZpsZu.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/whatsapp-image-2024-02-15-at-110202-am.jpeg"], "explanation": "<p><strong>Ans. B) Pseudoaneurysm the Blood collects between Tunica Media and Intima</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A true aortic aneurysm typically involves a weakening of all three layers of the aorta ( intima , media , and adventitia ), although in the case of aortic pseudoaneurysm the degeneration of the tunica adventitia is often considered the primary factor . The weakening can be caused by atherosclerosis , genetic factors , inflammation , and other conditions .</li><li>• Option A.</li><li>• true aortic aneurysm</li><li>• weakening</li><li>• all three layers</li><li>• aorta</li><li>• intima</li><li>• media</li><li>• adventitia</li><li>• aortic pseudoaneurysm</li><li>• degeneration</li><li>• tunica adventitia</li><li>• primary factor</li><li>• weakening</li><li>• atherosclerosis</li><li>• genetic factors</li><li>• inflammation</li><li>• other conditions</li><li>• Option C. This statement is correct . Most abdominal aortic aneurysms are infrarenal , meaning they occur below the level of the renal arteries . This is a significant clinical point , as the location of the aneurysm affects surgical approach and prognosis .</li><li>• Option C.</li><li>• correct</li><li>• infrarenal</li><li>• below</li><li>• level</li><li>• renal arteries</li><li>• clinical point</li><li>• location</li><li>• aneurysm affects</li><li>• surgical approach</li><li>• prognosis</li><li>• Option D. This statement is also correct . An infrarenal abdominal aortic aneurysm can lead to lower extremity ischemia, especially if it involves or extends to the iliac arteries , as in the case described. The narrowing or obstruction of these arteries can diminish blood flow to the lower limbs , leading to ischemia .</li><li>• Option D.</li><li>• correct</li><li>• lower extremity ischemia,</li><li>• involves</li><li>• extends</li><li>• iliac arteries</li><li>• narrowing</li><li>• obstruction</li><li>• diminish blood flow</li><li>• lower limbs</li><li>• ischemia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A pseudoaneurysm , or false aneurysm , occurs when there is a disruption in the arterial wall , leading to blood leaking out of the artery but being contained by surrounding tissues or the adventitia . It does not involve the collection of blood between the tunica media and intima. Instead, the blood escapes the normal layers of the arterial wall .</li><li>➤ pseudoaneurysm</li><li>➤ false aneurysm</li><li>➤ disruption</li><li>➤ arterial wall</li><li>➤ blood</li><li>➤ leaking out</li><li>➤ artery</li><li>➤ surrounding tissues</li><li>➤ adventitia</li><li>➤ blood escapes</li><li>➤ normal layers</li><li>➤ arterial wall</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1087</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1087</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 37-year-old woman, who was at 35 weeks of pregnancy, noticed that her feet and ankles were swollen at the end of the day, and she found it very uncomfortable trying to wear her ankle socks and walk in her normal shoes. She met her obstetrician and said that the swelling was worse if she had been standing for long periods. She also noticed that the veins around her ankles were becoming prominent. Which of the following statements pertaining to the above case is incorrect?", "options": [{"label": "A", "text": "The Enlarged Uterus is an Abdominal Organ and often compresses the Inferior Vena Cava.", "correct": false}, {"label": "B", "text": "The Pregnant Uterus presses on the Sympathetic Trunks, causing Vasodilatation of the Blood Vessels of the Legs.", "correct": true}, {"label": "C", "text": "Venous Back Pressure causes the Tissue Fluid to accumulate in the Subcutaneous Tissues of the Feet and Ankles.", "correct": false}, {"label": "D", "text": "Venous Back Pressure impairs the Venous Return in the Superficial Veins in Both the Legs, leading to Varicose Veins.", "correct": false}], "correct_answer": "B. The Pregnant Uterus presses on the Sympathetic Trunks, causing Vasodilatation of the Blood Vessels of the Legs.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture21_d7CXvYJ.jpg"], "explanation": "<p><strong>Ans. B) The Pregnant Uterus presses on the Sympathetic Trunks, causing Vasodilatation of the Blood Vessels of the Legs.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. As the uterus enlarges during pregnancy , it can compress the inferior vena cava , especially when the woman is lying on her back . This compression can reduce venous return from the lower limbs , contributing to edema ( swelling ) in the feet and ankles .</li><li>• Option A.</li><li>• enlarges</li><li>• pregnancy</li><li>• compress</li><li>• inferior vena cava</li><li>• woman</li><li>• lying</li><li>• back</li><li>• reduce</li><li>• venous return</li><li>• lower limbs</li><li>• edema</li><li>• swelling</li><li>• feet</li><li>• ankles</li><li>• Option C. This statement is correct . Increased venous pressure due to reduced venous return can lead to fluid accumulation ( edema ) in the subcutaneous tissues of the feet and ankles in pregnant women .</li><li>• Option C.</li><li>• correct</li><li>• Increased venous pressure</li><li>• reduced venous</li><li>• return</li><li>• fluid accumulation</li><li>• edema</li><li>• subcutaneous tissues</li><li>• feet</li><li>• ankles</li><li>• pregnant women</li><li>• Option D. This statement is also correct . The increased pressure in the veins due to the enlarged uterus and hormonal changes can lead to venous insufficiency and the development of varicose veins , which are prominent , twisted veins visible under the skin .</li><li>• Option D.</li><li>• correct</li><li>• increased pressure</li><li>• veins</li><li>• enlarged uterus</li><li>• hormonal changes</li><li>• venous insufficiency</li><li>• development</li><li>• varicose veins</li><li>• prominent</li><li>• twisted veins</li><li>• under</li><li>• skin</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pregnant uterus does not typically exert pressure on the sympathetic trunks in a manner that would cause vasodilation of the leg blood vessels. Vasodilation in pregnancy is more commonly related to hormonal changes , such as increased levels of progesterone , which can cause relaxation of the smooth muscles in the vessel walls . The sympathetic trunks are located in a position where they are unlikely to be compressed significantly by the uterus .</li><li>➤ The pregnant uterus does not typically exert pressure on the sympathetic trunks in a manner that would cause vasodilation of the leg blood vessels. Vasodilation in pregnancy is more commonly related to hormonal changes , such as increased levels of progesterone , which can cause relaxation of the smooth muscles in the vessel walls . The sympathetic trunks are located in a position where they are unlikely to be compressed significantly by the uterus .</li><li>➤ Vasodilation</li><li>➤ pregnancy</li><li>➤ hormonal changes</li><li>➤ increased levels</li><li>➤ progesterone</li><li>➤ relaxation</li><li>➤ smooth muscles</li><li>➤ vessel walls</li><li>➤ position</li><li>➤ significantly</li><li>➤ uterus</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 109</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 109</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old female (post-menopausal) who had five children from normal delivery had been assisting the chief cook in a restaurant. For the past 6 months, she felt the sensation of something coming down the vagina. She fixed an appointment with a gynaecologist. She told the gynaecologist that she also had dribbling of urine while bending down and frequency of micturition. The gynaecologist performed a per vaginal examination which revealed the descent of the cervix into the vagina. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Round Ligament is attached to the Uerine Cornua below and in front of the Fallopian Tube", "correct": false}, {"label": "B", "text": "Anteversion is maintained by Cardinal Ligaments", "correct": true}, {"label": "C", "text": "Broad Ligament of Uterus is a False Ligament", "correct": false}, {"label": "D", "text": "Pubocervical Ligament is true Ligament of Uterus", "correct": false}], "correct_answer": "B. Anteversion is maintained by Cardinal Ligaments", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture22_hJ4Zy33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture23_FC2ZxVv.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture24_c1mVq4q.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-105427.jpg"], "explanation": "<p><strong>Ans. B) Anteversion is maintained by Cardinal Ligaments</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The round ligaments of the uterus are fibromuscular structures that extend from the uterine cornua , pass through the inguinal canal , and terminate in the labia majora . They are located below and in front of the fallopian tubes and play a role in maintaining the anteversion of the uterus .</li><li>• Option A.</li><li>• round ligaments</li><li>• uterus</li><li>• fibromuscular structures</li><li>• extend</li><li>• uterine cornua</li><li>• inguinal canal</li><li>• terminate</li><li>• labia majora</li><li>• below</li><li>• front</li><li>• fallopian tubes</li><li>• maintaining</li><li>• anteversion</li><li>• uterus</li><li>• Option C. This statement is correct but needs clarification. The broad ligament is often referred to as a \" false ligament \" because it does not provide significant support to the uterus . It is more accurately described as a double layer of peritoneum that extends from the sides of the uterus to the lateral walls of the pelvis , enclosing the fallopian tubes , ovaries , and related structures .</li><li>• Option C.</li><li>• correct</li><li>• broad ligament</li><li>• false ligament</li><li>• does not</li><li>• significant</li><li>• uterus</li><li>• more accurately</li><li>• double layer</li><li>• peritoneum</li><li>• extends</li><li>• sides</li><li>• uterus</li><li>• lateral walls</li><li>• pelvis</li><li>• enclosing</li><li>• fallopian tubes</li><li>• ovaries</li><li>• related structures</li><li>• Option D. This statement is correct . The pubocervical ligament is a true ligament of the uterus , extending from the cervix and upper vagina to the pubic symphysis . It provides support to the anterior aspect of the uterus and helps maintain its position within the pelvis .</li><li>• Option D.</li><li>• correct</li><li>• true ligament</li><li>• uterus</li><li>• cervix</li><li>• upper vagina</li><li>• pubic symphysis</li><li>• support</li><li>• anterior aspect</li><li>• uterus</li><li>• maintain</li><li>• position</li><li>• pelvis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anteversion of the uterus, which refers to the uterus tilting forward over the bladder , is mainly maintained by the uterosacral and round ligaments , not the cardinal ligaments. The cardinal ligaments, also known as the transverse cervical ligaments , primarily provide lateral support to the cervix and uterus and help in maintaining their position within the pelvis , but they are not the key ligaments for maintaining anteversion.</li><li>➤ The anteversion of the uterus, which refers to the uterus tilting forward over the bladder , is mainly maintained by the uterosacral and round ligaments , not the cardinal ligaments. The cardinal ligaments, also known as the transverse cervical ligaments , primarily provide lateral support to the cervix and uterus and help in maintaining their position within the pelvis , but they are not the key ligaments for maintaining anteversion.</li><li>➤ anteversion</li><li>➤ uterus tilting</li><li>➤ forward</li><li>➤ bladder</li><li>➤ uterosacral</li><li>➤ round ligaments</li><li>➤ transverse cervical ligaments</li><li>➤ lateral support</li><li>➤ cervix</li><li>➤ uterus</li><li>➤ maintaining</li><li>➤ pelvis</li><li>➤ Structures attached to uterine cornua :</li><li>➤ Structures attached to uterine cornua :</li><li>➤ attached</li><li>➤ uterine cornua</li><li>➤ Fallopian tube Round ligament is attached to the uterine cornua below and in front of the fallopian tube. Ligament of ovary is attached to the uterine cornua below and behind the fallopian tube.</li><li>➤ Fallopian tube</li><li>➤ Round ligament is attached to the uterine cornua below and in front of the fallopian tube.</li><li>➤ Ligament of ovary is attached to the uterine cornua below and behind the fallopian tube.</li><li>➤ Anteversion is maintained by:</li><li>➤ Anteversion is maintained by:</li><li>➤ maintained</li><li>➤ Forward pull-on uterine fundus by traction of round ligament Backward pull on the cervix by traction of the uterosacral ligaments Intrinsic growth of uterine musculature</li><li>➤ Forward pull-on uterine fundus by traction of round ligament</li><li>➤ Backward pull on the cervix by traction of the uterosacral ligaments</li><li>➤ Intrinsic growth of uterine musculature</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1294</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female married for the past 4 months, experienced acute pain in the lower abdomen and was rushed to the hospital in a state of shock. A history of two missed periods suggested early pregnancy. The abdominal wall showed tenderness and guarding. Ultrasound revealed empty and enlarged uterus and fluid in the pouch of douglas. Which of the following statements is not true?", "options": [{"label": "A", "text": "The Diagnosis is Rupture Ectopic Pregnancy.", "correct": false}, {"label": "B", "text": "There is Hemorrhage in the Peritoneal Cavity, especially into the Pouch of Douglas.", "correct": false}, {"label": "C", "text": "Irritation of Parietal Peritoneum results in Tenderness and Muscle Guarding", "correct": false}, {"label": "D", "text": "Collection of Pus in Pouch of Douglas can be removed through an Incision in Anterior Fornix.", "correct": true}], "correct_answer": "D. Collection of Pus in Pouch of Douglas can be removed through an Incision in Anterior Fornix.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture25_2ZDePNu.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture26.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-105755.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-105826.jpg"], "explanation": "<p><strong>Ans. D) Collection of Pus in Pouch of Douglas can be removed through an Incision in Anterior Fornix.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The clinical presentation of acute pain , shock , history of missed periods , and an ultrasound showing an empty , enlarged uterus with fluid in the pouch of Douglas strongly suggests a ruptured ectopic pregnancy . In an ectopic pregnancy, the fertilized egg implants outside the uterus, often in a fallopian tube , and if it ruptures , it can cause severe internal bleeding .</li><li>• Option A.</li><li>• acute pain</li><li>• shock</li><li>• history</li><li>• missed periods</li><li>• ultrasound</li><li>• empty</li><li>• enlarged uterus</li><li>• fluid</li><li>• pouch of Douglas</li><li>• ruptured ectopic pregnancy</li><li>• fertilized egg</li><li>• implants</li><li>• outside</li><li>• fallopian tube</li><li>• ruptures</li><li>• severe internal bleeding</li><li>• Option B. In the case of a ruptured ectopic pregnancy , internal bleeding can occur, leading to the accumulation of blood in the peritoneal cavity , particularly in the pouch of Douglas , which is the lowest part of the peritoneal cavity in females .</li><li>• Option B.</li><li>• ruptured ectopic pregnancy</li><li>• internal bleeding</li><li>• leading</li><li>• accumulation</li><li>• blood</li><li>• peritoneal cavity</li><li>• pouch of Douglas</li><li>• lowest part</li><li>• peritoneal cavity</li><li>• females</li><li>• Option C. Irritation of the parietal peritoneum , such as from blood due to a ruptured ectopic pregnancy , can cause severe pain , tenderness , and reflexive muscle guarding in an attempt to protect the inflamed area .</li><li>• Option C. Irritation</li><li>• parietal peritoneum</li><li>• blood</li><li>• ruptured ectopic pregnancy</li><li>• severe pain</li><li>• tenderness</li><li>• reflexive muscle guarding</li><li>• protect</li><li>• inflamed area</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ First, the described situation involves hemorrhage (blood) , not pus. Pus in the pouch of Douglas typically indicates a pelvic abscess , which is a different condition. While it is true that a pelvic abscess located in the pouch of Douglas can be drained through an incision in the anterior fornix of the vagina , this is not relevant to the case described, which involves hemorrhage likely due to a ruptured ectopic pregnancy , not an abscess. Boundaries :</li><li>➤ First, the described situation involves hemorrhage (blood) , not pus. Pus in the pouch of Douglas typically indicates a pelvic abscess , which is a different condition. While it is true that a pelvic abscess located in the pouch of Douglas can be drained through an incision in the anterior fornix of the vagina , this is not relevant to the case described, which involves hemorrhage likely due to a ruptured ectopic pregnancy , not an abscess.</li><li>➤ hemorrhage (blood)</li><li>➤ Pus</li><li>➤ pouch</li><li>➤ Douglas</li><li>➤ pelvic abscess</li><li>➤ pelvic abscess</li><li>➤ pouch of Douglas</li><li>➤ drained</li><li>➤ incision</li><li>➤ anterior fornix</li><li>➤ vagina</li><li>➤ hemorrhage</li><li>➤ ruptured ectopic pregnancy</li><li>➤ Boundaries :</li><li>➤ Boundaries</li><li>➤ The Vagina forms Four Fornices around the Vaginal Part of the Cervix : Anterior , Posterior and two Laterals .</li><li>➤ The Vagina forms Four Fornices around the Vaginal Part of the Cervix : Anterior , Posterior and two Laterals .</li><li>➤ Vagina</li><li>➤ Four Fornices</li><li>➤ Vaginal Part</li><li>➤ Cervix</li><li>➤ Anterior</li><li>➤ Posterior</li><li>➤ two Laterals</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1295</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1295</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the given image, which among the following structures is not attached at the pointed area?", "options": [{"label": "A", "text": "Fallopian Tube", "correct": false}, {"label": "B", "text": "Mackenrodt's Ligament", "correct": true}, {"label": "C", "text": "Ligament of Ovary", "correct": false}, {"label": "D", "text": "Round Ligament", "correct": false}], "correct_answer": "B. Mackenrodt's Ligament", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture27_2Z9AU59.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture28_RooIu1X.jpg"], "explanation": "<p><strong>Ans. B) Mackenrodt's Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The fallopian tubes are indeed attached to the uterus . Each fallopian tube extends from the upper portion of the uterus toward the ovaries . They play a crucial role in the reproductive system , facilitating the passage of the ova (eggs) from the ovaries to the uterus .</li><li>• Option A.</li><li>• uterus</li><li>• extends</li><li>• upper portion</li><li>• uterus</li><li>• ovaries</li><li>• reproductive system</li><li>• passage</li><li>• ova (eggs)</li><li>• ovaries</li><li>• uterus</li><li>• Option C. Ligament of Ovary , also known as the ovarian ligament , it is a fibrous ligament that connects the ovary to the lateral surface of the uterus . This ligament is important in keeping the ovary in close relationship with the uterus.</li><li>• Option C.</li><li>• ,</li><li>• ovarian ligament</li><li>• fibrous ligament</li><li>• connects</li><li>• ovary</li><li>• lateral surface</li><li>• uterus</li><li>• Option D. The round ligament of the uterus is attached to the uterus, specifically at the uterine cornua . It extends from the uterus , passes through the inguinal canal , and terminates in the labia majora . It helps in maintaining the uterus in its anteverted position .</li><li>• Option D.</li><li>• uterine cornua</li><li>• extends</li><li>• uterus</li><li>• inguinal canal</li><li>• terminates</li><li>• labia majora</li><li>• maintaining</li><li>• uterus</li><li>• anteverted position</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Mackenrodt's ligament, also known as the cardinal ligament or transverse cervical ligament , is actually attached to the uterus . It extends from the side of the cervix and the vagina to the lateral pelvic wall . It is a major ligament that provides support to the uterus .</li><li>• cardinal ligament</li><li>• transverse cervical ligament</li><li>• actually</li><li>• uterus</li><li>• extends</li><li>• side</li><li>• cervix</li><li>• vagina</li><li>• lateral pelvic wall</li><li>• major ligament</li><li>• support</li><li>• uterus</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1294</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg No. 1294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old female, 38 weeks pregnant noticed decreased fetal movements. She immediately visited her obstetrician. Ultrasound revealed cord around the neck of fetus and an emergency caesarean section was planned. Which of the following statements is not true?", "options": [{"label": "A", "text": "Pfannenstiel Incision is most commonly used.", "correct": false}, {"label": "B", "text": "Rectus Abdominalis is cut Transversely.", "correct": true}, {"label": "C", "text": "Uterine Arteries arise from Internal Iliac Artery and run tortuously along the Lateral Surface of Uterus.", "correct": false}, {"label": "D", "text": "The Ureter lies 2 cm Lateral to the Supravaginal Portion of Cervix.", "correct": false}], "correct_answer": "B. Rectus Abdominalis is cut Transversely.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture29_SOiG9tl.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture30_ICxT65A.jpg"], "explanation": "<p><strong>Ans. B) Rectus abdominalis is cut transversely</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Pfannenstiel incision is a common surgical approach for cesarean sections . It is a transverse cut made just above the pubic bone and is favored due to its cosmetic results and lower risk of hernia formation post-operation .</li><li>• Option A.</li><li>• Pfannenstiel incision</li><li>• common surgical approach</li><li>• cesarean sections</li><li>• transverse cut</li><li>• above</li><li>• pubic bone</li><li>• favored</li><li>• cosmetic results</li><li>• lower risk</li><li>• hernia formation</li><li>• post-operation</li><li>• Option C. The uterine arteries are branches of the internal iliac arteries . They ascend to the uterus , supplying it with blood , and are known for their tortuous course along the organ . This is important to consider during cesarean sections to avoid vascular injury .</li><li>• Option C.</li><li>• uterine arteries</li><li>• internal iliac arteries</li><li>• ascend</li><li>• uterus</li><li>• blood</li><li>• tortuous course</li><li>• organ</li><li>• during cesarean sections</li><li>• avoid vascular injury</li><li>• Option D. The proximity of the ureters to the cervix is a critical anatomical relationship in gynecological surgery . The ureters run close to the uterus and can be at risk of injury during surgical procedures like hysterectomies and cesarean sections .</li><li>• Option D.</li><li>• proximity</li><li>• ureters</li><li>• cervix</li><li>• critical anatomical relationship</li><li>• gynecological surgery</li><li>• ureters</li><li>• close</li><li>• uterus</li><li>• risk</li><li>• injury</li><li>• surgical procedures</li><li>• hysterectomies</li><li>• cesarean sections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a Pfannenstiel incision , the skin and subcutaneous tissue are cut transversely , but the rectus abdominis muscles are not cut . Instead, they are usually separated along the midline , following the line of their fibers . This approach minimizes muscle damage and aids in better postoperative recovery .</li><li>➤ Pfannenstiel incision</li><li>➤ skin</li><li>➤ subcutaneous tissue</li><li>➤ cut transversely</li><li>➤ rectus abdominis muscles</li><li>➤ not cut</li><li>➤ midline</li><li>➤ line</li><li>➤ fibers</li><li>➤ minimizes</li><li>➤ muscle</li><li>➤ damage</li><li>➤ better postoperative recovery</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1294</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While during her night duty in the labour ward, the newly joined intern was all excited to conduct her first normal delivery of a 22-year-old primigravida. The patient was close to term and had been admitted with complaints of severe pain in the lower abdomen radiating to back and thigh. The normal delivery was conducted by the duty PG in the labour ward. As the pain progressed and the baby was about to be delivered the PG instructed and assisted the newly joined intern to make a cut in the perineum following which the baby was delivered without much struggle and then the cut edges were approximated by sutures. Which of the following is true about the procedure performed by the intern?", "options": [{"label": "A", "text": "It is called Episiotomy.", "correct": true}, {"label": "B", "text": "It is not done to prevent Overstretching and Rupture of the Perineal Muscles and Fascia.", "correct": false}, {"label": "C", "text": "Anterior Vaginal Wall is cut.", "correct": false}, {"label": "D", "text": "Posterolateral Episiotomy prevents Injury to the Rectus.", "correct": false}], "correct_answer": "A. It is called Episiotomy.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture31_ZZOHwvX.jpg"], "explanation": "<p><strong>Ans. A) It is called Episiotomy.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. It is wrong statement. An episiotomy is often performed to prevent severe tearing of the perineal muscles and fascia that might occur during childbirth . By controlling the site and extent of the incision , an episiotomy aims to reduce the risk of extensive perineal trauma .</li><li>• Option B.</li><li>• wrong</li><li>• episiotomy</li><li>• prevent</li><li>• tearing</li><li>• perineal muscles</li><li>• fascia</li><li>• during childbirth</li><li>• site</li><li>• extent</li><li>• incision</li><li>• reduce</li><li>• risk</li><li>• extensive perineal trauma</li><li>• Option C. It is wrong statement. In an episiotomy , the incision is made in the perineum , not the anterior vaginal wall. The cut usually extends from the vaginal opening towards the anus but does not involve the anterior vaginal wall.</li><li>• Option C.</li><li>• wrong</li><li>• episiotomy</li><li>• incision</li><li>• perineum</li><li>• extends</li><li>• vaginal opening</li><li>• anus</li><li>• Option D. This statement is also wrong . Mediolateral episiotomy is done, where the cut is made diagonally away from the anus , can reduce the risk of injury to the anal sphincter and rectum .</li><li>• Option D.</li><li>• wrong</li><li>• Mediolateral episiotomy</li><li>• cut</li><li>• diagonally</li><li>• away</li><li>• anus</li><li>• reduce</li><li>• risk of injury</li><li>• anal sphincter</li><li>• rectum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This statement is true . An episiotomy is a surgical cut made in the perineum — the area between the vagina and the anus — to enlarge the vaginal opening during childbirth . This procedure is performed to facilitate the delivery of the baby .</li><li>➤ This statement is true .</li><li>➤ This statement is true .</li><li>➤ true</li><li>➤ An episiotomy is a surgical cut made in the perineum — the area between the vagina and the anus — to enlarge the vaginal opening during childbirth . This procedure is performed to facilitate the delivery of the baby .</li><li>➤ An episiotomy is a surgical cut made in the perineum — the area between the vagina and the anus — to enlarge the vaginal opening during childbirth . This procedure is performed to facilitate the delivery of the baby .</li><li>➤ surgical cut</li><li>➤ perineum</li><li>➤ between</li><li>➤ vagina</li><li>➤ anus</li><li>➤ enlarge</li><li>➤ vaginal opening</li><li>➤ childbirth</li><li>➤ facilitate</li><li>➤ delivery</li><li>➤ baby</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1231</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1231</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female who was the mother of two boys was pregnant for the third time and gave birth to a girl child in normal delivery. Following which, she gave consent for the sterilization procedure and tubectomy was done successfully. Which of the following statements is not true?", "options": [{"label": "A", "text": "The Fallopian receives Blood Supply from Ovarian and Uterine Arteries.", "correct": false}, {"label": "B", "text": "During Tubectomy, Fallopian Tube is identified by its Fimbrial End.", "correct": false}, {"label": "C", "text": "The Preganglionic Sympathetic Fibres to Fallopian Tube come from T6 to T9 Segments of Spinal Cord.", "correct": true}, {"label": "D", "text": "Lymphatics from Intramural Part of Fallopian Tube drains into Superficial Inguinal Lymph Nodes.", "correct": false}], "correct_answer": "C. The Preganglionic Sympathetic Fibres to Fallopian Tube come from T6 to T9 Segments of Spinal Cord.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture32_VHgek0O.jpg"], "explanation": "<p><strong>Ans. C) The Preganglionic Sympathetic Fibres to Fallopian Tube come from T6 to T9 Segments of Spinal Cord.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The fallopian tubes receive blood supply from both the ovarian artery (which arises from the abdominal aorta ) and the uterine artery (which is a branch of the internal iliac artery ). This dual supply ensures adequate blood flow to the fallopian tubes .</li><li>• Option A.</li><li>• receive blood supply</li><li>• both</li><li>• ovarian artery</li><li>• arises</li><li>• abdominal aorta</li><li>• uterine artery</li><li>• branch</li><li>• internal iliac artery</li><li>• adequate blood flow</li><li>• fallopian tubes</li><li>• Option B. During a tubectomy , which is a procedure to cut , tie , or otherwise block the fallopian tubes ( tubal ligation ), the tubes are often identified by their fimbrial end . The fimbriae are the finger-like projections at the end of the fallopian tubes near the ovaries .</li><li>• Option B.</li><li>• tubectomy</li><li>• procedure</li><li>• cut</li><li>• tie</li><li>• otherwise block</li><li>• fallopian tubes</li><li>• tubal ligation</li><li>• identified</li><li>• fimbrial end</li><li>• finger-like projections</li><li>• end</li><li>• fallopian tubes</li><li>• ovaries</li><li>• Option D. The lymphatic drainage of the fallopian tubes primarily goes to the pelvic and para-aortic lymph nodes , not the superficial inguinal lymph nodes. The intramural part of the fallopian tube , which is the portion that passes through the uterine wall , would follow this general pattern of lymphatic drainage .</li><li>• Option D.</li><li>• lymphatic drainage</li><li>• fallopian tubes</li><li>• pelvic</li><li>• para-aortic lymph nodes</li><li>• intramural part</li><li>• fallopian tube</li><li>• uterine wall</li><li>• general pattern</li><li>• lymphatic drainage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sympathetic innervation of the fallopian tubes is not typically described as coming from the T6 to T9 spinal segments. Rather, the sympathetic fibers that innervate the pelvis , including the fallopian tubes , generally originate from the lower thoracic and upper lumbar segments ( around T10-L2 ).</li><li>➤ sympathetic fibers</li><li>➤ pelvis</li><li>➤ fallopian tubes</li><li>➤ originate</li><li>➤ lower thoracic</li><li>➤ upper lumbar segments</li><li>➤ around T10-L2</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1301</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1301</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old female from a rural area and mother to six children presented to gynec. OPD with complaints of back pain and the sensation of something “coming down” her vagina, especially when she was standing. She also complained of feeling of wetness when she coughed, sneezed, or lifted a heavy object. She also complained that her frequency to micturate has increased about fifteen times per day. Pelvic examination revealed a first degree uterine prolapse and prolapse of the bladder base. Vaginal hysterectomy and an anterior colporrhaphy were performed and the patient was subsequently relieved of her symptoms. Which of the following statements is not correct?", "options": [{"label": "A", "text": "Enterocele forms a Bulge at the Posterior Fornix.", "correct": false}, {"label": "B", "text": "Rectocele may bulge into the Lower Vagina.", "correct": false}, {"label": "C", "text": "Pubococcygeus Portion of Levator Ani assists Urinary Flow.", "correct": false}, {"label": "D", "text": "Broad Ligament is an important Uterine support to prevent Prolapse.", "correct": true}], "correct_answer": "D. Broad Ligament is an important Uterine support to prevent Prolapse.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture34_HIdeacJ.jpg"], "explanation": "<p><strong>Ans. D) Broad Ligament is an important Uterine support to prevent Prolapse.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . An enterocele is a type of pelvic organ prolapse where the small bowel descends into the lower pelvic cavity and creates a bulge in the posterior vaginal fornix . This condition usually occurs after a hysterectomy but can also be found in conjunction with other forms of prolapse.</li><li>• Option A</li><li>• pelvic organ</li><li>• small bowel</li><li>• descends</li><li>• lower pelvic cavity</li><li>• bulge</li><li>• posterior vaginal fornix</li><li>• after</li><li>• hysterectomy</li><li>• conjunction</li><li>• Option B. A rectocele occurs when the front wall of the rectum bulges into the back wall of the vagina . This usually happens due to a weakening of the supportive tissues between these two structures and is often noticeable as a bulge in the lower vagina .</li><li>• Option B.</li><li>• front wall</li><li>• rectum</li><li>• back wall</li><li>• vagina</li><li>• weakening</li><li>• supportive</li><li>• tissues</li><li>• two structures</li><li>• bulge</li><li>• lower vagina</li><li>• Option C. The pubococcygeus muscle is a part of the levator ani muscle group and plays a role in urinary continence . It supports the pelvic organs and assists in the control of urinary flow by maintaining the appropriate position and tension of the urethra . Urinary flow is controlled voluntarily by the striated urethrovaginal sphincter muscle . This action is assisted by the pubococcygeus portion ( levator prostate in the male ) of the levator ani .</li><li>• Option C.</li><li>• pubococcygeus muscle</li><li>• levator ani muscle group</li><li>• urinary continence</li><li>• supports</li><li>• pelvic organs</li><li>• assists</li><li>• control</li><li>• urinary flow</li><li>• appropriate position</li><li>• tension</li><li>• urethra</li><li>• voluntarily</li><li>• striated urethrovaginal sphincter muscle</li><li>• assisted</li><li>• pubococcygeus portion</li><li>• levator prostate</li><li>• male</li><li>• levator ani</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The broad ligament is a double layer of peritoneum that extends from the sides of the uterus to the lateral walls of the pelvis , but it does not provide significant structural support to the uterus. The primary supports of the uterus that prevent prolapse are the pelvic floor muscles ( levator ani ), uterosacral ligaments , cardinal ligaments , and the round ligaments . The broad ligament mainly serves as a mesentery for the uterus , fallopian tubes , and ovaries , but it is not a key structure in preventing uterine prolapse.</li><li>➤ double layer</li><li>➤ peritoneum</li><li>➤ extends</li><li>➤ sides</li><li>➤ uterus</li><li>➤ lateral walls</li><li>➤ pelvis</li><li>➤ prevent prolapse</li><li>➤ pelvic floor muscles</li><li>➤ levator ani</li><li>➤ uterosacral ligaments</li><li>➤ cardinal ligaments</li><li>➤ round ligaments</li><li>➤ mesentery</li><li>➤ uterus</li><li>➤ fallopian tubes</li><li>➤ ovaries</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 257</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 257</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female patient presented to gynaec OPD with complaints of irregular and painful menses, and an unexplained abdominal mass. The patient reports that she has four children. On physical examination, a large palpable, non-tender mass of 8 cm in diameter, in the lower abdomen. Bowel sounds are present and normal. An exploratory laparotomy was planned. The patient was advised that she may have to perform a hysterectomy if needed. For surgery, a midline incision up to the umbilicus was made, rectus muscles &amp; fascia were retracted. Intraoperatively, it was found that the uterus was enlarged and had large fibroid tumors. Ovaries were normal in size and morphology. Hysterectomy was performed. The excised uterus weighed in at four kilograms. Which of the following statements pertaining to the above case is not true?", "options": [{"label": "A", "text": "The Round Ligament of the Uterus needs to be cut to Excise the Uterus.", "correct": false}, {"label": "B", "text": "The Uterine Artery requires careful dissection.", "correct": false}, {"label": "C", "text": "Uterus is detached by cutting Below the Internal os of the Cervix.", "correct": true}, {"label": "D", "text": "Uterine Fibroids are Smooth Muscle Tumors of the Uterus.", "correct": false}], "correct_answer": "C. Uterus is detached by cutting Below the Internal os of the Cervix.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture35_56dl6Nb.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture36_TWLWfwD.jpg"], "explanation": "<p><strong>Ans. C) Uterus is detached by cutting Below the Internal os of the Cervix.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. During a hysterectomy , the round ligaments , which are attached to the uterus , need to be cut to remove the uterus . The round ligaments extend from the uterine cornua to the labia majora through the inguinal canal and are severed to allow for the removal of the uterus . The round ligament of the uterus , ligament of the ovary , anterior leaf of the broad ligament and the lateral attachments of the broad ligament are all cut to excise the uterus .</li><li>• Option A.</li><li>• hysterectomy</li><li>• round ligaments</li><li>• uterus</li><li>• cut</li><li>• remove</li><li>• uterus</li><li>• extend</li><li>• uterine cornua</li><li>• labia majora</li><li>• inguinal canal</li><li>• allow</li><li>• removal</li><li>• uterus</li><li>• round ligament</li><li>• uterus</li><li>• ligament</li><li>• ovary</li><li>• anterior leaf</li><li>• broad ligament</li><li>• lateral</li><li>• broad ligament</li><li>• cut</li><li>• excise</li><li>• uterus</li><li>• Option B. The uterine artery , which arises from the internal iliac artery and supplies blood to the uterus , must be carefully dissected and ligated during a hysterectomy to prevent excessive bleeding . The ureters pass under the uterine arteries on their way to the bladder , hence careful dissection of the uterine artery is essential to prevent injury to the ureter .</li><li>• Option B.</li><li>• uterine artery</li><li>• internal iliac artery</li><li>• blood</li><li>• uterus</li><li>• dissected</li><li>• ligated</li><li>• hysterectomy</li><li>• excessive bleeding</li><li>• ureters pass</li><li>• uterine arteries</li><li>• bladder</li><li>• careful dissection</li><li>• uterine artery</li><li>• prevent injury</li><li>• ureter</li><li>• Option D. Uterine fibroids, also known as leiomyomas or myomas , are benign ( non-cancerous ) tumors made up of smooth muscle cells and fibrous connective tissue . They develop in the uterus and are a common reason for performing a hysterectomy .</li><li>• Option D.</li><li>• leiomyomas</li><li>• myomas</li><li>• benign</li><li>• non-cancerous</li><li>• tumors</li><li>• smooth muscle cells</li><li>• fibrous connective tissue</li><li>• develop</li><li>• uterus</li><li>• performing</li><li>• hysterectomy</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In a total hysterectomy , the uterus is typically detached at the level of the cervix , which includes both the internal and external os . The cervix is removed along with the uterus . In a subtotal or partial hysterectomy , the uterine body is removed while leaving the cervix in place, but this does not involve cutting below the internal os.</li><li>➤ In a total hysterectomy , the uterus is typically detached at the level of the cervix , which includes both the internal and external os . The cervix is removed along with the uterus . In a subtotal or partial hysterectomy , the uterine body is removed while leaving the cervix in place, but this does not involve cutting below the internal os.</li><li>➤ total hysterectomy</li><li>➤ detached</li><li>➤ level</li><li>➤ cervix</li><li>➤ both</li><li>➤ internal</li><li>➤ external os</li><li>➤ cervix</li><li>➤ removed</li><li>➤ uterus</li><li>➤ subtotal</li><li>➤ partial hysterectomy</li><li>➤ uterine body</li><li>➤ removed</li><li>➤ leaving</li><li>➤ cervix</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 259</li><li>➤ Ref</li><li>➤ : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 259</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman pregnant with her first child had been in the second stage of labor (pushing) for several hours. The crown of the child’s head was just visible through the vaginal orifice, but the obstetrician was concerned that the woman was exhausted and was no longer able to push effectively. She decided to perform an episiotomy to enlarge the opening of the birth canal and assist the delivery of the baby. If a midline episiotomy incision were to continue tearing, all the following structures could be damaged except?", "options": [{"label": "A", "text": "Perineal Body", "correct": false}, {"label": "B", "text": "Rectum", "correct": false}, {"label": "C", "text": "Urethra", "correct": true}, {"label": "D", "text": "External Anal Sphincter", "correct": false}], "correct_answer": "C. Urethra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture37_ucaj8Oz.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture38_ix1mras.jpg"], "explanation": "<p><strong>Ans. C) Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The perineal body is a fibromuscular mass located between the vaginal orifice and the anus . It is an important structure for the integrity of the perineum and is at risk of damage if a midline episiotomy extends . Damage to the perineal body can lead to weakness of the pelvic floor and associated complications. If the incision tears further during the delivery , a median incision is more likely than a posterolateral incision to extend posteriorly through the perineal body , the external anal sphincter , the internal anal sphincter , and the rectum .</li><li>• Option A.</li><li>• fibromuscular mass</li><li>• between</li><li>• vaginal orifice</li><li>• anus</li><li>• integrity</li><li>• perineum</li><li>• risk</li><li>• damage</li><li>• midline episiotomy extends</li><li>• perineal body</li><li>• weakness</li><li>• pelvic floor</li><li>• incision tears</li><li>• during</li><li>• delivery</li><li>• median incision</li><li>• posterolateral incision</li><li>• extend posteriorly</li><li>• perineal body</li><li>• external</li><li>• anal sphincter</li><li>• internal</li><li>• sphincter</li><li>• rectum</li><li>• Option B. In cases where a midline episiotomy extends or tears further, it can potentially involve the anterior wall of the rectum . This is particularly concerning as it can lead to complications like rectovaginal fistula . Serious tears may become infected by bowel contents , as may the child as it passes through the birth canal . This may delay or impair adequate healing for the mother or even present significant health risks (i.e. septicemia ) for mother or child .</li><li>• Option B.</li><li>• midline episiotomy</li><li>• extends</li><li>• tears</li><li>• potentially</li><li>• anterior wall</li><li>• rectum</li><li>• lead</li><li>• rectovaginal fistula</li><li>• Serious tears</li><li>• infected</li><li>• bowel contents</li><li>• birth canal</li><li>• delay</li><li>• impair</li><li>• healing</li><li>• mother</li><li>• significant health risks</li><li>• septicemia</li><li>• mother</li><li>• child</li><li>• Option D. The external anal sphincter is at risk of damage if a midline episiotomy tears further. This can lead to issues with fecal incontinence if the sphincter is significantly damaged . External anal sphincter forms the posterior relation of vagina , if torn in episiotomy can later lead to faecal incontinence . The integrity of the perineal body is critical to the strength of the entire perineum in women . Unrepaired injury can cause dysfunction of the external anal sphincter , internal anal sphincter , and/or sexual dysfunction (e.g., dyspareunia ).</li><li>• Option D.</li><li>• risk</li><li>• damage</li><li>• midline episiotomy</li><li>• tears</li><li>• fecal incontinence</li><li>• sphincter</li><li>• damaged</li><li>• External anal sphincter</li><li>• posterior relation</li><li>• vagina</li><li>• torn</li><li>• episiotomy</li><li>• lead</li><li>• faecal incontinence</li><li>• integrity</li><li>• perineal body</li><li>• critical</li><li>• strength</li><li>• entire perineum</li><li>• women</li><li>• Unrepaired injury</li><li>• dysfunction</li><li>• external anal sphincter</li><li>• internal anal sphincter</li><li>• sexual dysfunction</li><li>• dyspareunia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The urethra, located anteriorly to the vaginal orifice , is generally not at risk of damage from a midline episiotomy. Midline episiotomies are made posteriorly and are aimed towards the perineum and anus . Therefore, the urethra is typically safe from damage in this scenario.</li><li>➤ anteriorly</li><li>➤ vaginal orifice</li><li>➤ Midline episiotomies</li><li>➤ posteriorly</li><li>➤ perineum</li><li>➤ anus</li><li>➤ urethra</li><li>➤ safe</li><li>➤ damage</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 225</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 225</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fertilisation occurs in which part of the Fallopian Tube?", "options": [{"label": "A", "text": "Ampulla", "correct": true}, {"label": "B", "text": "Isthmus", "correct": false}, {"label": "C", "text": "Interstitial", "correct": false}, {"label": "D", "text": "Infundibular", "correct": false}], "correct_answer": "A. Ampulla", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture39_wdvkMEe.jpg"], "explanation": "<p><strong>Ans. A) Ampulla</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The isthmus is the narrowest part of the fallopian tube , located between the ampulla and the uterine part of the tube . While sperm can pass through this area, it is less commonly the site of fertilization compared to the ampulla .</li><li>• Option B.</li><li>• narrowest part</li><li>• fallopian tube</li><li>• between</li><li>• ampulla</li><li>• uterine part</li><li>• tube</li><li>• site of fertilization</li><li>• ampulla</li><li>• Option C . Interstitial of the fallopian tube is the part that passes through the uterine wall . It connects the fallopian tube to the uterine cavity . Fertilization does not typically occur in this segment.</li><li>• Option C</li><li>• fallopian tube</li><li>• uterine wall</li><li>• connects</li><li>• fallopian tube</li><li>• uterine cavity</li><li>• Option D. The infundibulum is the funnel-shaped end of the fallopian tube near the ovary . It has finger-like projections called fimbriae , which help in capturing the released ovum from the ovary . While the infundibulum plays a crucial role in egg capture , it is not the primary site of fertilization.</li><li>• Option D.</li><li>• funnel-shaped end</li><li>• fallopian tube</li><li>• ovary</li><li>• finger-like</li><li>• projections</li><li>• fimbriae</li><li>• released ovum</li><li>• ovary</li><li>• egg capture</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ampulla is the widest section of the fallopian tube and is the usual site of fertilization . It is located between the infundibulum and the isthmus . The ampulla provides an ideal environment for the sperm to meet the ovum , and fertilization usually occurs here.</li><li>➤ widest section</li><li>➤ fallopian tube</li><li>➤ usual site</li><li>➤ fertilization</li><li>➤ infundibulum</li><li>➤ isthmus</li><li>➤ ideal environment</li><li>➤ sperm</li><li>➤ meet</li><li>➤ ovum</li><li>➤ fertilization</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 257</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 257</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incorrect statement about Levator Ani Muscle function and support:", "options": [{"label": "A", "text": "Supports Pelvic Viscera.", "correct": false}, {"label": "B", "text": "Converge Downwards and Medially.", "correct": false}, {"label": "C", "text": "Parts Iliococcygeus and Pubococcygeus", "correct": false}, {"label": "D", "text": "Attached to Pelvic Brim.", "correct": true}], "correct_answer": "D. Attached to Pelvic Brim.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture40_uu2BnJ0.jpg"], "explanation": "<p><strong>Ans. D) Attached to Pelvic Brim.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The levator ani muscle group plays a crucial role in supporting the pelvic viscera , including the bladder , intestines , and uterus in females . It forms a major part of the pelvic floor and helps maintain pelvic organ position and function . Levator ani supports pelvic viscera and counteracts downward thrust of diaphragm during increased intra-abdominal pressure .</li><li>• Option A.</li><li>• levator ani muscle group</li><li>• supporting</li><li>• pelvic viscera</li><li>• bladder</li><li>• intestines</li><li>• uterus</li><li>• females</li><li>• major part</li><li>• pelvic floor</li><li>• maintain</li><li>• pelvic organ position</li><li>• function</li><li>• pelvic viscera</li><li>• counteracts downward</li><li>• thrust</li><li>• diaphragm</li><li>• increased</li><li>• intra-abdominal pressure</li><li>• Option B. The fibers of the levator ani muscles converge towards the midline and move downwards . This orientation is important for their role in supporting the pelvic organs and maintaining continence .</li><li>• Option B.</li><li>• fibers</li><li>• levator ani muscles</li><li>• midline</li><li>• downwards</li><li>• role</li><li>• supporting</li><li>• pelvic organs</li><li>• maintaining continence</li><li>• Option C. The levator ani muscle is comprised of a few parts, with the iliococcygeus and pubococcygeus being two of them. Levator ani and coccygeus together form pelvic diaphragm . The puborectalis is another component of this muscle group. Each part has a specific role in pelvic floor function.</li><li>• Option C.</li><li>• levator ani muscle</li><li>• iliococcygeus</li><li>• pubococcygeus</li><li>• Levator ani</li><li>• coccygeus</li><li>• pelvic diaphragm</li><li>• puborectalis</li><li>• component</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The levator ani muscles are not attached to the pelvic brim. Instead, they originate from the inner surface of the pelvis , specifically from the pelvic sidewalls and areas such as the pubis and ischial spine . The pelvic brim is the edge of the pelvic inlet , which is higher up and not the point of attachment for these muscles.</li><li>➤ The levator ani muscles are not attached to the pelvic brim. Instead, they originate from the inner surface of the pelvis , specifically from the pelvic sidewalls and areas such as the pubis and ischial spine . The pelvic brim is the edge of the pelvic inlet , which is higher up and not the point of attachment for these muscles.</li><li>➤ The levator ani muscles are not attached to the pelvic brim. Instead, they originate from the inner surface of the pelvis , specifically from the pelvic sidewalls and areas such as the pubis and ischial spine . The pelvic brim is the edge of the pelvic inlet , which is higher up and not the point of attachment for these muscles.</li><li>➤ originate</li><li>➤ inner surface</li><li>➤ pelvis</li><li>➤ pelvic sidewalls</li><li>➤ areas</li><li>➤ pubis</li><li>➤ ischial spine</li><li>➤ pelvic brim</li><li>➤ edge</li><li>➤ pelvic inlet</li><li>➤ higher up</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 207</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 207</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old female presents with lower abdominal pain and discomfort. During a pelvic examination, the physician identifies tenderness and swelling in the lower lateral region of the vaginal wall. Which of the following structures is NOT typically related to the tenderness in this area?", "options": [{"label": "A", "text": "Ureter", "correct": false}, {"label": "B", "text": "Uterine Artery", "correct": false}, {"label": "C", "text": "Inferior Vesical Artery", "correct": true}, {"label": "D", "text": "Uterosacral Ligament", "correct": false}], "correct_answer": "C. Inferior Vesical Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture41.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture42.jpg"], "explanation": "<p><strong>Ans. C) Inferior Vesical Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The ureter is related to the lateral fornix , lies 2 cm lateral to the cervix . As the ureter approaches the bladder , it runs close to the cervix and the lateral fornices of the vagina . This anatomical relationship is clinically significant because surgical procedures involving the cervix or the upper vagina can put the ureters at risk of injury .</li><li>• Option A.</li><li>• lateral fornix</li><li>• 2 cm lateral</li><li>• cervix</li><li>• ureter</li><li>• approaches</li><li>• bladder</li><li>• close</li><li>• cervix</li><li>• lateral fornices</li><li>• vagina</li><li>• clinically significant</li><li>• surgical</li><li>• cervix</li><li>• upper vagina</li><li>• ureters</li><li>• injury</li><li>• Option B. The uterine artery is also related to the lateral fornix . The artery typically crosses above the ureter at the level of the internal os of the cervix , near the area of the lateral fornices . This relationship is described in surgical anatomy as the ureter being \" water under the bridge \" (the bridge being the uterine artery).</li><li>• Option B.</li><li>• lateral fornix</li><li>• artery</li><li>• crosses</li><li>• above</li><li>• ureter</li><li>• level</li><li>• internal os</li><li>• cervix</li><li>• area</li><li>• lateral fornices</li><li>• surgical anatomy</li><li>• ureter being</li><li>• water</li><li>• under the bridge</li><li>• Option D. Uterosacral Ligament are attached to the sacral vertebrae and doesnot found in broad ligament.</li><li>• Option D.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior vesical artery primarily supplies the bladder and is not directly related to the lateral fornix of the vagina. It branches from the internal iliac artery and primarily concerns the bladder and in males , the prostate .</li><li>➤ inferior vesical</li><li>➤ artery</li><li>➤ bladder</li><li>➤ branches</li><li>➤ internal iliac artery</li><li>➤ bladder</li><li>➤ males</li><li>➤ prostate</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female presents with severe pelvic pain and discomfort. During the physical examination, the physician notes tenderness in the lower abdomen and pelvic region. Imaging studies reveal an abnormality within the broad ligament. Which of the following structures is NOT typically found within the broad ligament?", "options": [{"label": "A", "text": "Ovary", "correct": true}, {"label": "B", "text": "Round Ligament", "correct": false}, {"label": "C", "text": "Ovarian Ligament", "correct": false}, {"label": "D", "text": "Round Ligament", "correct": false}], "correct_answer": "A. Ovary", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture43.jpg"], "explanation": "<p><strong>Ans. A) Ovary</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The round ligament of the uterus is indeed a content of the broad ligament . It runs within the broad ligament from the uterine horns to the labia majora , passing through the inguinal canal .</li><li>• Option B.</li><li>• round ligament</li><li>• broad ligament</li><li>• broad ligament</li><li>• uterine horns</li><li>• labia majora</li><li>• inguinal canal</li><li>• Option C. The ovarian ligament, which connects the ovaries to the uterus , is also contained within the broad ligament . It is a fibrous ligament that anchors the ovary to the lateral surface of the uterus .</li><li>• Option C.</li><li>• connects</li><li>• ovaries</li><li>• uterus</li><li>• broad ligament</li><li>• fibrous ligament</li><li>• anchors</li><li>• ovary</li><li>• lateral surface</li><li>• uterus</li><li>• Option D. This is also correct . The round ligament is a content of the broad ligament .</li><li>• Option D.</li><li>• correct</li><li>• broad ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The ovary is not a content of the broad ligament . The broad ligament is a fold of peritoneum that extends from the sides of the uterus to the lateral walls and floor of the pelvis . While it is associated with the ovaries, as it contains the mesovarium (the part of the broad ligament that attaches to the ovaries ), the ovaries themselves are not enclosed within the broad ligament.</li><li>➤ not</li><li>➤ content</li><li>➤ broad ligament</li><li>➤ fold</li><li>➤ peritoneum</li><li>➤ extends</li><li>➤ sides</li><li>➤ uterus</li><li>➤ lateral walls</li><li>➤ floor</li><li>➤ pelvis</li><li>➤ mesovarium</li><li>➤ part</li><li>➤ broad ligament</li><li>➤ attaches</li><li>➤ ovaries</li><li>➤ Contents of Broad Ligament:</li><li>➤ Uterine tube except intramural part Proximal part of round ligament Ligament of ovary Ovarian vessels Uterine vessels Tubules and ductules of epoophoron Tubules of paroophoron Lymphatics, nerves, accessory suprarenal tissue</li><li>➤ Uterine tube except intramural part</li><li>➤ Proximal part of round ligament</li><li>➤ Ligament of ovary</li><li>➤ Ovarian vessels</li><li>➤ Uterine vessels</li><li>➤ Tubules and ductules of epoophoron</li><li>➤ Tubules of paroophoron</li><li>➤ Lymphatics, nerves, accessory suprarenal tissue</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 262</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 262</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female presents with complaints of lower abdominal pain and discomfort. She describes the pain as sharp and constant, predominantly on her right side. During the physical examination, she mentions tenderness in the lower abdomen, and the physician suspects ovarian pathology. Which of the following regions is most commonly associated with referred pain in cases of ovarian pathology?", "options": [{"label": "A", "text": "Back of Thigh", "correct": false}, {"label": "B", "text": "Anterior Thigh", "correct": false}, {"label": "C", "text": "Medial Thigh", "correct": true}, {"label": "D", "text": "Gluteal Region", "correct": false}], "correct_answer": "C. Medial Thigh", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-110430.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture44.jpg"], "explanation": "<p><strong>Ans. C) Medial Thigh</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Lateral surface of Ovary rests on ovarian fossa , the floor of which is related to the obturator nerve beneath the peritoneum. Obturator nerve innervates muscles in the medial compartment of thigh and also skin over medial aspect of thigh . Hence, ovarian pathology is referred to the medial thigh . Pain from ovarian pathology is typically referred to the medial thigh . This referred pain occurs due to the shared nerve supply between the ovaries and the dermatomes of the medial thigh . The ovarian and pelvic structures are primarily innervated by the T10-L1 spinal segments. The obturator nerve , which innervates the medial aspect of the thigh , arises from the lumbar plexus formed by the L2-L4 nerve roots . Due to the overlap in this nerve supply, pain originating from the ovaries can be perceived in the medial thigh region .</li><li>• Lateral surface of Ovary rests on ovarian fossa , the floor of which is related to the obturator nerve beneath the peritoneum. Obturator nerve innervates muscles in the medial compartment of thigh and also skin over medial aspect of thigh . Hence, ovarian pathology is referred to the medial thigh .</li><li>• Lateral surface</li><li>• ovarian fossa</li><li>• floor</li><li>• obturator nerve</li><li>• Obturator nerve</li><li>• muscles</li><li>• medial compartment</li><li>• thigh</li><li>• skin</li><li>• medial aspect</li><li>• thigh</li><li>• medial thigh</li><li>• Pain from ovarian pathology is typically referred to the medial thigh . This referred pain occurs due to the shared nerve supply between the ovaries and the dermatomes of the medial thigh . The ovarian and pelvic structures are primarily innervated by the T10-L1 spinal segments.</li><li>• Pain</li><li>• ovarian pathology</li><li>• medial thigh</li><li>• shared nerve supply</li><li>• ovaries</li><li>• dermatomes</li><li>• medial thigh</li><li>• ovarian</li><li>• pelvic</li><li>• innervated</li><li>• T10-L1 spinal segments.</li><li>• The obturator nerve , which innervates the medial aspect of the thigh , arises from the lumbar plexus formed by the L2-L4 nerve roots . Due to the overlap in this nerve supply, pain originating from the ovaries can be perceived in the medial thigh region .</li><li>• obturator nerve</li><li>• innervates</li><li>• medial aspect</li><li>• thigh</li><li>• lumbar plexus</li><li>• L2-L4 nerve roots</li><li>• overlap</li><li>• pain</li><li>• ovaries</li><li>• perceived</li><li>• medial thigh region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Boundaries of Ovarian Fossa :</li><li>➤ Boundaries</li><li>➤ Ovarian Fossa</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li><li>➤ Ref</li><li>➤ : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female presents with severe pelvic pain and discomfort on her right side. She describes the pain as sharp and radiating towards her lower abdomen. During the physical examination, the physician suspects an issue within the ovarian fossa. Which of the following structures does NOT contribute to the formation of the ovarian fossa?", "options": [{"label": "A", "text": "Obliterated Umbilical Artery.", "correct": false}, {"label": "B", "text": "Internal Iliac Artery", "correct": false}, {"label": "C", "text": "Ureter", "correct": false}, {"label": "D", "text": "Round Ligament", "correct": true}], "correct_answer": "D. Round Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture45_Tfol98k.jpg"], "explanation": "<p><strong>Ans. D) Round Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The obliterated umbilical artery, also known as the medial umbilical ligament forms the anterosuperior relation for ovarian fossa . It is a remnant of the fetal umbilical artery and runs from the anterior abdominal wall to the umbilicus . It is not directly related to the ovarian fossa.</li><li>• Option A.</li><li>• medial umbilical ligament</li><li>• anterosuperior relation</li><li>• ovarian fossa</li><li>• remnant</li><li>• fetal umbilical artery</li><li>• anterior abdominal wall</li><li>• umbilicus</li><li>• Option B. The internal iliac artery is indeed related to the ovarian fossa . The ovarian fossa is bounded posteriorly by the internal iliac artery and its branches . The location of the fossa is just medial to where the internal iliac artery bifurcates into its anterior and posterior divisions .</li><li>• Option B.</li><li>• ovarian fossa</li><li>• posteriorly</li><li>• internal iliac artery</li><li>• branches</li><li>• location</li><li>• fossa</li><li>• medial</li><li>• internal iliac artery</li><li>• bifurcates</li><li>• anterior</li><li>• posterior divisions</li><li>• Option C. The ureter is also related to the ovarian fossa . The fossa is located anterior to the ureter . The relationship of the ovary to the ureter is clinically significant, particularly during surgical procedures in the pelvic area . Obturator nerve lies on the lateral wall/floor of ovarian fossa .</li><li>• Option C.</li><li>• ovarian fossa</li><li>• anterior</li><li>• ureter</li><li>• surgical procedures</li><li>• pelvic area</li><li>• Obturator nerve</li><li>• lateral wall/floor</li><li>• ovarian fossa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The round ligament of the uterus does not form a boundary of the ovarian fossa. The round ligament extends from the uterus , passes through the inguinal canal , and ends in the labia majora . It is not involved in the formation of the ovarian fossa.</li><li>➤ round ligament</li><li>➤ uterus</li><li>➤ inguinal canal</li><li>➤ ends</li><li>➤ labia majora</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lymph nodes draining the Upper Part of Vagina and Cervix are?", "options": [{"label": "A", "text": "Para Aortic", "correct": false}, {"label": "B", "text": "External Iliac", "correct": true}, {"label": "C", "text": "Superficial Inguinal", "correct": false}, {"label": "D", "text": "Deep Inguinal", "correct": false}], "correct_answer": "B. External Iliac", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture46.jpg"], "explanation": "<p><strong>Ans. B) External Iliac</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Para -aortic Lymph Nodes, located near the aorta , are indeed involved in the drainage of the cervix , particularly the upper part . They are a common site for metastasis in cases of cervical cancer . However, they are more commonly associated with the drainage of the fundus of the uterus rather than the upper part of the vagina .</li><li>• Option A.</li><li>• Para</li><li>• aorta</li><li>• drainage</li><li>• cervix</li><li>• upper part</li><li>• metastasis</li><li>• cervical cancer</li><li>• drainage</li><li>• fundus</li><li>• uterus</li><li>• upper part</li><li>• vagina</li><li>• Option C. Superficial Inguinal Lymph Nodes drain the lower extremities , the lower abdominal wall , and external genitalia including the lower part of the vagina . They are not primarily involved in the drainage of the upper part of the vagina or the cervix. Few lymphatics from the lateral angle of the uterus drain into superficial inguinal lymph nodes .</li><li>• Option C.</li><li>• lower extremities</li><li>• lower abdominal wall</li><li>• external genitalia</li><li>• lower part</li><li>• vagina</li><li>• Few lymphatics</li><li>• lateral angle</li><li>• uterus</li><li>• superficial inguinal lymph nodes</li><li>• Option D. Deep Inguinal Lymph Nodes, located deeper in the groin under the fascia , primarily drain the lower extremities , external genitalia , and lower part of the vagina , similar to the superficial inguinal nodes . They are not the primary nodes for drainage of the cervix or upper part of the vagina.</li><li>• Option D.</li><li>• deeper</li><li>• groin</li><li>• fascia</li><li>• drain</li><li>• lower extremities</li><li>• external genitalia</li><li>• lower part</li><li>• vagina</li><li>• superficial inguinal nodes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ External Iliac Lymph Nodes are primarily responsible for the lymphatic drainage of the upper part of the vagina and the cervix . They are situated along the external iliac vessels and are a key group in the pelvic lymphatic system . In cases of cervical and upper vaginal cancers , these nodes are often evaluated for metastasis .</li><li>➤ lymphatic drainage</li><li>➤ upper part</li><li>➤ vagina</li><li>➤ cervix</li><li>➤ external iliac vessels</li><li>➤ pelvic lymphatic system</li><li>➤ cervical</li><li>➤ upper vaginal cancers</li><li>➤ evaluated</li><li>➤ metastasis</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 269</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 269</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Secondary support of the Uterus is?", "options": [{"label": "A", "text": "Mackenrodt Ligament", "correct": false}, {"label": "B", "text": "Uterosacral Ligament", "correct": false}, {"label": "C", "text": "Round Ligament", "correct": false}, {"label": "D", "text": "Broad Ligament", "correct": true}], "correct_answer": "D. Broad Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-110616.jpg"], "explanation": "<p><strong>Ans. D) Broad Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Mackenrodt Ligament, Also known as the cardinal ligament , is a primary support of the uterus . It extends from the cervix to the lateral walls of the pelvis and is one of the key structures in maintaining the position of the uterus .</li><li>• Option A.</li><li>• cardinal ligament</li><li>• uterus</li><li>• extends</li><li>• cervix</li><li>• lateral walls</li><li>• pelvis</li><li>• maintaining</li><li>• position</li><li>• uterus</li><li>• Option B. The uterosacral ligament is also considered a primary support of the uterus . It extends from the cervix to the sacrum and helps to maintain the uterus in its normal anteverted position .</li><li>• Option B.</li><li>• primary support</li><li>• uterus</li><li>• extends</li><li>• cervix</li><li>• sacrum</li><li>• uterus</li><li>• normal anteverted position</li><li>• Option C. The round ligament of the uterus runs from the uterine horns through the inguinal canal to the labia majora . It is considered a secondary support of the uterus . The round ligament plays a role in maintaining the anteverted position of the uterus but is not as significant in terms of overall support as the primary ligaments like the cardinal or uterosacral ligaments.</li><li>• Option C.</li><li>• uterine horns</li><li>• inguinal canal</li><li>• labia majora</li><li>• secondary support</li><li>• uterus</li><li>• anteverted position</li><li>• uterus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The broad ligament is a double layer of peritoneum that extends from the sides of the uterus to the lateral walls and floor of the pelvis . It encloses the fallopian tubes , ovaries , and related structures. While the broad ligament is associated with the uterus , it is not considered a significant structural support. It is more of a mesentery that provides a pathway for blood vessels and nerves to the uterus and other pelvic structures.</li><li>➤ double layer</li><li>➤ peritoneum</li><li>➤ extends</li><li>➤ sides</li><li>➤ uterus</li><li>➤ lateral walls</li><li>➤ floor</li><li>➤ pelvis</li><li>➤ encloses</li><li>➤ fallopian tubes</li><li>➤ ovaries</li><li>➤ uterus</li><li>➤ mesentery</li><li>➤ pathway</li><li>➤ blood vessels</li><li>➤ nerves</li><li>➤ uterus</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol. II, Abdomen, Pg. 273</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3rd Edition, Vol. II, Abdomen, Pg. 273</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents with complaints of pain and discomfort in her perineal region. She reports sharp pain during urination and difficulty controlling her urine flow. The physician suspects an issue in the superficial perineal pouch. Which of the following structures is NOT typically found within the superficial perineal pouch in females and may not contribute to the patient's symptoms?", "options": [{"label": "A", "text": "Root of Clitoris", "correct": false}, {"label": "B", "text": "Dorsal Artery of Clitoris", "correct": false}, {"label": "C", "text": "Perineal Nerve", "correct": false}, {"label": "D", "text": "Sphincter Urethrae Muscle", "correct": true}], "correct_answer": "D. Sphincter Urethrae Muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture47.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-110806.jpg"], "explanation": "<p><strong>Ans. D) Sphincter Urethrae Muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The root of the clitoris is indeed a content of the superficial perineal pouch . It includes the crura of the clitoris and the bulbs of the vestibule , which are covered by the ischiocavernosus and bulbospongiosus muscles , respectively.</li><li>• Option A.</li><li>• root</li><li>• clitoris</li><li>• superficial perineal pouch</li><li>• crura</li><li>• clitoris</li><li>• bulbs</li><li>• vestibule</li><li>• ischiocavernosus</li><li>• bulbospongiosus muscles</li><li>• Option B. The dorsal artery of the clitoris, a branch of the internal pudendal artery , is also located in the superficial perineal pouch . This artery supplies blood to the clitoris .</li><li>• Option B.</li><li>• internal pudendal artery</li><li>• superficial perineal pouch</li><li>• blood</li><li>• clitoris</li><li>• Option C. The perineal nerve, a branch of the pudendal nerve , is present in the superficial perineal pouch . It provides sensory innervation to the perineal area and motor innervation to the muscles in the superficial and deep perineal pouches .</li><li>• Option C.</li><li>• branch</li><li>• pudendal nerve</li><li>• superficial perineal pouch</li><li>• sensory innervation</li><li>• perineal area</li><li>• motor innervation</li><li>• muscles</li><li>• superficial</li><li>• deep perineal</li><li>• pouches</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sphincter urethrae muscle , or the external urethral sphincter , is not located in the superficial perineal pouch. It is a part of the deep perineal pouch . This muscle is responsible for voluntary control of urination .</li><li>➤ sphincter urethrae muscle</li><li>➤ external urethral sphincter</li><li>➤ deep perineal pouch</li><li>➤ voluntary control</li><li>➤ urination</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 222</li><li>➤ Ref</li><li>➤ : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female presents with a bulge and discomfort in her lower abdomen. She reports a sensation of something protruding in the area. During the physical examination, the physician suspects an issue related to the inguinal canal. Which of the following structures typically does NOT pass through the inguinal canal in females and may not contribute to the patient's symptoms?", "options": [{"label": "A", "text": "Ilioinguinal Nerve", "correct": false}, {"label": "B", "text": "Round Ligament of Uterus", "correct": false}, {"label": "C", "text": "Lymphatics from Uterus", "correct": false}, {"label": "D", "text": "Inferior Epigastric Artery", "correct": true}], "correct_answer": "D. Inferior Epigastric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture48.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-110907.jpg"], "explanation": "<p><strong>Ans. D) Inferior Epigastric Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The ilioinguinal nerve does pass through the inguinal canal . It is a branch of the first lumbar nerve (L1) and provides sensory innervation to the skin of the lower part of the abdomen , upper medial thigh , and external genitalia .</li><li>• Option A.</li><li>• inguinal canal</li><li>• branch</li><li>• first lumbar nerve (L1)</li><li>• sensory innervation</li><li>• skin</li><li>• lower part</li><li>• abdomen</li><li>• upper medial thigh</li><li>• external genitalia</li><li>• Option B. The round ligament of the uterus indeed passes through the inguinal canal in females . It is a structure that extends from the uterine horns , passes through the inguinal canal , and ends in the labia majora .</li><li>• Option B.</li><li>• inguinal canal</li><li>• females</li><li>• extends</li><li>• uterine horns</li><li>• inguinal canal</li><li>• ends</li><li>• labia majora</li><li>• Option C. Lymphatic vessels from the uterus do pass through the inguinal canal . These lymphatics are particularly involved in the lymphatic drainage of the lower part of the uterus and are important in the context of the spread of certain types of uterine cancers.</li><li>• Option C.</li><li>• inguinal canal</li><li>• lymphatic drainage</li><li>• lower part</li><li>• uterus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior epigastric artery does not pass through the inguinal canal. It arises from the external iliac artery just above the inguinal ligament and ascends along the posterior surface of the rectus abdominis muscle . It is located in the abdominal wall and is not a content of the inguinal canal.</li><li>➤ arises</li><li>➤ external iliac</li><li>➤ artery</li><li>➤ above</li><li>➤ inguinal ligament</li><li>➤ ascends</li><li>➤ posterior surface</li><li>➤ rectus abdominis muscle</li><li>➤ abdominal wall</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 48</li><li>➤ Ref : Vishram Singh, Textbook of Anatomy, 3 rd Edition, Vol. II, Abdomen, Pg. 48</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 64-year-old known case of benign prostate hypertrophy experienced difficulty in micturition. On examination the lower abdomen was distended. Ultrasound abdomen showed a distended urinary bladder. Following failure of transurethral catheterization, the surgeon decided on percutaneous cystostomy. Which of the following statements is not correct in the above scenario?", "options": [{"label": "A", "text": "Posterior Approach to the Bladder can injure the Rectum.", "correct": false}, {"label": "B", "text": "Lateral Approach to the Bladder does not Damage Vascular Structures.", "correct": true}, {"label": "C", "text": "Suprapubic Cystostomy provides an Extraperitoneal Approach.", "correct": false}, {"label": "D", "text": "Apex of the Bladder gives attachment to Median Umbilical Ligament.", "correct": false}], "correct_answer": "B. Lateral Approach to the Bladder does not Damage Vascular Structures.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture49.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture50.jpg"], "explanation": "<p><strong>Ans. B) Lateral Approach to the Bladder does not Damage Vascular Structures.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A posterior approach to the bladder carries a risk of damaging the rectum . The rectum is located posteriorly to the bladder , and care must be taken to avoid rectal injury during any surgical intervention in this area.</li><li>• Option A.</li><li>• posterior approach</li><li>• bladder</li><li>• risk</li><li>• damaging</li><li>• rectum</li><li>• posteriorly</li><li>• bladder</li><li>• avoid rectal injury</li><li>• any surgical intervention</li><li>• Option C. A suprapubic cystostomy is performed above the pubic symphysis and allows access to the bladder without entering the peritoneal cavity , making it an extraperitoneal approach . This reduces the risk of intra-abdominal organ injury .</li><li>• Option C.</li><li>• suprapubic cystostomy</li><li>• above</li><li>• pubic symphysis</li><li>• allows access</li><li>• without</li><li>• entering</li><li>• peritoneal cavity</li><li>• extraperitoneal approach</li><li>• reduces</li><li>• risk</li><li>• intra-abdominal organ injury</li><li>• Option D. The apex of the bladder is connected to the umbilicus by the median umbilical ligament , which is a remnant of the urachus , a structure present during fetal development .</li><li>• Option D.</li><li>• connected</li><li>• umbilicus</li><li>• median umbilical ligament</li><li>• remnant</li><li>• urachus</li><li>• during fetal development</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral approach to the bladder does pose a risk to vascular structures . The internal iliac vessels and their branches, including the superior and inferior vesical arteries , are in close proximity to the bladder and can be damaged during a lateral approach . Hence, surgeons must be cautious of these vascular structures during the procedure.</li><li>➤ lateral approach</li><li>➤ bladder</li><li>➤ risk</li><li>➤ vascular structures</li><li>➤ internal iliac vessels</li><li>➤ superior</li><li>➤ inferior vesical arteries</li><li>➤ proximity</li><li>➤ bladder</li><li>➤ damaged</li><li>➤ lateral approach</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No.1255</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No.1255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male was posted for total hip replacement surgery following a road traffic accident.The newly joined staff nurse was instructed to catheterize the patient before surgery. The foley’s catheter was then successfully inserted and urine started to flow into the bag. Which of the following statements regarding the above procedure is incorrect?", "options": [{"label": "A", "text": "The Penis should be held at a 90 Degree and Catheter advanced into the External Urethral Meatus.", "correct": false}, {"label": "B", "text": "Maximum Resistance is encountered at the External Urethral Meatus.", "correct": false}, {"label": "C", "text": "The Catheter should be inserted Gently and should be kept as close as possible to the Roof of Navicular Fossa.", "correct": true}, {"label": "D", "text": "Membranous Urethra is the most fixed part of Male Urethra.", "correct": false}], "correct_answer": "C. The Catheter should be inserted Gently and should be kept as close as possible to the Roof of Navicular Fossa.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture51.jpg"], "explanation": "<p><strong>Ans. C) The Catheter should be inserted Gently and should be kept as close as possible to the Roof of Navicular Fossa.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . When inserting a catheter in a male , the penis should be held perpendicular to the body (at a 90-degree angle ) to straighten the natural S-curve of the urethra . This positioning facilitates easier insertion of the catheter.</li><li>• Option A.</li><li>• correct</li><li>• inserting</li><li>• catheter</li><li>• male</li><li>• penis</li><li>• perpendicular</li><li>• body</li><li>• 90-degree angle</li><li>• straighten</li><li>• natural S-curve</li><li>• urethra</li><li>• facilitates easier</li><li>• insertion</li><li>• catheter.</li><li>• Option B. This statement is generally correct . The narrowest part of the male urethra is typically the external urethral meatus , and resistance can be encountered at this point during catheterization . Care must be taken to gently navigate the catheter through this area.</li><li>• Option B.</li><li>• correct</li><li>• narrowest part</li><li>• male urethra</li><li>• external urethral meatus</li><li>• resistance</li><li>• encountered</li><li>• catheterization</li><li>• gently navigate</li><li>• catheter</li><li>• Option D. This statement is correct . The membranous urethra is the shortest and least dilatable part of the urethra , and it passes through the urogenital diaphragm . It is relatively fixed in position compared to the other parts of the urethra .</li><li>• Option D.</li><li>• correct</li><li>• membranous urethra</li><li>• shortest</li><li>• dilatable part</li><li>• urethra</li><li>• urogenital diaphragm</li><li>• fixed</li><li>• other parts</li><li>• urethra</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The navicular fossa is part of the anterior urethra . When inserting a catheter , there is no specific requirement or recommendation to keep the catheter close to the roof of the navicular fossa . The catheter should be inserted gently and smoothly without forcing it, following the natural course of the urethra .</li><li>➤ navicular fossa</li><li>➤ anterior urethra</li><li>➤ inserting</li><li>➤ catheter</li><li>➤ catheter close</li><li>➤ roof</li><li>➤ navicular fossa</li><li>➤ inserted gently</li><li>➤ smoothly</li><li>➤ natural course</li><li>➤ urethra</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No: 1261</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No: 1261</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old boy felt a sudden severe pain over his left scrotum. On examination in surgery OPD swelling and redness were noticed on left side of his scrotum, firm &amp; tender left testicle higher than the right side. Scrotal ultrasound showed decreased flow on the left side, left testis hypoechoic and swollen. Which of the following statement is not true?", "options": [{"label": "A", "text": "The Diagnosis is Torsion of Left Side Testis.", "correct": false}, {"label": "B", "text": "Torsion will compress the Sympathetic and cause Severe Pain.", "correct": true}, {"label": "C", "text": "Torsion may occur in Either Clockwise or Anticlockwise Direction.", "correct": false}, {"label": "D", "text": "The Spermatic Cord on the Left Side is Longer than the Right.", "correct": false}], "correct_answer": "B. Torsion will compress the Sympathetic and cause Severe Pain.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture52.jpg"], "explanation": "<p><strong>Ans. B) Torsion will compress the Sympathetic and cause Severe Pain.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The clinical presentation and ultrasound findings are consistent with testicular torsion , a urological emergency where the spermatic cord twists , cutting off blood supply to the testis .</li><li>• Option A.</li><li>• testicular torsion</li><li>• urological emergency</li><li>• spermatic cord twists</li><li>• cutting off blood supply</li><li>• testis</li><li>• Option C. Testicular torsion can occur in either direction – clockwise or anticlockwise . The direction of the torsion is not predictive of the outcome and does not change the urgency or treatment approach.</li><li>• Option C. Testicular torsion</li><li>• either direction</li><li>• clockwise</li><li>• anticlockwise</li><li>• Option D. While there can be individual variations in the length of the spermatic cord on either side , there is no established rule or tendency for the left spermatic cord to be longer than the right. Testicular torsion can occur on either side regardless of the length of the spermatic cord .</li><li>• Option D.</li><li>• length</li><li>• spermatic cord</li><li>• either side</li><li>• Testicular torsion</li><li>• either side</li><li>• regardless</li><li>• length</li><li>• spermatic cord</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Testicular torsion causes severe pain primarily due to ischemia ( lack of blood supply ) and subsequent infarction of the testicular tissue , not due to compression of the sympathetic nerves. The pain is acute and severe due to the sudden loss of blood supply and resultant damage to the testicular tissue .</li><li>➤ severe pain</li><li>➤ ischemia</li><li>➤ lack of blood supply</li><li>➤ subsequent infarction</li><li>➤ testicular tissue</li><li>➤ acute</li><li>➤ severe</li><li>➤ sudden loss</li><li>➤ blood supply</li><li>➤ resultant damage</li><li>➤ testicular tissue</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1272</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1272</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 90-day old male baby was brought to the paediatric OPD by an anxious mother who had noticed that the right scrotum of the boy was empty. On examination the left testis was present in the scrotum. A small swelling was noticed in the right inguinal region.Ultrasound examination confirmed the presence of right testis in inguinal canal. Which of the following statements is not true?", "options": [{"label": "A", "text": "The Diagnosis in this case is Undescended Testis.", "correct": false}, {"label": "B", "text": "Processus Vaginalis forms the Tunica Vaginalis at its Distal End.", "correct": false}, {"label": "C", "text": "Gubernaculum Testis forms the Fundiform Ligament.", "correct": true}, {"label": "D", "text": "Lymphatics of Testis drain into Para-Aortic Nodes.", "correct": false}], "correct_answer": "C. Gubernaculum Testis forms the Fundiform Ligament.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture53.jpg"], "explanation": "<p><strong>Ans. C) Gubernaculum Testis forms the Fundiform Ligament.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The clinical presentation of an empty scrotum with the testis located in the inguinal canal on ultrasound examination is consistent with an undescended testis ( cryptorchidism ). This condition occurs when one or both testes fail to descend into the scrotum .</li><li>• Option A.</li><li>• empty scrotum</li><li>• testis</li><li>• inguinal canal</li><li>• undescended testis</li><li>• cryptorchidism</li><li>• one</li><li>• both testes</li><li>• fail</li><li>• descend</li><li>• scrotum</li><li>• Option B. The processus vaginalis is an embryonic developmental outpouching of the peritoneum . As it descends into the scrotum , it forms the tunica vaginalis , which is the serous covering of the testis .</li><li>• Option B.</li><li>• processus vaginalis</li><li>• embryonic developmental</li><li>• outpouching</li><li>• peritoneum</li><li>• descends</li><li>• scrotum</li><li>• forms</li><li>• tunica vaginalis</li><li>• serous</li><li>• testis</li><li>• Option D. The lymphatics of the testis drain primarily into the para-aortic lymph nodes . This drainage pattern is clinically significant, particularly in the context of testicular cancer spread .</li><li>• Option D.</li><li>• lymphatics</li><li>• testis</li><li>• para-aortic lymph nodes</li><li>• context</li><li>• testicular cancer</li><li>• spread</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The gubernaculum testis is an embryological structure that guides the descent of the testis into the scrotum . In adults , the remnants of the gubernaculum exist as the scrotal ligament in males . The fundiform ligament , on the other hand, is derived from the lower abdominal subcutaneous tissue and is not formed from the gubernaculum. It's a supportive structure for the penis .</li><li>➤ gubernaculum testis</li><li>➤ embryological structure</li><li>➤ guides</li><li>➤ descent</li><li>➤ testis</li><li>➤ scrotum</li><li>➤ adults</li><li>➤ remnants</li><li>➤ gubernaculum exist</li><li>➤ scrotal ligament</li><li>➤ males</li><li>➤ fundiform ligament</li><li>➤ lower abdominal</li><li>➤ subcutaneous tissue</li><li>➤ supportive structure</li><li>➤ penis</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1285</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1285</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old male presents to the E.R. after a motorcycle vs. car accident. The patient is awake and alert, and reports pain in his abdomen and pelvis. On physical examination you note that his vital signs are heart rate 120, blood pressure 120/60, respiratory rate 30. Examination also reveals abrasions on his abdominal wall surface and no signs or presence of blood on his external urethral meatus. Palpation reveals generalized tenderness over the entire abdominal region. In addition, the patient shows particular discomfort when you attempt to assess the stability of his pelvis by placing your hands over his pubic symphysis and laterally applying pressure over the iliac blades. He does not have full hip extension and rotation when you assess his mobility while lying on the exam table. Rectal exam is negative for gross blood, and the patient has a normally placed prostate. X-Rays of the pelvis in 3 planes (AP, lateral, and oblique views) was ordered to determine if the patient has a fractured pelvis and a flat plate of the abdomen to determine if the patient has free air in his abdomen. A diagnostic supraumbilical peritoneal lavage turns out negative. The patient was diagnosed with a pelvic fracture, complicated by internal bleeding. Angiography showed a laceration of the internal pudendal artery, and a selective embolization is performed. External fixation of the pelvis is performed after the bleeding has been stabilized. Which of the following statements pertaining to the above case is not true?", "options": [{"label": "A", "text": "Stability of the Pelvic Ring is based in Large Part by Ligamentous attachments", "correct": false}, {"label": "B", "text": "The Internal Iliac Artery is known as the “Pelvic Artery”", "correct": false}, {"label": "C", "text": "Chance of Injury to Membranous or Spongy Urethra should be excluded", "correct": false}, {"label": "D", "text": "Internal Iliac Artery forms the Anterior Boundary of Ovarian Fossa in a Female", "correct": true}], "correct_answer": "D. Internal Iliac Artery forms the Anterior Boundary of Ovarian Fossa in a Female", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture54.jpg"], "explanation": "<p><strong>Ans. D) Internal Iliac Artery forms the Anterior Boundary of Ovarian Fossa in a Female</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The stability of the pelvic ring is indeed largely dependent on its ligamentous attachments . Anteriorly , the pubic portions are joined by the pubic symphysis and posteriorly they are attached to the sacrum by strong posterior and anterior sacroiliac ligament . These ligamentous attachments themselves can be displaced.</li><li>• Option A.</li><li>• ligamentous attachments</li><li>• Anteriorly</li><li>• pubic symphysis</li><li>• posteriorly</li><li>• sacrum</li><li>• strong posterior</li><li>• anterior sacroiliac ligament</li><li>• ligamentous</li><li>• attachments</li><li>• Option B . The internal iliac artery , also known as the hypogastric artery , is commonly referred to as the pelvic artery . It is a major artery supplying blood to the pelvic organs , gluteal region , and perineum , it divides into anterior and posterior division to provide the blood supply to most of the pelvic structures .</li><li>• Option B</li><li>• internal iliac artery</li><li>• hypogastric artery</li><li>• pelvic artery</li><li>• blood</li><li>• pelvic organs</li><li>• gluteal region</li><li>• perineum</li><li>• anterior</li><li>• posterior division</li><li>• blood supply</li><li>• pelvic structures</li><li>• Option C. In the setting of a pelvic fracture , particularly with reported abdominal pain and discomfort upon pelvic manipulation, it is important to consider and exclude the possibility of urethral injury . The membranous and spongy (penile) parts of the urethra are vulnerable in pelvic fractures .</li><li>• Option C.</li><li>• pelvic fracture</li><li>• reported abdominal pain</li><li>• discomfort</li><li>• consider</li><li>• exclude</li><li>• possibility</li><li>• urethral injury</li><li>• membranous</li><li>• spongy (penile) parts</li><li>• urethra</li><li>• vulnerable</li><li>• pelvic fractures</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The ovarian fossa is a shallow depression on the lateral wall of the pelvis in females , located posterior to the internal iliac artery , not anterior. Therefore, the internal iliac artery actually forms part of the posterior boundary of the ovarian fossa , not the anterior boundary.</li><li>• ovarian fossa</li><li>• shallow depression</li><li>• lateral wall</li><li>• pelvis</li><li>• females</li><li>• posterior</li><li>• internal iliac artery</li><li>• internal iliac artery</li><li>• posterior boundary</li><li>• ovarian fossa</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 254</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 254</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with urinary symptoms such as frequent urination and difficulty initiating urination. The physician performs a per rectal examination to assess the patient's condition. During the examination, certain structures are palpated. Which of the following structures is typically NOT felt with a per rectal examination in males and may not be relevant to the patient's urinary symptoms?", "options": [{"label": "A", "text": "Anorectal Ring", "correct": false}, {"label": "B", "text": "Prostate", "correct": false}, {"label": "C", "text": "Ureter", "correct": true}, {"label": "D", "text": "Bulb of Penis", "correct": false}], "correct_answer": "C. Ureter", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture55.jpg"], "explanation": "<p><strong>Ans. C) Ureter</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The anorectal ring, which is a muscular structure formed by the deep part of the external anal sphincter and the puborectalis muscle , can be felt during a per rectal examination . Surgical incision of anorectal ring produces faecal incontinence .</li><li>• Option A</li><li>• muscular structure</li><li>• deep part</li><li>• external</li><li>• anal sphincter</li><li>• puborectalis muscle</li><li>• a per rectal examination</li><li>• Surgical incision</li><li>• anorectal ring</li><li>• faecal incontinence</li><li>• Option B. The prostate gland can definitely be felt with a per rectal examination. It lies anterior to the rectum , and its size , shape , and consistency are key aspects assessed during this examination, especially in the context of screening for prostate conditions, including benign prostatic hyperplasia and prostate cancer .</li><li>• Option B.</li><li>• anterior</li><li>• rectum</li><li>• size</li><li>• shape</li><li>• consistency</li><li>• benign prostatic hyperplasia</li><li>• prostate cancer</li><li>• Option D. The bulb of the penis, part of the spongy urethra , can be felt anteriorly during a per rectal examination. It's located at the base of the penile shaft and is part of the corpus spongiosum .</li><li>• Option D.</li><li>• spongy urethra</li><li>• anteriorly</li><li>• base</li><li>• penile shaft</li><li>• corpus spongiosum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ureter is not typically palpable during a per rectal examination. It runs deeper in the pelvis and is not in close proximity to the rectum. The ureters carry urine from the kidneys to the bladder and are located retroperitoneally , away from the reach of a rectal examination .</li><li>➤ deeper</li><li>➤ pelvis</li><li>➤ urine</li><li>➤ kidneys</li><li>➤ bladder</li><li>➤ retroperitoneally</li><li>➤ away</li><li>➤ reach</li><li>➤ rectal examination</li><li>➤ Bulb of penis and spongy urethra can be felt in PR</li><li>➤ Bulb of penis</li><li>➤ spongy urethra</li><li>➤ felt</li><li>➤ PR</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 280</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 280</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male was brought to ER after meeting with an accident and injured his perineum. He gets urge to micturate but not able to. O/E blood was seen at tip of urethra and swelling of penis and scrotum. Injury is?", "options": [{"label": "A", "text": "Penile Urethra", "correct": true}, {"label": "B", "text": "Prostatic Urethra", "correct": false}, {"label": "C", "text": "Membranous Urethra", "correct": false}, {"label": "D", "text": "Urinary Bladder", "correct": false}], "correct_answer": "A. Penile Urethra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture56.jpg"], "explanation": "<p><strong>Ans. A) Penile Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Prostatic urethra presents colliculus seminalis and receives the opening of ejaculatory duct , prostatic utricle and prostate glands . Prostatic urethra injuries are usually associated with pelvic fractures . The described scenario does not specifically indicate a pelvic fracture, and injuries to the prostatic urethra typically do not present with visible blood at the urethral meatus.</li><li>• Option B.</li><li>• colliculus seminalis</li><li>• receives</li><li>• opening</li><li>• ejaculatory duct</li><li>• prostatic utricle</li><li>• prostate glands</li><li>• pelvic fractures</li><li>• Option C. The membranous urethra is the most vulnerable part of the urethra to injury , particularly in the context of perineal trauma . It is the shortest and least dilatable part of the urethra and is located in the deep perineum . Given the mechanism of injury ( perineal trauma ) and the symptoms ( inability to urinate , blood at the urethral meatus ), an injury to the membranous urethra is highly plausible .</li><li>• Option C.</li><li>• most vulnerable part</li><li>• urethra</li><li>• injury</li><li>• perineal trauma</li><li>• shortest</li><li>• least dilatable part</li><li>• urethra</li><li>• deep perineum</li><li>• mechanism of injury</li><li>• perineal trauma</li><li>• symptoms</li><li>• inability to urinate</li><li>• blood</li><li>• urethral meatus</li><li>• injury</li><li>• membranous urethra</li><li>• highly plausible</li><li>• Option D. While a urinary bladder injury could lead to an inability to urinate and blood at the urethral meatus , such injuries are more commonly associated with pelvic fractures and blunt abdominal trauma . Additionally, bladder injuries often result in hematuria , but not necessarily visible blood at the urethral tip.</li><li>• Option D.</li><li>• inability</li><li>• urinate</li><li>• blood</li><li>• urethral meatus</li><li>• pelvic fractures</li><li>• blunt abdominal trauma</li><li>• hematuria</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The penile urethra could be injured , especially considering the swelling of the penis and the presence of blood at the urethral meatus . However, penile urethral injuries are more commonly associated with direct trauma to the anterior part of the perineum or to the penis itself .</li><li>➤ injured</li><li>➤ swelling</li><li>➤ penis</li><li>➤ presence of blood</li><li>➤ urethral meatus</li><li>➤ direct trauma</li><li>➤ anterior part</li><li>➤ perineum</li><li>➤ penis itself</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old woman pregnant with her second child experienced considerable anxiety when she thought about the pain that she would experience during childbirth. Her obstetrician explained that there were several options that involved the use of local anesthetics which would relieve the pain and said that he usually p Ref erred to use a bilateral pudendal nerve block. Listed below are ALL the other nerves that would be needed to be blocked to provide complete anesthesia to the perineal region except?", "options": [{"label": "A", "text": "Genitofemoral Nerve", "correct": false}, {"label": "B", "text": "Ilioinguinal Nerve", "correct": false}, {"label": "C", "text": "Posterior Femoral Cutaneous Nerve", "correct": false}, {"label": "D", "text": "Perforating Cutaneous Nerve", "correct": true}], "correct_answer": "D. Perforating Cutaneous Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture57.jpg"], "explanation": "<p><strong>Ans. D) Perforating Cutaneous Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Genitofemoral Nerve arises from the lumbar plexus , specifically from the L1-L2 spinal nerve levels . Genital branch of genitofemoral nerve supplies the cremaster muscle &amp; scrotal skin , in female it accompanies the round ligament and supplies skin of mons pubis and labium majus . In childbirth, the genitofemoral nerve is not a major contributor to the innervation of the perineal area, which is the primary focus during delivery. Thus, blocking this nerve would not significantly contribute to perineal anesthesia.</li><li>• Option A.</li><li>• lumbar plexus</li><li>• L1-L2 spinal nerve levels</li><li>• Genital branch</li><li>• genitofemoral nerve supplies</li><li>• cremaster muscle</li><li>• scrotal skin</li><li>• round ligament</li><li>• supplies skin</li><li>• mons pubis</li><li>• labium majus</li><li>• Option B. Ilioinguinal Nerve, also originating from the lumbar plexus (L1), the ilioinguinal nerve passes through the inguinal canal and provides sensory innervation to the upper part of the inner thigh , the root of the penis and the upper part of the scrotum in men , and the mons pubis and labia majora in women . While this nerve is important for sensation in the inguinal and upper thigh area , its role in perineal innervation is limited . It may contribute some sensory input to the perineal region , but it's not the primary nerve involved in childbirth anesthesia.</li><li>• Option B.</li><li>• lumbar plexus (L1),</li><li>• inguinal canal</li><li>• sensory innervation</li><li>• upper part</li><li>• inner thigh</li><li>• root</li><li>• penis</li><li>• upper part</li><li>• scrotum</li><li>• men</li><li>• mons pubis</li><li>• labia majora</li><li>• women</li><li>• sensation</li><li>• inguinal</li><li>• upper thigh area</li><li>• perineal innervation</li><li>• limited</li><li>• some sensory input</li><li>• perineal region</li><li>• Option C. Posterior Femoral Cutaneous Nerve originates from the sacral plexus ( S1-S3 ), running along the posterior aspect of the thigh . It supplies sensation to the skin of the perineum and the lower part of the buttocks . It's more relevant in the context of childbirth anesthesia , as it contributes to the sensory innervation of the perineum , which is directly involved during childbirth . Blocking this nerve can help in numbing the perineal area , thus alleviating pain during delivery .</li><li>• Option C.</li><li>• sacral plexus</li><li>• S1-S3</li><li>• posterior aspect</li><li>• thigh</li><li>• sensation</li><li>• skin</li><li>• perineum</li><li>• lower part</li><li>• buttocks</li><li>• context</li><li>• childbirth anesthesia</li><li>• sensory innervation</li><li>• perineum</li><li>• childbirth</li><li>• numbing</li><li>• perineal area</li><li>• alleviating pain</li><li>• delivery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Perforating Cutaneous Nerve is not involved in providing anesthesia to the perineal region . The perforating cutaneous nerve arises from the sacral plexus and innervates a small area of skin near the coccyx . It does not significantly contribute to the sensory innervation of the perineal region, especially in the context of childbirth.</li><li>➤ anesthesia</li><li>➤ perineal region</li><li>➤ arises</li><li>➤ sacral plexus</li><li>➤ innervates</li><li>➤ small area</li><li>➤ skin near</li><li>➤ coccyx</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219,195</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219,195</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with complaints of severe pain and discomfort during bowel movements. The patient has been diagnosed with external hemorrhoids. Which of the following nerves is primarily responsible for mediating the pain experienced by the patient during the passage of stools?", "options": [{"label": "A", "text": "Hypogastric Nerves", "correct": false}, {"label": "B", "text": "Pudendal Nerve", "correct": true}, {"label": "C", "text": "Pelvic Splanchnic Nerve", "correct": false}, {"label": "D", "text": "Anococcygeal Nerves", "correct": false}], "correct_answer": "B. Pudendal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture58.jpg"], "explanation": "<p><strong>Ans. B) Pudendal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hypogastric Nerves convey postganglionic sympathetic fibres T10 to L2 .</li><li>• Option A.</li><li>• postganglionic sympathetic fibres</li><li>• T10 to L2</li><li>• They contribute to the innervation of the pelvic and abdominal viscera . The hypogastric nerves primarily carry sympathetic fibers , which are more involved in functions like regulating blood flow and visceral muscle tone rather than transmitting pain sensations from the external anal region . Therefore, they are not the primary mediators of pain in external hemorrhoids.</li><li>• innervation</li><li>• pelvic</li><li>• abdominal viscera</li><li>• sympathetic fibers</li><li>• regulating blood flow</li><li>• visceral muscle</li><li>• transmitting pain sensations</li><li>• external anal region</li><li>• Option C. Pelvic Splanchnic Nerves arise from the sacral spinal nerves ( S2-S4 ) and carry parasympathetic fibers to the pelvic organs . They are involved in the innervation of the lower part of the colon , rectum , urinary and reproductive organs . While they do play a role in the function of these organs and in transmitting visceral pain, they are not primarily involved in conveying pain from the external anal region or external hemorrhoids.</li><li>• Option C.</li><li>• sacral spinal nerves</li><li>• S2-S4</li><li>• carry parasympathetic fibers</li><li>• pelvic organs</li><li>• innervation</li><li>• lower part</li><li>• colon</li><li>• rectum</li><li>• urinary</li><li>• reproductive organs</li><li>• Option D. Anococcygeal Nerves are small nerves that arise from the sacral plexus and provide sensory innervation to the skin over the coccyx and nearby areas. They are more involved in the sensation of the skin near the tailbone rather than the anal region . Therefore, they are not typically associated with the pain from external hemorrhoids.</li><li>• Option D.</li><li>• small nerves</li><li>• arise</li><li>• sacral plexus</li><li>• sensory innervation</li><li>• skin</li><li>• coccyx</li><li>• sensation</li><li>• skin</li><li>• tailbone</li><li>• anal region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pudendal nerve arises from the sacral plexus ( S2-S4 ) and provides the primary innervation to the external genitalia and perineal region , including the muscles and skin around the anus . In the case of external hemorrhoids, which are located in the lower part of the anal canal and at the anal opening , it is the pudendal nerve that carries the pain sensation . The nerve is crucial for transmitting sensations , including pain , from the perianal area .</li><li>➤ arises</li><li>➤ sacral plexus</li><li>➤ S2-S4</li><li>➤ primary innervation</li><li>➤ external genitalia</li><li>➤ perineal region</li><li>➤ muscles</li><li>➤ skin</li><li>➤ anus</li><li>➤ lower part</li><li>➤ anal canal</li><li>➤ anal opening</li><li>➤ pudendal nerve</li><li>➤ carries</li><li>➤ pain sensation</li><li>➤ transmitting sensations</li><li>➤ pain</li><li>➤ perianal area</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 280</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 280</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with a suspected kidney condition that requires a posterior surgical approach for exposure and evaluation. During the surgical procedure, certain nerves are at risk of injury. Which of the following nerves is typically NOT at risk of injury when exposing the kidney from behind, and its preservation is crucial to avoid specific clinical symptoms?", "options": [{"label": "A", "text": "Lateral Cutaneous Nerve of Thigh", "correct": true}, {"label": "B", "text": "Ilioinguinal Nerve", "correct": false}, {"label": "C", "text": "Subcostal Nerve", "correct": false}, {"label": "D", "text": "Iliohypogastric Nerve", "correct": false}], "correct_answer": "A. Lateral Cutaneous Nerve of Thigh", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture59.jpg"], "explanation": "<p><strong>Ans. A) Lateral Cutaneous Nerve of Thigh</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Ilioinguinal Nerve, also a branch of the lumbar plexus ( arising from L1 ), runs along the iliac crest and into the inguinal region . It supplies sensation to the skin of the upper medial thigh and external genitalia . It can potentially be at risk during renal surgery , especially if the surgical approach extends lower towards the iliac crest or if there is a need to navigate through the lower abdominal muscles .</li><li>• Option B.</li><li>• branch</li><li>• lumbar plexus</li><li>• arising from L1</li><li>• iliac</li><li>• crest</li><li>• inguinal region</li><li>• supplies sensation</li><li>• skin</li><li>• upper medial thigh</li><li>• external genitalia</li><li>• potentially</li><li>• renal surgery</li><li>• extends lower</li><li>• towards</li><li>• iliac crest</li><li>• navigate</li><li>• lower abdominal muscles</li><li>• Option C. Subcostal Nerve is the 12th thoracic nerve (T12) and runs along the subcostal ( below the ribs ) margin . It supplies the muscles and skin of the lower anterior abdominal wall . Given its location, it can be at risk during retroperitoneal surgical approaches to the kidney , which may involve dissection near the lower ribs .</li><li>• Option C.</li><li>• 12th thoracic nerve (T12)</li><li>• subcostal</li><li>• below the ribs</li><li>• margin</li><li>• supplies</li><li>• muscles</li><li>• skin</li><li>• lower anterior abdominal wall</li><li>• retroperitoneal surgical approaches</li><li>• kidney</li><li>• dissection</li><li>• lower ribs</li><li>• Option D. Arising from the L1 spinal nerve , Iliohypogastric Nerve provides sensory innervation to the skin of the hip and lower abdominal wall , and motor innervation to the transversus abdominis and internal oblique muscles . Like the subcostal nerve, it is also susceptible to injury during renal surgery , especially in approaches that involve dissection through the abdominal muscles or near the iliac crest .</li><li>• Option D.</li><li>• L1 spinal nerve</li><li>• sensory innervation</li><li>• skin</li><li>• hip</li><li>• lower abdominal wall</li><li>• motor innervation</li><li>• transversus abdominis</li><li>• internal oblique muscles</li><li>• susceptible</li><li>• injury</li><li>• renal surgery</li><li>• dissection</li><li>• abdominal muscles</li><li>• near</li><li>• iliac crest</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lateral Cutaneous Nerve of Thigh, a branch of the lumbar plexus , emerges from the L2-L3 spinal nerves and is responsible for providing sensation to the skin of the lateral aspect of the thigh . Since its pathway is quite distant from the typical surgical field for kidney exposure (which is more posterior and superior ), it is unlikely to be injured in such a procedure.</li><li>➤ lumbar plexus</li><li>➤ emerges</li><li>➤ L2-L3 spinal nerves</li><li>➤ providing sensation</li><li>➤ skin</li><li>➤ lateral aspect</li><li>➤ thigh</li><li>➤ pathway</li><li>➤ quite distant</li><li>➤ typical surgical field</li><li>➤ kidney exposure</li><li>➤ posterior</li><li>➤ superior</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 161</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 161</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented with pain in the right testes. Examination reveals a bag of worms suggestive of varicocele. Right testicular vein drains into?", "options": [{"label": "A", "text": "Hemiazygos Vein", "correct": false}, {"label": "B", "text": "IVC", "correct": true}, {"label": "C", "text": "Inferior Mesenteric Vein", "correct": false}, {"label": "D", "text": "Renal Vein", "correct": false}], "correct_answer": "B. IVC", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture60.jpg"], "explanation": "<p><strong>Ans. B) IVC</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The hemiazygos vein is located on the left side of the vertebral column and primarily drains the lower intercostal spaces and the abdominal wall . It eventually drains into the azygos vein , which then empties into the superior vena cava . This vein is not involved in the drainage of the testicular veins.</li><li>• Option A.</li><li>• left side</li><li>• vertebral column</li><li>• drains</li><li>• lower intercostal spaces</li><li>• abdominal wall</li><li>• azygos vein</li><li>• empties</li><li>• superior vena</li><li>• cava</li><li>• Option C. Inferior Mesenteric Vein drains blood from the large intestine and rectum . It eventually joins the splenic vein to form the portal vein , which then carries blood to the liver . The inferior mesenteric vein does not receive blood from the testicular veins.</li><li>• Option C.</li><li>• blood</li><li>• large intestine</li><li>• rectum</li><li>• splenic vein</li><li>• portal vein</li><li>• carries blood</li><li>• liver</li><li>• Option D. While the left testicular vein drains into the left renal vein , this is not the case for the right testicular vein. The renal veins drain the kidneys and then empty into the IVC . The asymmetry in the drainage of the testicular veins is significant in the clinical presentation and incidence of varicoceles , which are more common on the left side due to the drainage pattern of the left testicular vein into the left renal vein and subsequently into the IVC .</li><li>• Option D.</li><li>• left testicular vein</li><li>• left renal vein</li><li>• kidneys</li><li>• empty</li><li>• IVC</li><li>• asymmetry</li><li>• drainage</li><li>• testicular veins</li><li>• clinical presentation</li><li>• incidence</li><li>• varicoceles</li><li>• left side</li><li>• drainage pattern</li><li>• left testicular vein</li><li>• left renal vein</li><li>• IVC</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right testicular vein drains directly into the inferior vena cava . The IVC collects blood from the lower half of the body and transports it to the right atrium of the heart . The direct drainage of the right testicular vein into the IVC is significant in the context of varicocele , as it can impact the pressure dynamics within the vein , contributing to varicocele formation .</li><li>➤ right testicular vein</li><li>➤ inferior vena</li><li>➤ cava</li><li>➤ blood</li><li>➤ lower half</li><li>➤ body</li><li>➤ transports</li><li>➤ right atrium</li><li>➤ heart</li><li>➤ direct drainage</li><li>➤ right testicular vein</li><li>➤ IVC</li><li>➤ varicocele</li><li>➤ impact</li><li>➤ pressure dynamics</li><li>➤ vein</li><li>➤ varicocele formation</li><li>➤ Tributaries of IVC :</li><li>➤ Tributaries</li><li>➤ IVC</li><li>➤ Right and Left Common Iliac Veins. Lumbar Veins Renal Veins Phrenic Veins Right Gonadal Vein Right Suprarenal Vein Hepatic Veins</li><li>➤ Right and Left Common Iliac Veins.</li><li>➤ Lumbar Veins</li><li>➤ Renal Veins</li><li>➤ Phrenic Veins</li><li>➤ Right Gonadal Vein</li><li>➤ Right Suprarenal Vein</li><li>➤ Hepatic Veins</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 62</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 62</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents with complaints of pain and swelling in the genital area following a trauma. The patient reports difficulty with urination and discomfort in the penile region. During the physical examination, the physician identifies a hematoma and suspects injury to the dorsal artery of the penis. In which anatomical layer does the dorsal artery of the penis pass beneath, and its injury can lead to these clinical symptoms?", "options": [{"label": "A", "text": "Colles Fascia", "correct": false}, {"label": "B", "text": "Buck’s Fascia", "correct": true}, {"label": "C", "text": "Dartos Layer", "correct": false}, {"label": "D", "text": "Tunica Albuginea", "correct": false}], "correct_answer": "B. Buck’s Fascia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture61.jpg"], "explanation": "<p><strong>Ans. B) Buck’s Fascia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deep fascia of perineum is colle’s fascia it fuses with the posterior part of urogenital diaphragm . This is a layer of superficial fascia found in the perineum . It is continuous with Scarpa's fascia in the abdomen and does not play a direct role in the penile structure. Therefore, it's not the layer beneath which the dorsal artery of the penis passes.</li><li>• Option A.</li><li>• Deep fascia</li><li>• perineum</li><li>• colle’s fascia</li><li>• fuses</li><li>• posterior part</li><li>• urogenital diaphragm</li><li>• superficial fascia</li><li>• perineum</li><li>• Scarpa's fascia</li><li>• abdomen</li><li>• Option C. The dartos layer is a layer of smooth muscle fibers found within the scrotum , not the penis. It is responsible for the wrinkling of the scrotal skin and does not encompass the penile structure where the dorsal artery is located.</li><li>• Option C.</li><li>• layer</li><li>• smooth muscle fibers</li><li>• within</li><li>• scrotum</li><li>• responsible</li><li>• wrinkling</li><li>• scrotal skin</li><li>• Option D. Tunica Albuginea is a fibrous envelope of the corpora cavernosa and is found deep to Buck’s fascia . While it is an important structural component of the penis , the dorsal artery of the penis does not pass beneath it but rather beneath Buck’s fascia.</li><li>• Option D.</li><li>• fibrous envelope</li><li>• corpora cavernosa</li><li>• deep</li><li>• Buck’s fascia</li><li>• penis</li><li>• dorsal artery</li><li>• penis</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Buck's fascia is a deep fascia layer that encloses the corpora cavernosa penis . It is an important anatomical structure in the penis , providing a protective layer for the dorsal nerves , arteries , and veins of the penis . The dorsal artery of the penis travels just beneath this layer , making it crucial for its protection and functional integrity .</li><li>• deep fascia layer</li><li>• encloses</li><li>• corpora cavernosa penis</li><li>• anatomical structure</li><li>• penis</li><li>• protective layer</li><li>• dorsal nerves</li><li>• arteries</li><li>• veins</li><li>• penis</li><li>• dorsal artery</li><li>• penis</li><li>• beneath</li><li>• layer</li><li>• crucial</li><li>• protection</li><li>• functional integrity</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 56</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 56</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male patient presents with a complaint of testicular pain and swelling following trauma to the groin area. During the physical examination, the physician tests the cremasteric reflex to assess the integrity of the nervous system. Which root value is primarily responsible for the cremasteric reflex, and its assessment can aid in diagnosing the patient's clinical symptoms?", "options": [{"label": "A", "text": "L1, L2", "correct": true}, {"label": "B", "text": "S2, S3", "correct": false}, {"label": "C", "text": "L3, L4", "correct": false}, {"label": "D", "text": "L4, S1", "correct": false}], "correct_answer": "A. L1, L2", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture62.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-111524.jpg"], "explanation": "<p><strong>Ans. A) L1, L2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. S2, S3 sacral nerve roots are more involved in the pelvic splanchnic nerves and contribute to the parasympathetic innervation of the pelvic organs . They are not involved in the cremasteric reflex.</li><li>• Option B.</li><li>• pelvic splanchnic nerves</li><li>• parasympathetic innervation</li><li>• pelvic organs</li><li>• Option C. L3, L4 lumbar nerve roots contribute to the femoral nerve and other structures, but they are not involved in the cremasteric reflex. The L3 and L4 nerve roots play a role in the patellar (knee-jerk) reflex , not the cremasteric reflex.</li><li>• Option C.</li><li>• femoral nerve</li><li>• L3</li><li>• L4 nerve roots</li><li>• role</li><li>• patellar (knee-jerk) reflex</li><li>• Option D. The L4 and S1 nerve roots are involved in the innervation of the lower limb , particularly in the sciatic nerve . They play a crucial role in reflexes like the ankle jerk reflex , but not in the cremasteric reflex.</li><li>• Option D.</li><li>• innervation</li><li>• lower limb</li><li>• sciatic nerve</li><li>• reflexes</li><li>• ankle jerk reflex</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cremasteric reflex involves the muscle that pulls up the testis ( the cremaster muscle ). This reflex is mediated by the fibers originating from the L1 and L2 spinal nerve roots . When the inner thigh is stroked , the sensory nerves ( genitofemoral nerve , derived from L1 and L2 ) carry the stimulus to the spinal cord . The response is the contraction of the cremaster muscle , causing the elevation of the testis , and this motor response is also mediated by the genitofemoral nerve , originating from the L1 and L2 spinal segments .</li><li>➤ cremasteric reflex</li><li>➤ muscle</li><li>➤ testis</li><li>➤ the cremaster muscle</li><li>➤ mediated</li><li>➤ fibers</li><li>➤ L1</li><li>➤ L2 spinal nerve roots</li><li>➤ inner thigh</li><li>➤ stroked</li><li>➤ sensory nerves</li><li>➤ genitofemoral nerve</li><li>➤ L1</li><li>➤ L2</li><li>➤ stimulus</li><li>➤ spinal cord</li><li>➤ contraction</li><li>➤ cremaster muscle</li><li>➤ elevation</li><li>➤ testis</li><li>➤ mediated</li><li>➤ genitofemoral nerve</li><li>➤ L1</li><li>➤ L2 spinal segments</li><li>➤ Cremasteric reflex is absent in Torsion Testis</li><li>➤ Cremasteric reflex is absent in Torsion Testis</li><li>➤ In UMN Lesions above segment L1, the Reflex is Lost</li><li>➤ In UMN Lesions above segment L1, the Reflex is Lost</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 34</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 34</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male patient presents with lower urinary tract symptoms, including difficulty in starting and stopping urination, weak urinary stream, and a feeling of incomplete emptying of the bladder. During the digital rectal examination (DRE), the physician notes an enlargement of the prostate gland. The patient's symptoms are suggestive of benign prostatic hyperplasia (BPH). Which specific part of the prostate, known as the \"uvula vesicae,\" is most likely responsible for causing these urinary symptoms in the patient?", "options": [{"label": "A", "text": "Anterior Lobe", "correct": false}, {"label": "B", "text": "Posterior", "correct": false}, {"label": "C", "text": "Lateral", "correct": false}, {"label": "D", "text": "Median Lobe", "correct": true}], "correct_answer": "D. Median Lobe", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture63.jpg"], "explanation": "<p><strong>Ans. D) Median Lobe</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. The anterior lobe of the prostate is less glandular and more fibromuscular . Anterior lobe is formed by the isthmus that connects the lateral lobe of both sides and is devoid of gland . It's situated at the front of the prostate and does not have a significant impact on the uvula vesicae, which is a feature seen at the base of the bladder .</li><li>• Option A.</li><li>• less glandular</li><li>• more fibromuscular</li><li>• Anterior lobe</li><li>• isthmus</li><li>• connects</li><li>• lateral lobe</li><li>• both sides</li><li>• devoid</li><li>• gland</li><li>• front</li><li>• prostate</li><li>• base</li><li>• bladder</li><li>• Option B. The posterior lobe is situated at the back of the prostate and is often the site of prostatic cancers. It is not directly involved in the formation of the uvula vesicae. Posterior lobe - lateral lobe continues behind urethra as posterior lobe and below ejaculatory duct .</li><li>• Option B.</li><li>• posterior lobe</li><li>• back</li><li>• prostate</li><li>• site</li><li>• prostatic cancers.</li><li>• Posterior lobe</li><li>• lateral lobe</li><li>• behind</li><li>• urethra</li><li>• posterior lobe</li><li>• below ejaculatory duct</li><li>• Option C. Lateral Lobes are on either side of the prostate and are the most prominent parts of the gland . While they are significant in terms of size and are often the site of Benign Prostatic Hyperplasia ( BPH ), they do not contribute directly to the formation of the uvula vesicae.</li><li>• Option C.</li><li>• either side</li><li>• prostate</li><li>• gland</li><li>• size</li><li>• site</li><li>• Benign Prostatic Hyperplasia</li><li>• BPH</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The median lobe of the prostate is situated between the two lateral lobes and beneath the bladder neck . When enlarged , it can protrude into the bladder , leading to a noticeable bulge known as the uvula vesicae . This protrusion can be significant in conditions like BPH , where the median lobe's enlargement pushes upwards into the bladder base .</li><li>➤ two lateral lobes</li><li>➤ beneath</li><li>➤ bladder neck</li><li>➤ enlarged</li><li>➤ bladder</li><li>➤ noticeable bulge</li><li>➤ uvula vesicae</li><li>➤ BPH</li><li>➤ median lobe's enlargement</li><li>➤ upwards</li><li>➤ bladder base</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 247</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 247</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old man had a low-grade fever for the past one week and a history of difficulty and frequency in micturition for the past 8 months. The surgeon performed a per rectal examination and confirmed the enlargement of the prostate. Which of the following statements is true?", "options": [{"label": "A", "text": "Prostatic Venous Plexus lies outside False Capsule of Prostate", "correct": false}, {"label": "B", "text": "The Base of the Prostate is traversed by the Urethra to the Right of the Median Plane", "correct": false}, {"label": "C", "text": "Base of Median Lobe forms Uvula Vesicae at the Apex of Trigone", "correct": true}, {"label": "D", "text": "Ejaculatory Duct passes Posteromedial to the Median Lobe", "correct": false}], "correct_answer": "C. Base of Median Lobe forms Uvula Vesicae at the Apex of Trigone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture64.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture65.jpg"], "explanation": "<p><strong>Ans. C) Base of Median Lobe forms Uvula Vesicae at the Apex of Trigone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The prostatic venous plexus , also known as the Santorini plexus , is indeed located outside the prostatic capsule . However, it's typically described as being located around or near the true capsule rather than the false capsule . The false capsule is formed by the compressed peripheral zone of the prostate , and the venous plexus is generally external to this.</li><li>• Option A.</li><li>• prostatic venous plexus</li><li>• Santorini plexus</li><li>• outside</li><li>• prostatic capsule</li><li>• located</li><li>• around</li><li>• true capsule</li><li>• false capsule</li><li>• false capsule</li><li>• compressed peripheral zone</li><li>• prostate</li><li>• venous plexus</li><li>• external</li><li>• Option B. The urethra traverses the prostate approximately in the median plane . It enters the prostate at its base and exits at the apex . There is no consistent anatomical deviation to the right of the median plane.</li><li>• Option B.</li><li>• urethra traverses</li><li>• prostate</li><li>• median plane</li><li>• enters</li><li>• prostate</li><li>• base</li><li>• exits</li><li>• apex</li><li>• Option D. The ejaculatory ducts pass through the prostate and open into the urethra . They are located centrally in the prostate and are not specifically posteromedial to the median lobe.</li><li>• Option D.</li><li>• ejaculatory ducts</li><li>• prostate</li><li>• open</li><li>• urethra</li><li>• centrally</li><li>• prostate</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The median lobe of the prostate , when enlarged , can protrude into the bladder at the base , forming a bulge known as the uvula vesicae . This occurs at the apex of the trigone , an area of the bladder defined by the two ureteric orifices and the internal urethral orifice .</li><li>➤ median lobe</li><li>➤ prostate</li><li>➤ enlarged</li><li>➤ protrude</li><li>➤ bladder</li><li>➤ base</li><li>➤ bulge</li><li>➤ uvula vesicae</li><li>➤ apex</li><li>➤ trigone</li><li>➤ area</li><li>➤ bladder</li><li>➤ two ureteric orifices</li><li>➤ internal urethral orifice</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 1266</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 1266</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male presents to the clinic with complaints of pain and swelling in the genital area. He reports a recent history of unprotected sexual intercourse. On examination, there is tenderness and swelling in the glans penis. The patient denies any urinary symptoms. A genital examination reveals a small ulcer on the glans. Which of the following is the most likely drainage pathway for lymphatic fluid from the affected area?", "options": [{"label": "A", "text": "Superficial Inguinal Lymph Nodes", "correct": false}, {"label": "B", "text": "Deep Inguinal Lymph Nodes", "correct": true}, {"label": "C", "text": "Para Aortic Nodes", "correct": false}, {"label": "D", "text": "Internal Iliac Nodes", "correct": false}], "correct_answer": "B. Deep Inguinal Lymph Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture66.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture67.jpg"], "explanation": "<p><strong>Ans. B) Deep Inguinal Lymph Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While the superficial inguinal lymph nodes are important for the drainage of the lower abdomen , perineum , and lower limbs , they are not the primary lymph nodes responsible for the drainage of the glans penis. The skin of the penis and the superficial structures may drain into these nodes , but the glans penis specifically has a deeper drainage pattern .</li><li>• Option A.</li><li>• superficial inguinal lymph nodes</li><li>• drainage</li><li>• lower abdomen</li><li>• perineum</li><li>• lower limbs</li><li>• skin</li><li>• penis</li><li>• superficial structures</li><li>• drain</li><li>• nodes</li><li>• glans penis</li><li>• deeper drainage pattern</li><li>• Option C. The para-aortic lymph nodes, located near the aorta , are responsible for the lymphatic drainage of the testes , ovaries , kidneys , and uterus , but not specifically for the glans penis. These nodes are more involved in the lymphatic system of the upper urogenital tract .</li><li>• Option C.</li><li>• aorta</li><li>• lymphatic drainage</li><li>• testes</li><li>• ovaries</li><li>• kidneys</li><li>• uterus</li><li>• lymphatic system</li><li>• upper urogenital tract</li><li>• Option D. Internal iliac nodes drain parts of the lower urinary tract and the pelvic organs , but the primary lymphatic drainage of the glans penis is not directly to these nodes. They may be involved in the secondary or tertiary drainage , especially in pathological conditions.</li><li>• Option D.</li><li>• parts</li><li>• lower urinary tract</li><li>• pelvic organs</li><li>• primary lymphatic drainage</li><li>• glans penis</li><li>• not directly</li><li>• secondary</li><li>• tertiary drainage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lymph from the glans penis drains primarily to the deep inguinal lymph nodes . These nodes are located under the fascia lata on the medial side of the femoral vein and play a crucial role in the lymphatic drainage of the glans penis . This drainage pattern is clinically significant , especially in the context of penile cancers or infections .</li><li>➤ glans penis</li><li>➤ deep inguinal lymph nodes</li><li>➤ under</li><li>➤ fascia lata</li><li>➤ medial side</li><li>➤ femoral vein</li><li>➤ crucial role</li><li>➤ lymphatic drainage</li><li>➤ glans penis</li><li>➤ clinically significant</li><li>➤ context</li><li>➤ penile cancers</li><li>➤ infections</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 59</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 59</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents to the clinic with difficulty urinating and a weak urinary stream. He has a history of benign prostatic hyperplasia. On examination, there is tenderness in the perineal region. Digital rectal examination reveals an enlarged, non-tender prostate. His symptoms are most likely related to pathology in which part of the urethra?", "options": [{"label": "A", "text": "Prostatic Urethra", "correct": false}, {"label": "B", "text": "Membranous Urethra", "correct": true}, {"label": "C", "text": "Bulbar Urethra", "correct": false}, {"label": "D", "text": "Penile Urethra", "correct": false}], "correct_answer": "B. Membranous Urethra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture68.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture69.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-111852.jpg"], "explanation": "<p><strong>Ans. B) Membranous Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Prostatic Urethra runs through the prostate gland and is relatively longer than the membranous urethra . It is the widest and most dilatable part of the urethra , but not the shortest.</li><li>• Option A.</li><li>• prostate gland</li><li>• relatively longer</li><li>• membranous urethra</li><li>• widest</li><li>• dilatable part</li><li>• urethra</li><li>• Option C. Bulbar Urethra is part of the spongy urethra that lies within the bulb of the penis . It is longer than the membranous urethra and extends up to the penile portion of the urethra .</li><li>• Option C.</li><li>• spongy urethra</li><li>• bulb</li><li>• penis</li><li>• longer</li><li>• membranous urethra</li><li>• extends</li><li>• penile portion</li><li>• urethra</li><li>• Option D. Penile Urethra ( also known as Spongy or Cavernous Urethra) is the longest part of the urethra , running the length of the penis . It extends from the end of the bulbar urethra to the external urethral orifice at the tip of the penis .</li><li>• Option D. Penile Urethra (</li><li>• Spongy or Cavernous Urethra)</li><li>• longest part</li><li>• urethra</li><li>• length</li><li>• penis</li><li>• extends</li><li>• end</li><li>• bulbar urethra</li><li>• external urethral orifice</li><li>• tip</li><li>• penis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The membranous urethra is the shortest segment of the male urethra . It passes through the urogenital diaphragm and is surrounded by the external urethral sphincter . It's typically about 1-2 cm long , making it the shortest part of the urethra .</li><li>➤ membranous urethra</li><li>➤ shortest segment</li><li>➤ male urethra</li><li>➤ urogenital diaphragm</li><li>➤ external urethral sphincter</li><li>➤ 1-2 cm long</li><li>➤ shortest part</li><li>➤ urethra</li><li>➤ Ref . Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg238</li><li>➤ Ref . Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the clinic complaining of discharge from his urethra. He denies any pain during urination or history of sexually transmitted infections. He mentions a recent episode of significant straining during bowel movements. Physical examination reveals no abnormalities of the external genitalia. A urethral swab is negative for gonococcal and chlamydial infection. The discharge is most likely originating from glands that open into which part of the urethra?", "options": [{"label": "A", "text": "Membranous Urethra", "correct": false}, {"label": "B", "text": "Spongy Urethra", "correct": true}, {"label": "C", "text": "Prostatic Urethra", "correct": false}, {"label": "D", "text": "Intramural Urethra", "correct": false}], "correct_answer": "B. Spongy Urethra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture70.jpg"], "explanation": "<p><strong>Ans. B) Spongy Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The membranous urethra is a short segment of the male urethra that passes through the urogenital diaphragm . The bulbourethral glands do not open into this part of the urethra.</li><li>• Option A.</li><li>• short segment</li><li>• male urethra</li><li>• urogenital diaphragm</li><li>• Option C. Prostatic Urethra runs through the prostate gland . The prostatic urethra receives the ejaculatory ducts and several prostatic ducts but not the ducts from the bulbourethral glands.</li><li>• Option C.</li><li>• prostate gland</li><li>• receives</li><li>• ejaculatory ducts</li><li>• prostatic ducts</li><li>• Option D. The term \" intramural urethra \" is not commonly used in anatomical terminology. The urethra is usually divided into the prostatic , membranous , and spongy (or penile ) segments . The intramural urethra could refer to the part of the urethra that is embedded in the bladder wall , but this is not where the bulbourethral glands open.</li><li>• Option D.</li><li>• intramural urethra</li><li>• prostatic</li><li>• membranous</li><li>• spongy</li><li>• penile</li><li>• segments</li><li>• embedded</li><li>• bladder wall</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The bulbourethral glands are located in the deep perineal pouch . They open into the spongy urethra , which is the longest part of the urethra and runs along the length of the penis . The secretions of these glands are responsible for lubricating the urethra and are released during sexual arousal , contributing to the pre-ejaculate fluid .</li><li>➤ deep perineal pouch</li><li>➤ spongy urethra</li><li>➤ longest part</li><li>➤ urethra</li><li>➤ length</li><li>➤ penis</li><li>➤ lubricating</li><li>➤ urethra</li><li>➤ sexual arousal</li><li>➤ pre-ejaculate fluid</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents with a painless swelling in his right testicle. He denies any history of trauma or infection. On examination, the swelling is firm and does not transilluminate. Ultrasonography of the scrotum reveals a solid mass within the right testis. A CT scan of the abdomen is ordered to assess for metastasis. Which lymph nodes are most likely to be involved if this testicular mass is malignant?", "options": [{"label": "A", "text": "Internal Iliac", "correct": false}, {"label": "B", "text": "Para Aortic Node", "correct": true}, {"label": "C", "text": "Superficial Inguinal", "correct": false}, {"label": "D", "text": "Deep Inguinal", "correct": false}], "correct_answer": "B. Para Aortic Node", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture71.jpg"], "explanation": "<p><strong>Ans. B) Para Aortic Node</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The internal iliac lymph nodes are primarily responsible for the drainage of pelvic organs , but they are not the primary drainage nodes for the testes. The testes, being originally abdominal organs (they descend into the scrotum during fetal development ), have lymphatic drainage that reflects their abdominal origin . Internal iliac nodes drains prostatic and membranous part of male urethra</li><li>• Option A.</li><li>• drainage</li><li>• pelvic organs</li><li>• abdominal organs</li><li>• descend</li><li>• scrotum</li><li>• fetal development</li><li>• lymphatic drainage</li><li>• abdominal origin</li><li>• Internal iliac nodes</li><li>• prostatic</li><li>• membranous part</li><li>• male urethra</li><li>• Option C. The superficial inguinal lymph nodes are responsible for the lymphatic drainage of the lower limb , superficial perineal area , and lower abdominal wall . They are not involved in the drainage of the testes, which has a more abdominal origin . Lymphatics from scrotum , skin of penis including prepuce into horizontal group of superficial inguinal nodes</li><li>• Option C.</li><li>• lymphatic drainage</li><li>• lower limb</li><li>• superficial perineal area</li><li>• lower abdominal wall</li><li>• more abdominal origin</li><li>• Lymphatics</li><li>• scrotum</li><li>• skin of penis</li><li>• prepuce</li><li>• horizontal group</li><li>• superficial inguinal nodes</li><li>• Option D. Like the superficial inguinal nodes, the deep inguinal lymph nodes primarily drain the lower extremities and some parts of the external genitalia , but not the testes. Spongy part of male urethra , glans penis into deep inguinal nodes</li><li>• Option D.</li><li>• drain</li><li>• lower extremities</li><li>• external genitalia</li><li>• Spongy part</li><li>• male urethra</li><li>• glans</li><li>• penis</li><li>• deep inguinal nodes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The testes drain into the para-aortic lymph nodes located near the aorta in the lumbar region . This is because the testes develop in the abdomen and late r descend into the scrotum , carrying their lymphatic drainage system with them. As a result, diseases of the testis , such as testicular cancer , can metastasize to these abdominal lymph nodes .</li><li>➤ para-aortic lymph nodes</li><li>➤ aorta</li><li>➤ lumbar region</li><li>➤ develop</li><li>➤ abdomen</li><li>➤ descend</li><li>➤ scrotum</li><li>➤ carrying</li><li>➤ lymphatic drainage system</li><li>➤ diseases</li><li>➤ testis</li><li>➤ testicular cancer</li><li>➤ metastasize</li><li>➤ abdominal lymph nodes</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 243</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 243</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the clinic for a vasectomy consultation. During the discussion, the patient, who has a background in biology, asks detailed questions about the anatomy of the vas deferens. You decide to test his knowledge. Which of the following statements about the vas deferens is incorrect?", "options": [{"label": "A", "text": "Its Terminal Part is dilated to form Ampulla", "correct": false}, {"label": "B", "text": "It crosses Ureter in the Region of Ischial Spine", "correct": true}, {"label": "C", "text": "It passes Lateral to Inferior Epigastric Artery at Deep Inguinal Ring", "correct": false}, {"label": "D", "text": "It is not separated from Base of Bladder by Peritoneum", "correct": false}], "correct_answer": "B. It crosses Ureter in the Region of Ischial Spine", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture72.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture73.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture74.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture75.jpg"], "explanation": "<p><strong>Ans. B) It crosses Ureter in the Region of Ischial Spine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . The vas deferens, as it approaches the prostate gland , expands to form an ampulla . This ampullary part stores and helps transport sperm .</li><li>• Option A.</li><li>• correct</li><li>• approaches</li><li>• prostate gland</li><li>• ampulla</li><li>• ampullary part stores</li><li>• transport sperm</li><li>• Option C. This statement is correct . The vas deferens enters the inguinal canal at the deep inguinal ring , passing lateral to the inferior epigastric vessels . This relationship is important during hernia surgeries to avoid damaging the vas deferens.</li><li>• Option C.</li><li>• correct</li><li>• vas deferens</li><li>• enters</li><li>• inguinal canal</li><li>• deep inguinal ring</li><li>• lateral</li><li>• inferior epigastric vessels</li><li>• hernia</li><li>• surgeries</li><li>• avoid damaging</li><li>• Option D. The vas deferens, as it travels towards the seminal vesicles and prostate , lies in close proximity to the base of the bladder , but it is not separated from it by peritoneum. The peritoneum , in fact, reflects off the bladder to cover the rectum , leaving the vas deferens in direct contact with the bladder base without a peritoneal layer in between.</li><li>• Option D.</li><li>• towards</li><li>• seminal vesicles</li><li>• prostate</li><li>• close proximity</li><li>• base</li><li>• bladder</li><li>• peritoneum</li><li>• reflects off</li><li>• bladder</li><li>• cover</li><li>• rectum</li><li>• leaving</li><li>• vas deferens</li><li>• direct contact</li><li>• bladder</li><li>• without</li><li>• peritoneal layer</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vas deferens crosses the ureter in the pelvic cavity near the sacroiliac joint , not at the ischial spine, as it moves medially towards the prostate gland .</li><li>➤ crosses</li><li>➤ ureter</li><li>➤ pelvic cavity</li><li>➤ sacroiliac joint</li><li>➤ moves medially</li><li>➤ prostate gland</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 250</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 250</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male with a history of benign prostatic hyperplasia presents to the clinic complaining of difficulty initiating urination and a weak urine stream. During the discussion, you decide to assess his understanding of the anatomy involved in his condition. Which of the following statements about the prostatic urethra is not correct?", "options": [{"label": "A", "text": "It is the Widest and most Dilatable Part", "correct": false}, {"label": "B", "text": "Presents a Concavity Posteriorly", "correct": true}, {"label": "C", "text": "Lies closer to Anterior Surface of Prostate", "correct": false}, {"label": "D", "text": "Receives Prostatic Ductules along its Posterior Wall", "correct": false}], "correct_answer": "B. Presents a Concavity Posteriorly", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture76.jpg"], "explanation": "<p><strong>Ans. B) Presents a Concavity Posteriorly</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct . The prostatic urethra, which runs through the prostate gland , is indeed the widest and most dilatable part of the urethra . It can accommodate a greater volume due to the elastic nature of the prostate tissue .</li><li>• Option A.</li><li>• correct</li><li>• prostate gland</li><li>• widest</li><li>• dilatable part</li><li>• urethra</li><li>• accommodate</li><li>• greater volume</li><li>• elastic nature</li><li>• prostate tissue</li><li>• Option C. This statement is correct . The prostatic urethra is situated closer to the anterior surface of the prostate gland than the posterior surface. This anatomical positioning is relevant in surgical procedures and pathologies involving the prostate .</li><li>• Option C.</li><li>• correct</li><li>• closer</li><li>• anterior surface</li><li>• prostate gland</li><li>• posterior surface.</li><li>• surgical procedures</li><li>• pathologies</li><li>• prostate</li><li>• Option D. This statement is also correct . The prostatic urethra receives numerous small prostatic ductules along its posterior wall . These ductules arise from the prostate gland and open into the urethra , allowing for the secretion of prostatic fluid into the urethra .</li><li>• Option D.</li><li>• correct</li><li>• numerous small prostatic ductules</li><li>• posterior wall</li><li>• arise</li><li>• prostate gland</li><li>• urethra</li><li>• allowing</li><li>• secretion</li><li>• prostatic fluid</li><li>• urethra</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The prostatic urethra does not present a concavity posteriorly. Instead, it has a slight convexity due to the protrusion of the prostatic tissue into the urethra , known as the urethral crest . This crest runs along the posterior wall of the prostatic urethra .</li><li>➤ slight convexity</li><li>➤ protrusion</li><li>➤ prostatic tissue</li><li>➤ urethra</li><li>➤ urethral crest</li><li>➤ crest</li><li>➤ posterior wall</li><li>➤ prostatic urethra</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old male presents with nocturia, difficulty initiating urination, and a sensation of incomplete bladder emptying. He has a history of hypertension and type 2 diabetes mellitus. Digital rectal examination reveals an enlarged, firm, and smooth prostate. These symptoms are most likely due to the obstruction of the urinary tract caused by the enlargement of which part of the prostate gland?", "options": [{"label": "A", "text": "Entire Prostate Gland", "correct": false}, {"label": "B", "text": "Lateral Lobes", "correct": false}, {"label": "C", "text": "Median Lobe", "correct": true}, {"label": "D", "text": "Posterior Lobe", "correct": false}], "correct_answer": "C. Median Lobe", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture77.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture78png.jpg"], "explanation": "<p><strong>Ans. C) Median Lobe</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While BPH can affect the entire Prostate gland , it typically does not involve uniform enlargement of all parts of the prostate. The enlargement is usually more pronounced in specific lobes .</li><li>• Option A.</li><li>• BPH</li><li>• affect</li><li>• Prostate gland</li><li>• more pronounced</li><li>• specific lobes</li><li>• Option B. The lateral lobes are often involved in BPH , and their enlargement can contribute to urinary obstruction . However, the characteristic feature that leads to the most significant urinary symptoms is the enlargement of another lobe .</li><li>• Option B.</li><li>• BPH</li><li>• enlargement</li><li>• urinary obstruction</li><li>• characteristic feature</li><li>• leads</li><li>• most significant urinary symptoms</li><li>• enlargement</li><li>• another lobe</li><li>• Option D. The posterior lobe is more commonly associated with prostate cancer rather than BPH . Enlargement of the posterior lobe is not typically the main contributor to urinary obstruction in BPH.</li><li>• Option D.</li><li>• prostate cancer</li><li>• BPH</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The enlargement of the median lobe of the prostate is most commonly associated with the obstruction seen in BPH . The median lobe, when enlarged , protrudes into the bladder and can impinge on the urethra , leading to urinary obstruction . This lobe's enlargement can cause a more significant impact on urinary flow than enlargement of other lobes.</li><li>➤ enlargement</li><li>➤ median lobe</li><li>➤ prostate</li><li>➤ obstruction</li><li>➤ BPH</li><li>➤ enlarged</li><li>➤ protrudes</li><li>➤ bladder</li><li>➤ impinge</li><li>➤ urethra</li><li>➤ urinary obstruction</li><li>➤ significant impact</li><li>➤ urinary flow</li><li>➤ enlargement</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 243</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 243</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old man presents to the clinic with a 2-day history of left-sided scrotal pain and swelling. He denies any trauma or recent heavy lifting. He also reports mild dysuria but no fever. On examination, the left scrotum is tender and slightly swollen. Transillumination of the scrotum reveals no abnormalities. A Doppler ultrasound shows normal blood flow to the testis. The patient's history and examination are most consistent with a diagnosis of epididymitis. Considering the anatomy relevant to this condition, which of the following is NOT a component of the spermatic cord, which might be involved in the patient's symptoms?", "options": [{"label": "A", "text": "Iliohypogastric Nerve", "correct": true}, {"label": "B", "text": "Genitofemoral Nerve", "correct": false}, {"label": "C", "text": "Vas Deferens", "correct": false}, {"label": "D", "text": "Pampiniform Plexus", "correct": false}], "correct_answer": "A. Iliohypogastric Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture80.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture81.jpg"], "explanation": "<p><strong>Ans. A) Iliohypogastric Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Part of the genitofemoral nerve, specifically the genital branch , runs along with the spermatic cord . This nerve originates from the L1-L2 spinal nerves and its genital branch is involved in the innervation of the cremaster muscle .</li><li>• Option B.</li><li>• genital branch</li><li>• spermatic cord</li><li>• originates</li><li>• L1-L2 spinal nerves</li><li>• genital branch</li><li>• innervation</li><li>• cremaster muscle</li><li>• Option C. The vas deferens, also known as the ductus deferens , is a key component of the spermatic cord . It is a muscular tube that transports sperm from the epididymis to the ejaculatory ducts .</li><li>• Option C.</li><li>• ductus deferens</li><li>• spermatic cord</li><li>• muscular tube</li><li>• transports sperm</li><li>• epididymis</li><li>• ejaculatory ducts</li><li>• Option D. The pampiniform plexus, a network of many small veins , is also a component of the spermatic cord . It helps in the regulation of temperature in the testicular environment , which is crucial for proper spermatogenesis .</li><li>• Option D.</li><li>• network</li><li>• many small veins</li><li>• component</li><li>• spermatic cord</li><li>• regulation</li><li>• temperature</li><li>• testicular environment</li><li>• crucial</li><li>• proper spermatogenesis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The iliohypogastric nerve is a nerve of the abdominal wall and does not run within the spermatic cord. It arises from the L1 spinal nerve and provides sensory innervation to the skin of the hip and lower abdominal wall .</li><li>➤ abdominal wall</li><li>➤ arises</li><li>➤ L1 spinal nerve</li><li>➤ sensory innervation</li><li>➤ skin</li><li>➤ hip</li><li>➤ lower abdominal wall</li><li>➤ Contents of Spermatic cord</li><li>➤ Contents of Spermatic cord</li><li>➤ Vas Deferens Pampiniform Plexus of Veins Testicular Artery, Artery to Vas Deferens, Cremasteric Artery Lymphatics of Testis and Epididymis Genital Branch of Genitofemoral Nerve Sympathetics from T10, T11 Processus Vaginalis remnants Accessory Suprarenal Tissue</li><li>➤ Vas Deferens</li><li>➤ Pampiniform Plexus of Veins</li><li>➤ Testicular Artery, Artery to Vas Deferens, Cremasteric Artery</li><li>➤ Lymphatics of Testis and Epididymis</li><li>➤ Genital Branch of Genitofemoral Nerve</li><li>➤ Sympathetics from T10, T11</li><li>➤ Processus Vaginalis remnants</li><li>➤ Accessory Suprarenal Tissue</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 48</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 48</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with a complaint of \"feeling a bulge\" in her vagina, which worsens by the end of the day or after prolonged standing. She also reports occasional urinary incontinence, especially when coughing or sneezing. On examination, there is evidence of a cystocele. The physician explains that her symptoms are due to pelvic floor weakness, which can affect various muscles and structures in the region. In the context of pelvic floor anatomy, which of the following muscles is NOT directly attached to the perineal body, and thus less likely to be involved in her condition?", "options": [{"label": "A", "text": "Ischiocavernosus", "correct": true}, {"label": "B", "text": "Bulbospongiosus", "correct": false}, {"label": "C", "text": "Superficial Transverse Perinei", "correct": false}, {"label": "D", "text": "Deep Transverse Perinei", "correct": false}], "correct_answer": "A. Ischiocavernosus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture82.jpg"], "explanation": "<p><strong>Ans. A) Ischiocavernosus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Bulbospongiosus muscle is attached to the perineal body . In males, it covers the bulb of the penis and in females , the vestibular bulb . It contributes to the erection of the penis and clitoris , respectively, and also plays a role in ejaculation in males and in the closing of the vaginal orifice in females .</li><li>• Option B.</li><li>• perineal body</li><li>• covers</li><li>• bulb</li><li>• penis</li><li>• females</li><li>• vestibular bulb</li><li>• erection</li><li>• penis</li><li>• clitoris</li><li>• ejaculation</li><li>• males</li><li>• closing</li><li>• vaginal orifice</li><li>• females</li><li>• Option C. Superficial Transverse Perinei muscle also attaches to the perineal body . It is a small , superficial muscle in the perineal region that helps stabilize the perineal body .</li><li>• Option C.</li><li>• perineal body</li><li>• small</li><li>• superficial muscle</li><li>• perineal region</li><li>• stabilize</li><li>• perineal body</li><li>• Option D. The deep transverse perineal muscle, part of the urogenital diaphragm , is attached to the perineal body . It supports the pelvic floor and helps in maintaining continence of urine .</li><li>• Option D.</li><li>• urogenital diaphragm</li><li>• perineal body</li><li>• supports</li><li>• pelvic floor</li><li>• continence</li><li>• urine</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ischiocavernosus muscle is not attached to the perineal body. Instead, it arises from the ischial tuberosity and the ischial ramus and extends along the sides of the penis in males and the clitoris in females . Its function is to help maintain erection by compressing the outflow of blood from the corpus cavernosum .</li><li>➤ arises</li><li>➤ ischial tuberosity</li><li>➤ ischial ramus</li><li>➤ extends</li><li>➤ sides</li><li>➤ penis</li><li>➤ males</li><li>➤ clitoris</li><li>➤ females</li><li>➤ maintain erection</li><li>➤ compressing</li><li>➤ outflow</li><li>➤ blood</li><li>➤ corpus cavernosum</li><li>➤ 10 Muscles attached to perineal body</li><li>➤ 10 Muscles attached to perineal body</li><li>➤ Levator Ani Muscle (2) Superficial Tansverse Perineii (2) Deep Transverse Perinei (2) Bulbospongiosus (2) Sphincter Urethrae (1) External Anal Sphincter (1)</li><li>➤ Levator Ani Muscle (2)</li><li>➤ Superficial Tansverse Perineii (2)</li><li>➤ Deep Transverse Perinei (2)</li><li>➤ Bulbospongiosus (2)</li><li>➤ Sphincter Urethrae (1)</li><li>➤ External Anal Sphincter (1)</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of diabetes mellitus comes to the clinic complaining of difficulty maintaining an erection for the past 6 months. He is particularly concerned because his diabetes is well-controlled, and he has not had any significant lifestyle changes recently. He inquires about the potential causes of his erectile dysfunction, emphasizing his interest in understanding how nerve function impacts this process. Given the role of neural pathways in penile erection, which of the following neural structures is LEAST likely to be directly involved in the mediation of penile erection?", "options": [{"label": "A", "text": "Pudendal Nerve", "correct": false}, {"label": "B", "text": "Sacral Plexus", "correct": false}, {"label": "C", "text": "Hypogastric Plexus", "correct": true}, {"label": "D", "text": "Nervi Erigentes", "correct": false}], "correct_answer": "C. Hypogastric Plexus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture83.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture84.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture85.jpg"], "explanation": "<p><strong>Ans. C) Hypogastric Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The pudendal nerve , originating from the sacral plexus ( S2-S4 ), is primarily involved in the sensory and motor innervation of the perineal region . It plays a role in the control of the external urethral sphincter and the ischiocavernosus and bulbospongiosus muscles , which assist in maintaining the erection , but it is not the primary mediator of the vascular changes leading to erection.</li><li>• Option A.</li><li>• pudendal nerve</li><li>• sacral plexus</li><li>• S2-S4</li><li>• sensory</li><li>• motor innervation</li><li>• perineal region</li><li>• control</li><li>• external urethral sphincter</li><li>• ischiocavernosus</li><li>• bulbospongiosus muscles</li><li>• maintaining</li><li>• erection</li><li>• Option B. The sacral plexus, particularly its parasympathetic components ( S2-S4 ), plays a crucial role in the process of erection . Parasympathetic fibers from the sacral plexus contribute to the pelvic splanchnic nerves ( nervierigentes ), which are directly involved in causing vasodilation and blood flow to the erectile tissues of the penis .</li><li>• Option B.</li><li>• parasympathetic components</li><li>• S2-S4</li><li>• process</li><li>• erection</li><li>• pelvic splanchnic nerves</li><li>• nervierigentes</li><li>• vasodilation</li><li>• blood flow</li><li>• erectile tissues</li><li>• penis</li><li>• Option D. Nervi Erigentes, also known as the pelvic splanchnic nerves , these nerves arise from the S2-S4 levels of the spinal cord and are part of the parasympathetic nervous system . They are directly involved in initiating the erection of the penis by causing vasodilation of penile arteries , leading to increased blood flow into the erectile tissues .</li><li>• Option D.</li><li>• pelvic splanchnic nerves</li><li>• arise</li><li>• S2-S4 levels</li><li>• spinal cord</li><li>• parasympathetic nervous system</li><li>• initiating</li><li>• erection</li><li>• penis</li><li>• vasodilation</li><li>• penile arteries</li><li>• increased blood flow</li><li>• erectile tissues</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The hypogastric plexus is part of the sympathetic nervous system and is primarily involved in ejaculation and the sensation of orgasm . While it has a role in the reproductive system , it is not directly involved in mediating the erection of the penis. In fact, sympathetic activation is generally associated with the inhibition of erection .</li><li>➤ hypogastric plexus</li><li>➤ sympathetic nervous system</li><li>➤ ejaculation</li><li>➤ sensation</li><li>➤ orgasm</li><li>➤ reproductive system</li><li>➤ sympathetic activation</li><li>➤ inhibition</li><li>➤ erection</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 55</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 55</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents to the urology clinic with complaints of erectile dysfunction that has progressively worsened over the past year. He is particularly concerned as this issue is starting to affect his relationship with his partner. He has a history of hypertension but is otherwise healthy. He does not smoke and only drinks alcohol occasionally. During the consultation, the urologist explains the physiology of erection and the vascular structures involved. As part of the discussion, the urologist quizzes the patient about the arterial supply critical for erection, asking which artery the helicine arteries, responsible for allowing blood flow into the penile corpora cavernosa, are branches of", "options": [{"label": "A", "text": "Deep Artery of Penis", "correct": true}, {"label": "B", "text": "Femoral Artery", "correct": false}, {"label": "C", "text": "External Pudendal Artery", "correct": false}, {"label": "D", "text": "Dorsal Artery of Penis", "correct": false}], "correct_answer": "A. Deep Artery of Penis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/whatsapp-image-2024-02-15-at-110829-am.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-113127.jpg"], "explanation": "<p><strong>Ans. A) Deep Artery of Penis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The femoral artery is a major blood vessel in the thigh that supplies blood to the lower limb . It does not directly give rise to the helicine arteries of the penis.</li><li>• Option B.</li><li>• major blood vessel</li><li>• thigh</li><li>• supplies</li><li>• blood</li><li>• lower limb</li><li>• Option C. The external pudendal artery, a branch of the femoral artery , supplies blood to the external genitalia and the lower part of the abdominal wall . While it is important for the blood supply to the superficial structures of the genital area , it does not give rise to the helicine arteries.</li><li>• Option C.</li><li>• femoral artery</li><li>• blood</li><li>• external genitalia</li><li>• lower part</li><li>• abdominal wall</li><li>• blood supply</li><li>• superficial structures</li><li>• genital area</li><li>• Option D. The dorsal artery of the penis, one of the terminal branches of the internal pudendal artery , primarily supplies blood to the skin and fascia of the penis and the glans penis . It does not give rise to the helicine arteries, which are specifically branches of the deep artery of the penis .</li><li>• Option D.</li><li>• terminal branches</li><li>• internal pudendal artery</li><li>• supplies blood</li><li>• skin</li><li>• fascia</li><li>• penis</li><li>• glans penis</li><li>• specifically branches</li><li>• deep artery</li><li>• penis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The helicine arteries are small , coiled branches of the deep artery of the penis . They play a crucial role in the mechanism of penile erection . During erection , these arteries uncoil and dilate to allow increased blood flow into the cavernous spaces of the corpus cavernosum , leading to the engorgement of the penis .</li><li>➤ helicine arteries</li><li>➤ small</li><li>➤ coiled branches</li><li>➤ deep artery</li><li>➤ penis</li><li>➤ mechanism</li><li>➤ penile erection</li><li>➤ erection</li><li>➤ uncoil</li><li>➤ dilate</li><li>➤ allow increased</li><li>➤ blood flow</li><li>➤ cavernous spaces</li><li>➤ corpus cavernosum</li><li>➤ engorgement</li><li>➤ penis</li><li>➤ Arterial Supply of Penis:</li><li>➤ Arterial Supply of Penis:</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 55</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 55</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man presents to the emergency department following a straddle injury sustained during a motorcycle accident. He complains of perineal pain and difficulty urinating. On examination, there is significant bruising and swelling in the perineal region, but no blood at the urethral meatus. The attending physician is concerned about potential injury to the structures of the urogenital diaphragm. As part of the assessment, the physician reviews the anatomy of the urogenital diaphragm with the resident, highlighting its components and their significance in relation to the patient's injury. Which of the following is NOT a component of the urogenital diaphragm, and the Ref ore less likely to be directly impacted by the patient's injury?", "options": [{"label": "A", "text": "Deep Transverse Perineii", "correct": false}, {"label": "B", "text": "Perineal Membrane", "correct": false}, {"label": "C", "text": "Colle’s Fascia", "correct": true}, {"label": "D", "text": "Sphincter Urethrae", "correct": false}], "correct_answer": "C. Colle’s Fascia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture86.jpg"], "explanation": "<p><strong>Ans. C) Colle’s Fascia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deep Transverse Perineii muscles are indeed a part of the urogenital diaphragm . They span the anterior part of the pelvic outlet and play a role in supporting the pelvic organs.</li><li>• Option A.</li><li>• urogenital diaphragm</li><li>• span</li><li>• anterior part</li><li>• pelvic outlet</li><li>• supporting</li><li>• pelvic organs.</li><li>• Option B. Perineal Membrane is a layer of fascia that is part of the urogenital diaphragm . It provides support to the pelvic floor and is an attachment point for various muscles.</li><li>• Option B.</li><li>• layer of fascia</li><li>• urogenital diaphragm</li><li>• support</li><li>• pelvic floor</li><li>• Option D. Sphincter Urethrae muscle is part of the urogenital diaphragm . It surrounds the urethra and contributes to urinary continence by providing voluntary control over the flow of urine .</li><li>• Option D.</li><li>• urogenital diaphragm</li><li>• surrounds</li><li>• urethra</li><li>• contributes</li><li>• urinary continence</li><li>• voluntary control</li><li>• flow of urine</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Colles' fascia is not a component of the urogenital diaphragm. It is a layer of superficial fascia found in the perineum and lower abdomen , external to the urogenital diaphragm . It is mainly involved in enclosing the superficial perineal space .</li><li>➤ layer</li><li>➤ superficial fascia</li><li>➤ perineum</li><li>➤ lower abdomen</li><li>➤ external</li><li>➤ urogenital diaphragm</li><li>➤ enclosing</li><li>➤ superficial perineal space</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old man with a history of Benign Prostatic Hyperplasia (BPH) and recent Trans-Urethral Resection of the Prostate (TURP) surgery presents to the urology clinic for a follow-up visit. He reports satisfaction with the improvement in urinary symptoms but expresses concern about new-onset erectile dysfunction since the procedure. The urologist explains that this complication can occur due to injury or disruption of the nerves involved in the erectile process during surgery. To educate the patient further, the urologist discusses the characteristics of the nervierigentes, which play a crucial role in penile erection. Which of the following statements about the nervierigentes is INCORRECT?", "options": [{"label": "A", "text": "Autonomic Nerve", "correct": false}, {"label": "B", "text": "Parasympathetic Outflow", "correct": false}, {"label": "C", "text": "Arise from Ventral Rami", "correct": false}, {"label": "D", "text": "Joins Superior Hypogastric Plexus", "correct": true}], "correct_answer": "D. Joins Superior Hypogastric Plexus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture87.jpg"], "explanation": "<p><strong>Ans. D) Joins Superior Hypogastric Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The nervierigentes are part of the autonomic nervous system . They are specifically part of the parasympathetic division , which is responsible for \" rest and digest \" functions . It carries preganglionic parasympathetic motor fibres and viscerosensory fibres</li><li>• Option A.</li><li>• nervierigentes</li><li>• autonomic nervous system</li><li>• parasympathetic division</li><li>• rest and digest</li><li>• functions</li><li>• preganglionic parasympathetic</li><li>• motor fibres</li><li>• viscerosensory fibres</li><li>• Option B. The nervierigentes are indeed parasympathetic outflows . They originate from the sacral region of the spinal cord ( S2-S4 ) and are involved in the activation of the parasympathetic response in the pelvic organs .</li><li>• Option B.</li><li>• parasympathetic outflows</li><li>• originate</li><li>• sacral region</li><li>• spinal cord</li><li>• S2-S4</li><li>• activation</li><li>• parasympathetic response</li><li>• pelvic organs</li><li>• Option C. The nervierigentes arise from the ventral rami ( anterior divisions ) of the S2-S4 spinal nerves . They carry the parasympathetic fibers that originate in the sacral spinal cord .</li><li>• Option C.</li><li>• ventral rami</li><li>• anterior divisions</li><li>• S2-S4 spinal nerves</li><li>• parasympathetic fibers</li><li>• sacral spinal cord</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The nervierigentes do not join the superior hypogastric plexus. The superior hypogastric plexus is a sympathetic structure located in the lower abdomen . Instead, the nervierigentes contribute to the formation of the inferior hypogastric plexus (also known as the pelvic plexus ) and are responsible for supplying parasympathetic innervation to the pelvic organs , including the bladder and genitals .</li><li>• superior hypogastric plexus</li><li>• sympathetic structure</li><li>• lower abdomen</li><li>• formation</li><li>• inferior hypogastric plexus</li><li>• pelvic plexus</li><li>• supplying parasympathetic innervation</li><li>• pelvic organs</li><li>• bladder</li><li>• genitals</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 195</li><li>• Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 195</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old female athlete presents to the clinic with complaints of discomfort and swelling in the perineal area, exacerbated during cycling. She denies any history of trauma, infection, or urinary symptoms. On examination, there is tenderness and mild swelling in the superficial perineal region, without any signs of abscess or infection. The physician suspects a strain or minor injury to the structures within the superficial perineal pouch, possibly related to her cycling. As part of patient education, the physician discusses the contents of the superficial perineal pouch and their relevance to her symptoms. Which of the following is NOT typically found in the superficial perineal pouch and therefore unlikely to be directly involved in the patient's symptoms?", "options": [{"label": "A", "text": "Root of Penis", "correct": false}, {"label": "B", "text": "Posterior Labial Vessels", "correct": false}, {"label": "C", "text": "Greater Vestibular Glands", "correct": false}, {"label": "D", "text": "Membranous Urethra", "correct": true}], "correct_answer": "D. Membranous Urethra", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Membranous Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The root of the penis (including the bulb and crura of the penis ) is indeed located in the superficial perineal pouch in males . This area contributes to the stability and function of the penis .</li><li>• Option A.</li><li>• bulb</li><li>• crura</li><li>• penis</li><li>• superficial perineal pouch</li><li>• males</li><li>• stability</li><li>• function</li><li>• penis</li><li>• Option B. Posterior Labial Vessels, which supply blood to the labia in females , are located in the superficial perineal pouch .</li><li>• Option B.</li><li>• blood</li><li>• labia</li><li>• females</li><li>• superficial perineal pouch</li><li>• Option C. In females, the greater vestibular glands (Bartholin's glands) are found in the superficial perineal pouch . These glands are responsible for secreting mucus to lubricate the vagina .</li><li>• Option C.</li><li>• (Bartholin's glands)</li><li>• superficial perineal pouch</li><li>• secreting mucus</li><li>• lubricate</li><li>• vagina</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The membranous urethra is not contained within the superficial perineal pouch. It is actually located in the deep perineal pouch . The membranous urethra is the portion of the urethra that passes through the urogenital diaphragm .</li><li>➤ deep perineal pouch</li><li>➤ urethra</li><li>➤ urogenital diaphragm</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 222</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old man presents to the emergency department following a pelvic injury sustained in a motor vehicle accident. He complains of severe perineal pain and difficulty urinating. The initial assessment reveals no blood at the urethral meatus, and a catheter is placed without difficulty, draining clear urine. Given the nature of the injury, the emergency physician is concerned about potential damage to the structures within the deep perineal pouch. As the team plans for further diagnostic imaging and management, they review the anatomy relevant to the patient's injury. Which of the following structures is NOT typically found in the deep perineal pouch and therefore less likely to be directly involved in the patient's symptoms?", "options": [{"label": "A", "text": "Dorsal Nerve of Penis", "correct": false}, {"label": "B", "text": "Root of Penis", "correct": true}, {"label": "C", "text": "Bulbourethral Glands", "correct": false}, {"label": "D", "text": "Sphincter Urethrae", "correct": false}], "correct_answer": "B. Root of Penis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture88.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-113339.jpg"], "explanation": "<p><strong>Ans. B) Root of Penis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The dorsal nerve of the penis, a branch of the pudendal nerve , is indeed located in the deep perineal pouch . It provides sensory innervation to the penis .</li><li>• Option A.</li><li>• pudendal nerve</li><li>• deep perineal pouch</li><li>• sensory innervation</li><li>• penis</li><li>• Option C. Bulbourethral Glands, also known as Cowper's glands , these are located in the deep perineal pouch . They are responsible for secreting fluid that is part of the semen .</li><li>• Option C.</li><li>• Cowper's glands</li><li>• deep perineal pouch</li><li>• secreting fluid</li><li>• semen</li><li>• Option D. The sphincter urethrae, or the urethral sphincter , is a muscle located in the deep perineal pouch . It plays a crucial role in controlling the passage of urine from the bladder .</li><li>• Option D.</li><li>• urethral sphincter</li><li>• deep perineal pouch</li><li>• controlling</li><li>• passage</li><li>• urine</li><li>• bladder</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The root of the penis, which includes the bulb and the crura of the penis , is located in the superficial perineal pouch , not the deep perineal pouch.</li><li>➤ bulb</li><li>➤ crura</li><li>➤ penis</li><li>➤ superficial perineal pouch</li><li>➤ Contents of Deep Perineal Pouch</li><li>➤ Contents of Deep Perineal Pouch</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 221</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old woman presents to the clinic with persistent left lower quadrant abdominal pain and a recent history of urinary frequency and urgency. She has a past medical history of diverticulosis and a previous surgical procedure for ovarian cyst removal. During her evaluation, the physician considers the anatomical structures that may be implicated in her symptoms, given her clinical history and the location of her pain. In discussing the potential involvement of the left ureter in her symptoms, the physician reviews its anatomical relations. Which of the following structures is NOT typically an anterior relation of the abdominal part of the left ureter and therefore less likely to be directly involved in the patient's symptoms?", "options": [{"label": "A", "text": "Sigmoid Mesentery", "correct": true}, {"label": "B", "text": "Genitofemoral Nerve", "correct": false}, {"label": "C", "text": "Colic Branches", "correct": false}, {"label": "D", "text": "Gonadal Vessels", "correct": false}], "correct_answer": "A. Sigmoid Mesentery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture89.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-113453.jpg"], "explanation": "<p><strong>Ans. A) Sigmoid Mesentery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The genitofemoral nerve runs anterior to the ureter as it descends in the abdomen . It arises from the lumbar plexus and descends on the anterior surface of the psoas major muscle , crossing anterior to the ureter in the pelvic region .</li><li>• Option B.</li><li>• anterior</li><li>• ureter</li><li>• descends</li><li>• abdomen</li><li>• arises</li><li>• lumbar plexus</li><li>• descends</li><li>• anterior surface</li><li>• psoas major muscle</li><li>• anterior</li><li>• ureter</li><li>• pelvic region</li><li>• Option C. The colic branches, which refer to blood vessels supplying the colon , can be anterior relations of the left ureter . Specifically, the vessels supplying the descending colon might cross in front of the ureter .</li><li>• Option C.</li><li>• blood vessels</li><li>• colon</li><li>• anterior relations</li><li>• left ureter</li><li>• supplying</li><li>• descending colon</li><li>• cross</li><li>• ureter</li><li>• Option D. The gonadal vessels ( testicular or ovarian vessels ) are indeed anterior to the ureter . In males , the testicular vessels , and in females , the ovarian vessels , cross anterior to the ureter as they travel to and from the reproductive organs .</li><li>• Option D.</li><li>• testicular</li><li>• ovarian vessels</li><li>• anterior</li><li>• ureter</li><li>• males</li><li>• testicular vessels</li><li>• females</li><li>• ovarian vessels</li><li>• anterior</li><li>• ureter</li><li>• reproductive organs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sigmoid mesentery, which suspends the sigmoid colon , is not typically an anterior relation of the abdominal part of the left ureter. Instead, it is more related to the posterior aspect of the sigmoid colon and the lower left ureter . The ureter usually runs behind the sigmoid mesocolon .</li><li>➤ The sigmoid mesentery, which suspends the sigmoid colon , is not typically an anterior relation of the abdominal part of the left ureter. Instead, it is more related to the posterior aspect of the sigmoid colon and the lower left ureter . The ureter usually runs behind the sigmoid mesocolon .</li><li>➤ suspends</li><li>➤ sigmoid colon</li><li>➤ posterior aspect</li><li>➤ sigmoid colon</li><li>➤ lower left ureter</li><li>➤ runs behind</li><li>➤ sigmoid mesocolon</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 172</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 172</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old man presents to the urology clinic with complaints of intermittent left-sided flank pain radiating to the groin, accompanied by episodes of hematuria. He has a history of recurrent calcium oxalate kidney stones. A CT urogram is ordered to evaluate his urinary tract, with particular attention to the course of the ureter and potential sites of obstruction. During the review of the imaging findings, the attending urologist takes the opportunity to educate the resident about the anatomical relations of the ureter, particularly its pelvic course, and how stones can impact these areas. Which of the following structures is NOT typically a lateral relation of the pelvic course (first part) of the ureter, thus less likely to be directly impacted by a ureteral stone at this location?", "options": [{"label": "A", "text": "Obturator Vessels", "correct": false}, {"label": "B", "text": "Obturator Nerve", "correct": false}, {"label": "C", "text": "Internal Iliac Vessels", "correct": true}, {"label": "D", "text": "Inferior Vesical Artery", "correct": false}], "correct_answer": "C. Internal Iliac Vessels", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture90.jpg"], "explanation": "<p><strong>Ans. C) Internal Iliac Vessels</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The obturator vessels, which include the obturator artery and vein , are indeed lateral to the ureter in its pelvic course . These vessels arise from the internal iliac artery and vein , and they pass through the obturator canal to reach the medial thigh . They are closely related to the lateral side of the ureter as it descends in the pelvis .</li><li>• Option A.</li><li>• obturator artery</li><li>• vein</li><li>• lateral</li><li>• ureter</li><li>• pelvic course</li><li>• arise</li><li>• internal iliac artery</li><li>• vein</li><li>• obturator canal</li><li>• medial thigh</li><li>• lateral side</li><li>• ureter</li><li>• descends</li><li>• pelvis</li><li>• Option B. Similarly, the obturator nerve , which also travels through the obturator canal , is a lateral relation to the pelvic ureter . This nerve provides motor and sensory innervation to the medial thigh and is closely associated with the obturator vessels .</li><li>• Option B.</li><li>• obturator nerve</li><li>• obturator canal</li><li>• lateral relation</li><li>• pelvic ureter</li><li>• motor</li><li>• sensory innervation</li><li>• medial thigh</li><li>• obturator vessels</li><li>• Option D. The inferior vesical artery, a branch of the internal iliac artery , can be a lateral relation to the ureter in males (in females , the vaginal artery , a homologous structure, takes a similar course). It supplies the bladder and, in males , the prostate and seminal vesicles . Its proximity to the ureter varies but can be lateral in some parts of the ureter's pelvic course .</li><li>• Option D.</li><li>• internal iliac artery</li><li>• lateral relation</li><li>• ureter</li><li>• males</li><li>• females</li><li>• vaginal artery</li><li>• supplies</li><li>• bladder</li><li>• males</li><li>• prostate</li><li>• seminal vesicles</li><li>• ureter varies</li><li>• lateral</li><li>• ureter's pelvic course</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The internal iliac vessels are not a lateral relation to the first part of the pelvic ureter. Instead, these vessels, including the internal iliac artery and its branches , are more medial and superior in relation to the ureter at this point of its course. The ureter actually runs anterior to the internal iliac vessels as it enters the pelvis .</li><li>➤ internal iliac artery</li><li>➤ branches</li><li>➤ medial</li><li>➤ superior</li><li>➤ ureter</li><li>➤ anterior</li><li>➤ internal iliac vessels</li><li>➤ enters</li><li>➤ pelvis</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 172</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 172</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman is brought to the emergency department with severe right flank pain that radiates to the groin, accompanied by nausea and vomiting. She describes the pain as \"the worst she has ever felt,\" and it came on suddenly. Her vital signs are within normal limits, but she appears to be in considerable distress. A non-contrast CT of the abdomen and pelvis is performed, which reveals a 5 mm stone at the distal end of the right ureter. The attending physician explains to the patient that the stone is located at one of the ureter's naturally narrow points, which is why it is causing significant pain and symptoms. Which part of the ureter is known to be the narrowest and is the most common site for such stones to cause obstruction?", "options": [{"label": "A", "text": "At Pelvic Brim", "correct": false}, {"label": "B", "text": "At Ischial Spine", "correct": false}, {"label": "C", "text": "Pelvic Ureteric Junction", "correct": false}, {"label": "D", "text": "At the Entry of the Bladder", "correct": true}], "correct_answer": "D. At the Entry of the Bladder", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture72_tzts37Z.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-113650_P3Wsv0O.jpg"], "explanation": "<p><strong>Ans. D) At the Entry of the Bladder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While the ureter does undergo a change in direction at the pelvic brim , it is not typically the narrowest part of the ureter. The pelvic brim is where the ureter crosses over the common iliac vessels .</li><li>• Option A.</li><li>• change</li><li>• direction</li><li>• pelvic brim</li><li>• ureter</li><li>• crosses</li><li>• common iliac vessels</li><li>• Option B.</li><li>• pudendal nerve</li><li>• Option C. The pelvic ureteric junction is where the ureter transitions from the abdominal part to the pelvic part . It can be a site of constriction , but it's not typically the narrowest point of the ureter.</li><li>• Option C.</li><li>• ureter transitions</li><li>• abdominal part</li><li>• pelvic part</li><li>• site</li><li>• constriction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ureteric orifice, where the ureter enters the bladder , is the narrowest part of the ureter . This point is clinically significant because it is a common site for kidney stones to become lodged , leading to obstruction .</li><li>➤ enters</li><li>➤ bladder</li><li>➤ narrowest part</li><li>➤ ureter</li><li>➤ common site</li><li>➤ kidney stones</li><li>➤ lodged</li><li>➤ obstruction</li><li>➤ Sites of Constrictions of ureter</li><li>➤ Sites of Constrictions</li><li>➤ ureter</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 171</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 171</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 59-year-old man with a history of hypertension and chronic kidney disease is undergoing a pre-operative assessment for a planned nephrectomy due to a renal tumor. As part of the surgical planning, the vascular surgeon reviews the renal and suprarenal vasculature to anticipate potential complications and ensure preservation of essential blood supply. The patient is curious about the blood supply to his kidneys and the adjacent adrenal glands, prompting a discussion on the various arterial sources. The surgeon explains that while the kidneys and adrenal glands have a rich vascular supply, one of the listed arteries does not typically contribute to the suprarenal (adrenal) glands. Which of the following arteries is NOT a usual source of blood supply for the suprarenal glands?", "options": [{"label": "A", "text": "Aorta", "correct": false}, {"label": "B", "text": "Renal Artery", "correct": false}, {"label": "C", "text": "Inferior Phrenic Artery", "correct": false}, {"label": "D", "text": "Superior Mesenteric Artery", "correct": true}], "correct_answer": "D. Superior Mesenteric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture91.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture92.jpg"], "explanation": "<p><strong>Ans. D) Superior mesenteric artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The suprarenal glands are supplied by the superior suprarenal arteries , which arise directly from the aorta . Middle suprarenal artery arises from abdominal aorta .</li><li>• Option A.</li><li>• suprarenal glands</li><li>• superior suprarenal arteries</li><li>• aorta</li><li>• Middle suprarenal artery</li><li>• abdominal aorta</li><li>• Option B. The middle suprarenal arteries , which supply the adrenal glands , typically arise from the renal arteries . Inferior suprarenal artery from renal artery .</li><li>• Option B.</li><li>• middle suprarenal arteries</li><li>• supply</li><li>• adrenal glands</li><li>• renal arteries</li><li>• Inferior suprarenal artery</li><li>• renal artery</li><li>• Option C. The inferior suprarenal arteries are branches of the inferior phrenic arteries , which supply the adrenal glands . Superior suprarenal artery from inferior phrenic artery .</li><li>• Option C.</li><li>• branches</li><li>• inferior phrenic arteries</li><li>• supply</li><li>• adrenal glands</li><li>• inferior phrenic artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior mesenteric artery does not typically give off branches to supply the adrenal glands. The superior mesenteric artery primarily supplies the midgut , including parts of the small intestine and the early sections of the large intestine , but not the suprarenal glands.</li><li>➤ supplies</li><li>➤ midgut</li><li>➤ small intestine</li><li>➤ large intestine</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 176</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the gastroenterology clinic with a history of chronic, episodic abdominal pain that worsens after eating, accompanied by significant weight loss and occasional nausea. She reports that the pain is often relieved when she leans forward or assumes a fetal position. Despite extensive gastrointestinal workup, including endoscopy and abdominal ultrasound, no significant abnormalities have been found. The gastroenterologist suspects a vascular cause for her symptoms and plans further diagnostic evaluation. Based on the patient's clinical presentation, which artery's involvement should be considered in the differential diagnosis of her condition?", "options": [{"label": "A", "text": "Inferior Mesenteric Artery", "correct": false}, {"label": "B", "text": "Renal Artery", "correct": false}, {"label": "C", "text": "Coeliac Trunk", "correct": true}, {"label": "D", "text": "Gonadal Artery", "correct": false}], "correct_answer": "C. Coeliac Trunk", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture93.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture94.jpg"], "explanation": "<p><strong>Ans. C) Coeliac Trunk</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Inferior mesenteric artery arises from front of aorta 4 cm above its bifurcation opposite L3 Vertebra . The inferior mesenteric artery supplies parts of the large intestine . It is not typically associated with Dunbar's syndrome.</li><li>• Option A</li><li>• front of aorta</li><li>• 4 cm</li><li>• above</li><li>• bifurcation</li><li>• opposite L3 Vertebra</li><li>• parts</li><li>• large intestine</li><li>• Option B. The renal artery supplies the kidneys . While renal artery stenosis can cause issues like hypertension , it is not related to Dunbar's syndrome. Renal arteries arises from sides of aorta just below origin of superior mesenteric artery opposite L2 vertebra</li><li>• Option B.</li><li>• supplies</li><li>• kidneys</li><li>• stenosis</li><li>• hypertension</li><li>• arises</li><li>• sides</li><li>• aorta</li><li>• below origin</li><li>• superior mesenteric artery</li><li>• opposite L2 vertebra</li><li>• Option D. The gonadal arteries supply the gonads (testes in males and ovaries in females). They are not involved in Dunbar's syndrome. Gonadal arteries (Testicular and ovarian arteries) arise from aorta a little below the origin of renal arteries</li><li>• Option D.</li><li>• supply</li><li>• gonads</li><li>• Gonadal arteries</li><li>• aorta</li><li>• little below</li><li>• origin</li><li>• renal arteries</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dunbar's syndrome is characterized by the compression of the coeliac trunk , a major artery that supplies blood to the stomach , liver , spleen , and upper part of the small intestine . The compression is typically caused by the median arcuate ligament of the diaphragm , leading to abdominal pain , especially after eating .</li><li>➤ compression</li><li>➤ coeliac trunk</li><li>➤ major artery</li><li>➤ blood</li><li>➤ stomach</li><li>➤ liver</li><li>➤ spleen</li><li>➤ upper part</li><li>➤ small intestine</li><li>➤ median arcuate ligament</li><li>➤ diaphragm</li><li>➤ abdominal pain</li><li>➤ after eating</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 185</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old male 3 months ago started to feel a bulging lesion on the surface of glans penis. known smoker for 20 years, no multiple sexual partners and no viral infection. Patient was circumcised. He started having difficulty in micturition. He went to the surgery OP. the glans penis was fully covered and invasion was detected in the urethral meatus. Biopsy was taken from the patient and the urethral meatus was opened. The biopsy result was squamous cell carcinoma. In the above condition which group of lymph nodes enlarge?", "options": [{"label": "A", "text": "Medial Members of the Upper Horizontal Group of Superficial Inguinal Lymph Nodes", "correct": false}, {"label": "B", "text": "Lateral Members of the Upper Horizontal Group of Superficial Inguinal Lymph Nodes", "correct": false}, {"label": "C", "text": "Lower / Vertical Group of Superficial Inguinal Lymph Nodes", "correct": false}, {"label": "D", "text": "Deep Inguinal Lymph Nodes", "correct": true}], "correct_answer": "D. Deep Inguinal Lymph Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture95.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-114351.jpg"], "explanation": "<p><strong>Ans. D) Deep Inguinal Lymph Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. These lymph nodes are part of the superficial inguinal group and are located just below the inguinal ligament . They receive lymphatic drainage from the penile and scrotal area . While these nodes can be involved in penile cancers , they are not typically the first group of nodes to show enlargement.</li><li>• Option A.</li><li>• superficial inguinal group</li><li>• below</li><li>• inguinal ligament</li><li>• receive lymphatic drainage</li><li>• penile</li><li>• scrotal area</li><li>• involved</li><li>• penile cancers</li><li>• Option B. Similar to the medial members , these nodes are also part of the superficial inguinal group and can be involved in the lymphatic drainage of the penile region . They might be affected by metastasis in penile cancer , but they are generally not the primary or initial site of enlargement.</li><li>• Option B.</li><li>• medial members</li><li>• superficial inguinal group</li><li>• lymphatic drainage</li><li>• penile region</li><li>• affected</li><li>• metastasis</li><li>• penile cancer</li><li>• Option C. These nodes are also part of the superficial inguinal group and are located more medially and inferiorly compared to the upper horizontal group . They too receive drainage from the penile area and can be involved in the spread of penile cancer .</li><li>• Option C.</li><li>• superficial inguinal group</li><li>• medially</li><li>• inferiorly</li><li>• upper horizontal group</li><li>• drainage</li><li>• penile area</li><li>• spread</li><li>• penile cancer</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The deep inguinal lymph nodes are a common site for the initial spread of penile cancers like squamous cell carcinoma . These nodes lie beneath the fascia lata and along the femoral vein . Given their anatomical location and lymphatic drainage patterns, they are often the first group of nodes to exhibit enlargement in the case of penile cancer.</li><li>➤ The deep inguinal lymph nodes are a common site for the initial spread of penile cancers like squamous cell carcinoma . These nodes lie beneath the fascia lata and along the femoral vein . Given their anatomical location and lymphatic drainage patterns, they are often the first group of nodes to exhibit enlargement in the case of penile cancer.</li><li>➤ deep inguinal lymph nodes</li><li>➤ initial spread</li><li>➤ penile cancers</li><li>➤ squamous cell carcinoma</li><li>➤ beneath</li><li>➤ fascia lata</li><li>➤ femoral vein</li><li>➤ first group</li><li>➤ nodes</li><li>➤ exhibit enlargement</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 1320</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 1320</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old lady was admitted in the emergency department for complaints of abdominal pain and frequent episodes of vomiting and she also complained of a swelling in right groin with a 3-month history. The swelling became painful 24-hour prior to admission. On examination, the abdomen was distended with loud peristaltic sounds. The groin swelling was diagnosed as femoral hernia. Which of the following statements is not true about the groin swelling in this condition?", "options": [{"label": "A", "text": "Femoral Hernia is more common in Females", "correct": false}, {"label": "B", "text": "Abnormal Obturator Artery can get injured during Repair", "correct": false}, {"label": "C", "text": "The Swelling is located Below and Medial to Pubic Tubercle", "correct": true}, {"label": "D", "text": "Femoral Ring is bounded behind by Pectineus Muscle", "correct": false}], "correct_answer": "C. The Swelling is located Below and Medial to Pubic Tubercle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture96.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-15-114525.jpg"], "explanation": "<p><strong>Ans. C) The Swelling is located Below and Medial to Pubic Tubercle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Femoral hernias are indeed more common in females than in males . This is partly due to the wider female pelvis , which provides a larger femoral canal and a greater potential space for herniation .</li><li>• Option A.</li><li>• common</li><li>• females</li><li>• males</li><li>• partly</li><li>• wider female pelvis</li><li>• larger femoral canal</li><li>• greater potential space</li><li>• herniation</li><li>• Option B. The obturator artery , in some individuals, may have an abnormal course known as the \" corona mortis ,\" where it crosses the area usually involved in hernia repairs . Surgeons must be cautious of this variant during surgical repair to avoid injuring the artery .</li><li>• Option B.</li><li>• obturator artery</li><li>• abnormal course</li><li>• corona mortis</li><li>• crosses</li><li>• area</li><li>• hernia repairs</li><li>• surgical repair</li><li>• avoid injuring</li><li>• artery</li><li>• Option D. The femoral ring , which is the anatomical site where femoral hernias protrude , is bounded posteriorly by the pectineus muscle . Other boundaries include the inguinal ligament anteriorly , the femoral vein laterally , and the lacunar ligament medially .</li><li>• Option D.</li><li>• femoral ring</li><li>• anatomical site</li><li>• femoral hernias protrude</li><li>• posteriorly</li><li>• pectineus muscle</li><li>• inguinal ligament anteriorly</li><li>• femoral vein laterally</li><li>• lacunar ligament medially</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Femoral hernias appear below and lateral to the pubic tubercle . In contrast, inguinal hernias , another type of groin hernia , typically appear above and medial to the pubic tubercle .</li><li>➤ Femoral hernias</li><li>➤ below</li><li>➤ lateral</li><li>➤ pubic tubercle</li><li>➤ inguinal hernias</li><li>➤ groin hernia</li><li>➤ appear above</li><li>➤ medial</li><li>➤ pubic</li><li>➤ tubercle</li><li>➤ Femoral hernia is common in females because of:</li><li>➤ common</li><li>➤ females</li><li>➤ Wider femoral ring due to greater breadth of female pelvis Narrower diameter of femoral vessels</li><li>➤ Wider femoral ring due to greater breadth of female pelvis</li><li>➤ Wider femoral</li><li>➤ ring</li><li>➤ greater breadth</li><li>➤ female pelvis</li><li>➤ Narrower diameter of femoral vessels</li><li>➤ Narrower diameter</li><li>➤ femoral vessels</li><li>➤ Boundaries of femoral ring :</li><li>➤ femoral ring</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1338</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1338</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old male visited the surgery OPD with complaints of passing blood-stained stools for the past 6 weeks. The surgeon examined the patient using a proctoscope and confirmed the diagnosis as internal hemorrhoids. Which of the following statements pertaining to the above case is incorrect?", "options": [{"label": "A", "text": "Internal Rectal Venous Plexus is situated between External and Internal Anal Sphincter", "correct": true}, {"label": "B", "text": "External Anal Sphincter is supplied by Inferior Rectal Nerve", "correct": false}, {"label": "C", "text": "Rectal Veins are important sites of Portosystemic Anastomosis", "correct": false}, {"label": "D", "text": "Superior Rectal Artery is the Principal Artery of Rectum", "correct": false}], "correct_answer": "A. Internal Rectal Venous Plexus is situated between External and Internal Anal Sphincter", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture97_oUvTJXA.jpg"], "explanation": "<p><strong>Ans. A) Internal Rectal Venous Plexus is situated between External and Internal Anal Sphincter</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The external anal sphincter is a muscle that is voluntarily controlled and is supplied by the inferior rectal nerve , a branch of the pudendal nerve . This nerve provides motor innervation to the external anal sphincter .</li><li>• Option B.</li><li>• voluntarily controlled</li><li>• supplied</li><li>• inferior rectal nerve</li><li>• pudendal nerve</li><li>• motor innervation</li><li>• external anal sphincter</li><li>• Option C. The rectal veins are part of the anastomotic network between the portal and systemic venous systems . The superior rectal vein drains into the portal system , while the middle and inferior rectal veins drain into the systemic venous system . This anastomosis is clinically significant, particularly in conditions like portal hypertension.</li><li>• Option C.</li><li>• rectal veins</li><li>• anastomotic network</li><li>• portal</li><li>• systemic venous systems</li><li>• drains</li><li>• portal system</li><li>• middle</li><li>• inferior rectal veins</li><li>• systemic venous system</li><li>• Option D. The superior rectal artery , a branch of the inferior mesenteric artery , is the main artery supplying the rectum . It provides blood to the upper part of the rectum and is involved in the vascular supply to the area where internal hemorrhoids develop .</li><li>• Option D.</li><li>• superior rectal</li><li>• artery</li><li>• inferior mesenteric artery</li><li>• main artery</li><li>• rectum</li><li>• blood</li><li>• upper part</li><li>• rectum</li><li>• vascular supply</li><li>• area</li><li>• internal hemorrhoids develop</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The internal rectal ( hemorrhoidal ) venous plexus is actually located in the submucosa of the rectum , above the dentate line , and not between the external and internal anal sphincters. This plexus is responsible for the formation of internal hemorrhoids when it becomes dilated or engorged .</li><li>➤ internal rectal</li><li>➤ hemorrhoidal</li><li>➤ venous plexus</li><li>➤ submucosa</li><li>➤ rectum</li><li>➤ above</li><li>➤ dentate line</li><li>➤ formation</li><li>➤ internal hemorrhoids</li><li>➤ dilated</li><li>➤ engorged</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1150</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 67-year-old male, retired high school teacher was admitted to the surgery ward for complaints of weight loss, passing blood-stained stools and altered bowel habits for the past 8 weeks. He also complained of pain radiating down the back of both the thighs and weakness of back of thigh muscles. The surgeon palpated a growth on the posterior rectal wall on per rectal examination. Which among the following statements is true?", "options": [{"label": "A", "text": "Rectosigmoid Junction lies opposite the Intervertebral Disc between L5 and S1", "correct": false}, {"label": "B", "text": "Rectum is Devoid of Taenia Coli", "correct": true}, {"label": "C", "text": "Rectovesical Pouch is situated 5 cm above the Anus", "correct": false}, {"label": "D", "text": "Growth compressing Gluteal Arteries and causing Thigh Pain", "correct": false}], "correct_answer": "B. Rectum is Devoid of Taenia Coli", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture98.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture99.jpg"], "explanation": "<p><strong>Ans. B) Rectum is Devoid of Taenia Coli</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The rectosigmoid junction is the anatomical point where the sigmoid colon transitions into the rectum . It is typically located at the level of the third sacral vertebra ( S3 ), not between the L5 and S1 intervertebral disc. The location can vary slightly depending on individual anatomy and factors like age and body habitus .</li><li>• Option A.</li><li>• anatomical point</li><li>• sigmoid colon transitions</li><li>• rectum</li><li>• third sacral vertebra</li><li>• S3</li><li>• individual anatomy</li><li>• factors</li><li>• age</li><li>• body habitus</li><li>• Option C. The rectovesical pouch is a space between the rectum and the urinary bladder in males , part of the peritoneal cavity . It is not situated a fixed distance from the anus but rather depends on the peritoneal reflection, which can vary in location. Moreover, the notion of it being \" 5 cm above the anus \" is not a standard anatomical description.</li><li>• Option C.</li><li>• rectum</li><li>• urinary bladder</li><li>• males</li><li>• peritoneal cavity</li><li>• 5 cm above the anus</li><li>• Option D. A growth on the posterior wall of the rectum is unlikely to compress the superior and inferior gluteal arteries to a significant extent , as these arteries are located more posteriorly and laterally relative to the rectum . The pain radiating down the back of the thighs and weakness in the thigh muscles might be more attributable to nerve involvement or compression (e.g., sacral plexus ) rather than vascular compression .</li><li>• Option D.</li><li>• posterior wall</li><li>• rectum</li><li>• compress</li><li>• superior</li><li>• inferior gluteal arteries</li><li>• extent</li><li>• posteriorly</li><li>• laterally</li><li>• rectum</li><li>• radiating down</li><li>• back</li><li>• thighs</li><li>• weakness</li><li>• thigh muscles</li><li>• nerve involvement</li><li>• compression</li><li>• sacral plexus</li><li>• vascular compression</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The rectum is indeed devoid of taenia coli . Taenia coli are three separate longitudinal ribbons of smooth muscle on the outside of the colon from the cecum to the rectum . They are absent in the rectum , which is the final straight portion of the large intestine . Since this anatomical detail is accurate , this statement is true .</li><li>➤ rectum</li><li>➤ devoid</li><li>➤ taenia coli</li><li>➤ three separate</li><li>➤ longitudinal ribbons</li><li>➤ smooth muscle</li><li>➤ outside</li><li>➤ colon</li><li>➤ cecum</li><li>➤ rectum</li><li>➤ absent</li><li>➤ rectum</li><li>➤ final straight</li><li>➤ large intestine</li><li>➤ anatomical detail</li><li>➤ accurate</li><li>➤ true</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1146</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1146</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male patient presented to ER with a history of lower abdominal pain for the past 24 hours that became more severe over the last 2 hours prior to his ER visit. The pain was colicky in nature, started around the umbilicus and shifted to right iliac fossa. It was associated with nausea and vomiting. There was no history of fever, diarrhoea or bleeding per rectum. On palpation guarding and tenderness was present over right iliac fossa and umbilical areas. CT scan showed multiple pockets of intraperitoneal air, seen predominantly in central and anterior abdomen and signs of abnormal thickening of ileal loops. Which of the following statements is not true?", "options": [{"label": "A", "text": "The Diagnosis in the above case is Inflamed and perforated Meckel's Diverticulum (MD)", "correct": false}, {"label": "B", "text": "MD is attached to the Mesenteric Border 2 Feet proximal to Ileocaecal junction", "correct": true}, {"label": "C", "text": "It is a remnant of proximal part of Vitellointestinal Duct", "correct": false}, {"label": "D", "text": "Meckel Scan with 99mTc-pertechnetate will diagnose MD than CT scan or Ultrasound", "correct": false}], "correct_answer": "B. MD is attached to the Mesenteric Border 2 Feet proximal to Ileocaecal junction", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture100.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture101.jpg"], "explanation": "<p><strong>Ans. B) MD is attached to the Mesenteric Border 2 Feet proximal to Ileocaecal junction.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The clinical presentation of the patient - lower abdominal pain that started around the umbilicus and shifted to the right iliac fossa , associated with nausea , vomiting , and findings of guarding and tenderness in the right iliac fossa , along with CT scan findings of intraperitoneal air and abnormal thickening of ileal loops - is suggestive of an acute abdomen , possibly due to intestinal perforation . Inflamed and perforated Meckel's diverticulum is a plausible diagnosis in this context. Meckel's diverticulum can become inflamed and mimic symptoms of appendicitis ; if it perforates , it can lead to peritonitis , which seems consistent with the CT findings . Therefore, this statement is potentially true .</li><li>• Option A.</li><li>• lower abdominal pain</li><li>• umbilicus</li><li>• shifted</li><li>• right iliac fossa</li><li>• nausea</li><li>• vomiting</li><li>• guarding</li><li>• tenderness</li><li>• right iliac fossa</li><li>• intraperitoneal air</li><li>• abnormal thickening</li><li>• ileal loops</li><li>• acute abdomen</li><li>• intestinal perforation</li><li>• Meckel's diverticulum</li><li>• inflamed</li><li>• mimic symptoms</li><li>• appendicitis</li><li>• perforates</li><li>• peritonitis</li><li>• CT findings</li><li>• true</li><li>• Option C. Meckel's diverticulum is indeed a congenital anomaly that results from the incomplete obliteration of the omphalomesenteric ( vitellointestinal ) duct . This duct normally connects the yolk sac to the midgut in the developing embryo and usually disappears during the 5th to 7th week of gestation . Persistence of a portion of this duct leads to the formation of Meckel's diverticulum . Thus, this statement is true .</li><li>• Option C.</li><li>• congenital anomaly</li><li>• results</li><li>• incomplete obliteration</li><li>• omphalomesenteric</li><li>• vitellointestinal</li><li>• duct</li><li>• connects</li><li>• yolk sac</li><li>• midgut</li><li>• developing embryo</li><li>• disappears</li><li>• 5th</li><li>• 7th</li><li>• week</li><li>• gestation</li><li>• Persistence</li><li>• portion</li><li>• leads</li><li>• formation</li><li>• Meckel's diverticulum</li><li>• true</li><li>• Option D. A Meckel scan , using the radioactive tracer technetium-99m pertechnetate , is a specialized nuclear medicine test often used to diagnose Meckel's diverticulum , particularly when it contains ectopic gastric mucosa , which can absorb the tracer . While CT scans and ultrasounds can be used to identify complications of Meckel's diverticulum like obstruction or inflammation , they are less effective in identifying the diverticulum itself , especially if it's not inflamed. A Meckel scan is generally more specific for detecting Meckel's diverticulum . Therefore, this statement is true .</li><li>• Option D.</li><li>• Meckel scan</li><li>• radioactive tracer technetium-99m pertechnetate</li><li>• nuclear medicine</li><li>• test</li><li>• diagnose Meckel's diverticulum</li><li>• ectopic gastric mucosa</li><li>• absorb</li><li>• tracer</li><li>• CT scans</li><li>• Meckel's diverticulum</li><li>• obstruction</li><li>• inflammation</li><li>• less effective</li><li>• diverticulum itself</li><li>• Meckel scan</li><li>• detecting Meckel's diverticulum</li><li>• true</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meckel's diverticulum is typically located on the anti-mesenteric border of the ileum , not the mesenteric border as stated in the option. It's usually found within 2 feet ( about 60 cm ) of the ileocecal valve . This anatomical detail is crucial for surgical identification and intervention .</li><li>➤ Meckel's diverticulum</li><li>➤ anti-mesenteric</li><li>➤ border</li><li>➤ ileum</li><li>➤ within 2</li><li>➤ feet</li><li>➤ about 60 cm</li><li>➤ ileocecal valve</li><li>➤ surgical identification</li><li>➤ intervention</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1128</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1128</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "3 weeks after drainage of perianal abscess a 40-year-old female presented with ongoing low volume serosanguinous discharge from the site of abscess incision and drainage. On examination a firm cord between the opening and anal canal is palpated. Which of the following is incorrect?", "options": [{"label": "A", "text": "The Diagnosis is Fistula in Ano", "correct": false}, {"label": "B", "text": "Subcutaneous part of External Sphincter is separated from Skin by External Venous Plexus", "correct": false}, {"label": "C", "text": "An Abscess in Perianal Space is usually very Painful", "correct": false}, {"label": "D", "text": "Pudendal Canal is situated in the Medial Wall of Ischioanal Fossa", "correct": true}], "correct_answer": "D. Pudendal Canal is situated in the Medial Wall of Ischioanal Fossa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture102.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture103.jpg"], "explanation": "<p><strong>Ans. D) Pudendal Canal is situated in the Medial Wall of Ischioanal Fossa</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The presence of ongoing serosanguinous discharge from the site of a previously drained perianal abscess and the palpation of a firm cord between the opening and the anal canal are highly suggestive of a fistula in ano . A fistula in ano is an abnormal connection between the epithelialized surface of the anal canal and the perianal skin . The palpable cord-like structure is likely the tract of the fistula .</li><li>• Option A.</li><li>• suggestive</li><li>• fistula in ano</li><li>• abnormal connection</li><li>• epithelialized surface</li><li>• anal canal</li><li>• perianal skin</li><li>• tract</li><li>• fistula</li><li>• Option B. The external anal sphincter has three parts : subcutaneous , superficial , and deep . The subcutaneous part of the external sphincter is indeed close to the skin and separated by the external venous plexus and fat . The anal canal's anatomy is more complex , involving various structures including muscle , connective tissue , and blood vessels .</li><li>• Option B.</li><li>• external</li><li>• anal sphincter</li><li>• three parts</li><li>• subcutaneous</li><li>• superficial</li><li>• deep</li><li>• skin</li><li>• external venous plexus</li><li>• fat</li><li>• more complex</li><li>• muscle</li><li>• connective tissue</li><li>• blood vessels</li><li>• Option C. Perianal space is bounded above by perianal fascia and below by perianal skin . it is subdivided into numerous compartment by fibroelastic septa , hence perianal abscess produce tremendous pain due to tension and may burst through perianal skin . An abscess in the perianal area is typically very painful , due to the inflammation and infection in an area rich with nerve endings and sensitive tissue . This pain is often what leads patients to seek medical attention .</li><li>• Option C.</li><li>• above</li><li>• perianal fascia</li><li>• below</li><li>• perianal skin</li><li>• numerous compartment</li><li>• fibroelastic septa</li><li>• perianal abscess</li><li>• tremendous pain</li><li>• tension</li><li>• burst</li><li>• perianal skin</li><li>• abscess</li><li>• perianal area</li><li>• very painful</li><li>• inflammation</li><li>• infection</li><li>• rich</li><li>• nerve endings</li><li>• sensitive tissue</li><li>• seek medical attention</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pudendal canal , also known as Alcock's canal , is indeed located in the lateral wall of the ischioanal ( ischio-rectal ) fossa . It contains the pudendal nerve and internal pudendal vessels .</li><li>➤ The pudendal canal , also known as Alcock's canal , is indeed located in the lateral wall of the ischioanal ( ischio-rectal ) fossa . It contains the pudendal nerve and internal pudendal vessels .</li><li>➤ pudendal canal</li><li>➤ Alcock's canal</li><li>➤ lateral wall</li><li>➤ ischioanal</li><li>➤ ischio-rectal</li><li>➤ fossa</li><li>➤ pudendal nerve</li><li>➤ internal pudendal vessels</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1153</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During incision and drainage of ischiorectal abscess which nerve is affected?", "options": [{"label": "A", "text": "Superior Rectal Nerve", "correct": false}, {"label": "B", "text": "Superior Gluteal Nerve", "correct": false}, {"label": "C", "text": "Inferior Rectal Nerve", "correct": true}, {"label": "D", "text": "Ilioinguinal Nerve", "correct": false}], "correct_answer": "C. Inferior Rectal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture104.jpg"], "explanation": "<p><strong>Ans. C) Inferior Rectal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior Rectal Nerve is a branch of the inferior hypogastric plexus . It mainly supplies the rectum and joins in the pelvis with branches from the pelvic plexuses . The superior rectal nerve is not typically involved in an ischiorectal abscess procedure because this nerve is located higher in the rectum and is not usually in the vicinity of the ischiorectal fossa, where abscesses typically form.</li><li>• Option A.</li><li>• inferior hypogastric plexus</li><li>• supplies</li><li>• rectum</li><li>• joins</li><li>• pelvis</li><li>• pelvic plexuses</li><li>• located higher</li><li>• rectum</li><li>• Option B. Superior Gluteal Nerve originates from the sacral plexus and supplies the gluteus medius , minimus , and tensor fasciae latae muscles . It exits the pelvis through the greater sciatic foramen , above the piriformis muscle . This nerve is generally not affected during the incision and drainage of an ischiorectal abscess, as it is located more posteriorly and superiorly relative to the site of the typical ischiorectal abscess .</li><li>• Option B.</li><li>• sacral plexus</li><li>• supplies</li><li>• gluteus medius</li><li>• minimus</li><li>• tensor fasciae latae muscles</li><li>• exits</li><li>• pelvis</li><li>• greater sciatic foramen</li><li>• piriformis muscle</li><li>• more posteriorly</li><li>• superiorly</li><li>• site</li><li>• typical ischiorectal abscess</li><li>• Option D. Ilioinguinal Nerve is a branch of the first lumbar nerve (L1) . It provides sensory innervation to the upper part of the thigh , the root of the penis and upper part of the scrotum in males , and the mons pubis and labia majora in females . This nerve is not typically involved in an ischiorectal abscess procedure, as it is located in a different anatomical region.</li><li>• Option D.</li><li>• branch</li><li>• first lumbar nerve (L1)</li><li>• sensory innervation</li><li>• upper part</li><li>• thigh</li><li>• root</li><li>• penis</li><li>• upper part</li><li>• scrotum</li><li>• males</li><li>• mons pubis</li><li>• labia majora</li><li>• females</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It innervates the external anal sphincter and provides sensory innervation to the perianal skin . This nerve is the most likely to be affected during the procedure, as it runs through the ischiorectal fossa , where abscesses commonly form. Care must be taken to avoid damage to this nerve during incision and drainage .</li><li>➤ It innervates the external anal sphincter and provides sensory innervation to the perianal skin . This nerve is the most likely to be affected during the procedure, as it runs through the ischiorectal fossa , where abscesses commonly form. Care must be taken to avoid damage to this nerve during incision and drainage .</li><li>➤ external</li><li>➤ anal sphincter</li><li>➤ sensory innervation</li><li>➤ perianal skin</li><li>➤ runs</li><li>➤ ischiorectal fossa</li><li>➤ abscesses</li><li>➤ avoid damage</li><li>➤ incision</li><li>➤ drainage</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 219</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the emergency department with severe abdominal pain that started abruptly 6 hours ago. The pain is localized to the mid-abdomen and radiates to the back. He has a history of alcohol abuse and chronic pancreatitis. On examination, his abdomen is tender, and there is a palpable mass in the midline. Laboratory tests reveal elevated amylase and lipase levels. A CT scan of the abdomen is ordered, which shows an inflammatory mass involving the pancreas and adjacent structures. The radiologist notes involvement of a major vascular structure adjacent to the third part of the duodenum, which could be contributing to the patient's symptoms. Based on the anatomical relationship, which of the following is most likely to be the involved vascular structure in relation to the third part of the duodenum in this patient's condition?", "options": [{"label": "A", "text": "Portal Vein", "correct": false}, {"label": "B", "text": "Head of Pancreas", "correct": false}, {"label": "C", "text": "Hepatic Artery", "correct": false}, {"label": "D", "text": "Superior Mesenteric Vein", "correct": true}], "correct_answer": "D. Superior Mesenteric Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture105.jpg"], "explanation": "<p><strong>Ans. D) Superior Mesenteric Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The portal vein is formed by the union of the superior mesenteric vein and the splenic vein behind the neck of the pancreas . While it is closely related to the duodenum, it does not specifically relate to the third part of the duodenum. The third part of the duodenum primarily crosses the IVC and aorta , with the portal vein being more superior in relation to this part of the duodenum.</li><li>• Option A.</li><li>• union</li><li>• superior mesenteric vein</li><li>• splenic vein</li><li>• neck</li><li>• pancreas</li><li>• third part</li><li>• duodenum</li><li>• crosses</li><li>• IVC</li><li>• aorta</li><li>• portal vein</li><li>• more superior</li><li>• Option B. The head of the pancreas nestles into the C-shaped curve created by the duodenum . This relationship is more pertinent to the first and second parts of the duodenum rather than the third part . The third part of the duodenum runs horizontally at the level of L3 vertebra and is anterior to the uncinate process of the pancreas , not the head of the pancreas.</li><li>• Option B.</li><li>• head</li><li>• pancreas nestles</li><li>• C-shaped curve</li><li>• duodenum</li><li>• first</li><li>• second parts</li><li>• duodenum</li><li>• third part</li><li>• horizontally</li><li>• level</li><li>• L3 vertebra</li><li>• anterior</li><li>• uncinate process</li><li>• pancreas</li><li>• Option C. The common hepatic artery, a branch of the celiac trunk , supplies blood to the liver , pylorus of the stomach , duodenum , and pancreas . However, its relationship is not specific to the third part of the duodenum. The hepatic artery primarily runs superior to the first part of the duodenum .</li><li>• Option C.</li><li>• branch</li><li>• celiac trunk</li><li>• supplies</li><li>• blood</li><li>• liver</li><li>• pylorus</li><li>• stomach</li><li>• duodenum</li><li>• pancreas</li><li>• runs</li><li>• superior</li><li>• first part</li><li>• duodenum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The third part of the duodenum is intimately related to the superior mesenteric vein . The superior mesenteric vein runs to the right of the superior mesenteric artery and, together with the artery , it crosses anterior to the third part of the duodenum . This anatomical relationship is critical, as the third part of the duodenum can be compressed between the superior mesenteric artery and the aorta , a condition known as the \" superior mesenteric artery syndrome” .</li><li>➤ third part</li><li>➤ duodenum</li><li>➤ superior mesenteric vein</li><li>➤ right</li><li>➤ superior mesenteric artery</li><li>➤ artery</li><li>➤ crosses anterior</li><li>➤ third part</li><li>➤ duodenum</li><li>➤ third part</li><li>➤ duodenum</li><li>➤ superior mesenteric artery</li><li>➤ aorta</li><li>➤ superior mesenteric artery syndrome”</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 121</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the clinic with anal discomfort and occasional bleeding during bowel movements. He reports a history of intermittent constipation and straining. On examination, there is mild tenderness around the anal canal, and digital rectal examination reveals a small, tender mass just within the anal verge. The physician suspects an anal fissure and decides to explain the anatomy of the anal canal to the patient, focusing on the significance of the dentate line in relation to his symptoms. Which of the following statements regarding the dentate line is INCORRECT and would require clarification in the context of the patient's clinical presentation?", "options": [{"label": "A", "text": "Columns of Morgagni seen Above the Line", "correct": false}, {"label": "B", "text": "Anal Glands open at the line", "correct": false}, {"label": "C", "text": "Dentate Line lies 2 cm above Anal Verge", "correct": false}, {"label": "D", "text": "Transitional Epithelium lies Above Dentate Line", "correct": true}], "correct_answer": "D. Transitional Epithelium lies Above Dentate Line", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture106.jpg"], "explanation": "<p><strong>Ans. D) Transitional Epithelium lies Above Dentate Line</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The columns of Morgagni, also known as anal columns , are a series of small , longitudinal folds in the mucosa of the upper part of the anal canal . They are located above the dentate line . Anal columns of Morgagni are permanent mucous folds , longitudinal in direction.</li><li>• Option A.</li><li>• anal columns</li><li>• series</li><li>• small</li><li>• longitudinal folds</li><li>• mucosa</li><li>• upper part</li><li>• anal canal</li><li>• above</li><li>• dentate line</li><li>• Anal columns</li><li>• Morgagni</li><li>• permanent mucous folds</li><li>• longitudinal</li><li>• Option B. The anal glands , which can give rise to anal abscesses and fistulas , open into the anal canal at the level of the dentate line . Anal glands open into anal sinuses situated above the anal valves</li><li>• Option B.</li><li>• anal glands</li><li>• rise</li><li>• anal abscesses</li><li>• fistulas</li><li>• anal canal</li><li>• level</li><li>• dentate line</li><li>• anal sinuses</li><li>• above</li><li>• anal valves</li><li>• Option C. The dentate line is located approximately 2 cm above the anal verge , although there can be some individual variation. Pectinate line / Dentate line corresponds with the position of anal valves</li><li>• Option C.</li><li>• approximately 2 cm above</li><li>• anal verge</li><li>• Pectinate line</li><li>• Dentate line</li><li>• position</li><li>• anal valves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The epithelium above the dentate line is not transitional epithelium; it is columnar epithelium . The anal canal above the dentate line is lined with columnar or rectal type epithelium . Below the dentate line , the lining changes to a non-keratinized stratified squamous epithelium .</li><li>➤ columnar epithelium</li><li>➤ above</li><li>➤ dentate line</li><li>➤ columnar</li><li>➤ rectal type epithelium</li><li>➤ Below</li><li>➤ dentate line</li><li>➤ lining changes</li><li>➤ non-keratinized stratified squamous epithelium</li><li>➤ Transitional epithelium , typically found in the urinary system , is not a feature of the anal canal.</li><li>➤ Transitional epithelium</li><li>➤ urinary system</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 278</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 278</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a permanent mucous fold", "options": [{"label": "A", "text": "Spiral Valves of Heister", "correct": false}, {"label": "B", "text": "Gastric Rugae", "correct": true}, {"label": "C", "text": "Circular Fold", "correct": false}, {"label": "D", "text": "Transverse Rectal Fold", "correct": false}], "correct_answer": "B. Gastric Rugae", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture107.jpg"], "explanation": "<p><strong>Ans. B) Gastric Rugae</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Spiral valves of Heister are crescentic folds seen in interior of cystic duct and keeps the duct open . These are folds found in the cystic duct , the part of the biliary system that connects the gallbladder to the common bile duct . The spiral valves of Heister are considered permanent mucosal folds that help maintain the patency of the cystic duct .</li><li>• Option A.</li><li>• crescentic folds</li><li>• interior</li><li>• cystic duct</li><li>• duct open</li><li>• cystic duct</li><li>• biliary system</li><li>• connects</li><li>• gallbladder</li><li>• common bile duct</li><li>• permanent mucosal folds</li><li>• patency</li><li>• cystic duct</li><li>• Option C. Circular Fold, also known as the plicae circulares , these are deep folds of the mucosa and submucosa in the small intestine , particularly prominent in the jejunum . They are permanent structures and do not flatten out like the gastric rugae. Their primary function is to slow the passage of food through the intestines and increase surface area for absorption .</li><li>• Option C.</li><li>• plicae circulares</li><li>• deep folds</li><li>• mucosa</li><li>• submucosa</li><li>• small intestine</li><li>• jejunum</li><li>• permanent structures</li><li>• slow</li><li>• passage</li><li>• food</li><li>• intestines</li><li>• increase</li><li>• surface area</li><li>• absorption</li><li>• Option D. Transverse rectal folds/ Houston's valves are semilunar situated against the concavities of lateral curvatures of rectum . Also known as the Houston valves , they are usually two or three in number and extend inward from the lateral walls of the rectum . Unlike the gastric rugae, these folds are permanent and do not flatten out.</li><li>• Option D.</li><li>• Houston's valves</li><li>• semilunar</li><li>• against</li><li>• concavities</li><li>• lateral curvatures</li><li>• rectum</li><li>• Houston valves</li><li>• usually two</li><li>• three</li><li>• number</li><li>• extend inward</li><li>• lateral walls</li><li>• rectum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Gastric rugae are the folds in the stomach lining . These are not permanent structures. They are prominent when the stomach is empty and flatten as the stomach expands after the ingestion of food . The ability of the gastric rugae to change shape allows for the expansion of the stomach .</li><li>➤ folds</li><li>➤ stomach lining</li><li>➤ prominent</li><li>➤ empty</li><li>➤ flatten</li><li>➤ stomach expands</li><li>➤ after</li><li>➤ ingestion</li><li>➤ food</li><li>➤ ability</li><li>➤ gastric rugae</li><li>➤ change shape</li><li>➤ expansion</li><li>➤ stomach</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 274</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 274</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male with a history of chronic constipation presents to the clinic with recent changes in bowel habits, including alternating constipation and diarrhea, and noticeable rectal bleeding. On physical examination, a digital rectal exam reveals a palpable mass. Further imaging and biopsy confirm a diagnosis of rectal cancer. Considering the anatomical structures involved in the spread of rectal cancer, which of the following is least likely to be directly involved?", "options": [{"label": "A", "text": "Inferior Rectal Vein", "correct": true}, {"label": "B", "text": "Superior Rectal Vein", "correct": false}, {"label": "C", "text": "Perirectal Node", "correct": false}, {"label": "D", "text": "Inferior Mesenteric Plexus", "correct": false}], "correct_answer": "A. Inferior Rectal Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture108.jpg"], "explanation": "<p><strong>Ans. A) Inferior Rectal Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The superior rectal vein is a continuation of the inferior mesenteric vein and drains the upper part of the rectum . It is a significant component of the mesorectum , as it is involved in the venous drainage of this area. Radicles of the superior rectal vein pass upwards through anal columns and unite to form the trunk which pierces the posterior rectal wall about 7.5cm above anus .</li><li>• Option B.</li><li>• continuation</li><li>• inferior mesenteric vein</li><li>• drains</li><li>• upper part</li><li>• rectum</li><li>• significant component</li><li>• mesorectum</li><li>• venous drainage</li><li>• Radicles</li><li>• superior rectal vein</li><li>• upwards</li><li>• anal</li><li>• columns</li><li>• trunk</li><li>• pierces</li><li>• posterior rectal wall</li><li>• 7.5cm above anus</li><li>• Option C. Perirectal nodes, or lymph nodes surrounding the rectum , are indeed found within the mesorectum. These nodes are important in the lymphatic drainage of the rectum and are a key focus in the staging and treatment of rectal cancers . Pararectal nodes are situated on each side of rectosigmoid junction , receive lymphatics from upper rectum</li><li>• Option C.</li><li>• surrounding</li><li>• rectum</li><li>• lymphatic drainage</li><li>• rectum</li><li>• key focus</li><li>• staging</li><li>• treatment</li><li>• rectal cancers</li><li>• Pararectal nodes</li><li>• each side</li><li>• rectosigmoid junction</li><li>• lymphatics</li><li>• upper rectum</li><li>• Option D. The inferior mesenteric plexus provides autonomic nerve supply to the rectum and is located within the mesorectum . This plexus includes sympathetic and parasympathetic fibers that regulate various functions of the rectum . The inferior mesenteric plexus belongs to the aortic plexus , which is located in front of the abdominal aorta and is responsible for the sympathetic innervation of mesenteric , pelvic , and urogenital organs . It is supplied directly by the left L2 lumbar splanchnic nerve .</li><li>• Option D.</li><li>• autonomic nerve supply</li><li>• rectum</li><li>• mesorectum</li><li>• sympathetic</li><li>• parasympathetic fibers</li><li>• rectum</li><li>• aortic plexus</li><li>• front</li><li>• abdominal aorta</li><li>• responsible</li><li>• sympathetic innervation</li><li>• mesenteric</li><li>• pelvic</li><li>• urogenital organs</li><li>• directly</li><li>• left L2 lumbar splanchnic nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior rectal veins are tributaries of the internal pudendal vein . They drain the lower part of the anal canal and are not typically considered a part of the mesorectum. Instead, they are located more distally in relation to the rectum . Inferior rectal veins terminate into internal pudendal vein , also medially communicates with external rectal venous plexus .</li><li>➤ The inferior rectal veins are tributaries of the internal pudendal vein . They drain the lower part of the anal canal and are not typically considered a part of the mesorectum. Instead, they are located more distally in relation to the rectum . Inferior rectal veins terminate into internal pudendal vein , also medially communicates with external rectal venous plexus .</li><li>➤ internal pudendal vein</li><li>➤ drain</li><li>➤ lower part</li><li>➤ anal canal</li><li>➤ more distally</li><li>➤ rectum</li><li>➤ Inferior rectal veins</li><li>➤ terminate</li><li>➤ internal pudendal vein</li><li>➤ medially</li><li>➤ communicates</li><li>➤ external rectal venous plexus</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 275</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 275</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old female presents to the clinic with a history of pelvic pressure and discomfort, worsened during bowel movements. She reports a feeling of incomplete evacuation and has noticed blood on the toilet paper after defecation. Digital rectal examination and subsequent imaging studies suggest a rectal mass with potential involvement of surrounding pelvic structures. The surgical team is considering resection and is assessing the involvement of the fascial structures for surgical planning. Which of the following fasciae, extending from the rectum to the posterior pelvic wall, is most relevant in this patient's case for potential involvement by the rectal mass?", "options": [{"label": "A", "text": "Fascia of Waldeyer", "correct": true}, {"label": "B", "text": "Fascia of Denonvillier", "correct": false}, {"label": "C", "text": "Scarpa’s Fascia", "correct": false}, {"label": "D", "text": "Colles Fascia", "correct": false}], "correct_answer": "A. Fascia of Waldeyer", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture109.jpg"], "explanation": "<p><strong>Ans. A) Fascia of Waldeyer</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Denonvilliers' fascia is located in the male pelvis , separating the rectum from the prostate and seminal vesicles . In females , it separates the rectum from the vagina . It is an important structure in pelvic surgery but is not the fascia that connects the rectum to the posterior pelvic wall.</li><li>• Option B.</li><li>• male pelvis</li><li>• rectum</li><li>• prostate</li><li>• seminal vesicles</li><li>• females</li><li>• separates</li><li>• rectum</li><li>• vagina</li><li>• pelvic surgery</li><li>• Option C. Scarpa’s fascia is a layer of deep fascia found in the abdominal wall . It is superficial to the muscular layer and is primarily involved in the structure and function of the anterior abdominal wall , not the pelvis or the rectum.</li><li>• Option C.</li><li>• deep fascia</li><li>• abdominal wall</li><li>• superficial</li><li>• muscular layer</li><li>• structure</li><li>• function</li><li>• anterior abdominal wall</li><li>• Option D. Deep fascia of perineum is called Colles fascia . Colles' fascia is a membranous layer of superficial fascia in the perineum . It covers the superficial perineal muscles and is important in the spread of infections in this region. Like Scarpa’s fascia, it is not directly related to the rectum or the posterior pelvic wall.</li><li>• Option D. Deep fascia</li><li>• perineum</li><li>• Colles fascia</li><li>• membranous layer</li><li>• superficial fascia</li><li>• perineum</li><li>• covers</li><li>• superficial perineal muscles</li><li>• spread</li><li>• infections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The fascia of Waldeyer is a layer of connective tissue that extends from the rectum to the posterior pelvic wall . It's important in rectal surgery , particularly in the context of total mesorectal excision for rectal cancer . This fascial layer provides a natural plane for surgical dissection .</li><li>➤ The fascia of Waldeyer is a layer of connective tissue that extends from the rectum to the posterior pelvic wall . It's important in rectal surgery , particularly in the context of total mesorectal excision for rectal cancer . This fascial layer provides a natural plane for surgical dissection .</li><li>➤ layer</li><li>➤ connective tissue</li><li>➤ extends</li><li>➤ rectum</li><li>➤ posterior pelvic wall</li><li>➤ rectal surgery</li><li>➤ total mesorectal excision</li><li>➤ rectal cancer</li><li>➤ natural plane</li><li>➤ surgical dissection</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 275</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 275</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old male presents to the clinic with urinary hesitancy, decreased force of stream, and nocturia. Digital rectal examination (DRE) is performed to assess the prostate. During the examination, the physician explains the structures that can typically be palpated or assessed. Which of the following structures is NOT typically palpable or felt anteriorly during a digital rectal examination in an adult male?", "options": [{"label": "A", "text": "Internal Iliac Nodes", "correct": true}, {"label": "B", "text": "Bulb of Penis", "correct": false}, {"label": "C", "text": "Prostate", "correct": false}, {"label": "D", "text": "Seminal Vesicles on Enlarged", "correct": false}], "correct_answer": "A. Internal Iliac Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture110.jpg"], "explanation": "<p><strong>Ans. A) Internal Iliac Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The bulb of the penis is part of the spongy urethra and is located at the base of the penis . It can be palpated anteriorly during a per rectal examination , especially if there is any pathology enlarging it. Bulb of the penis, spongy urethra, urinary bladder, terminal part of ureter can be palpated per rectum. An enlarged prostate is palpable 4 cm above anus .</li><li>• Option B.</li><li>• spongy urethra</li><li>• base</li><li>• penis</li><li>• palpated anteriorly</li><li>• a per rectal examination</li><li>• pathology enlarging</li><li>• enlarged prostate</li><li>• palpable 4 cm above anus</li><li>• Option C. The prostate gland is readily palpable anteriorly during a per rectal examination. It lies immediately in front of the rectum , and its size , shape , and consistency can be assessed through this examination. The examination of the prostate is a routine part of male physical examinations , especially in older men .</li><li>• Option C.</li><li>• anteriorly</li><li>• immediately</li><li>• front</li><li>• rectum</li><li>• size</li><li>• shape</li><li>• consistency</li><li>• assessed</li><li>• routine part</li><li>• male physical examinations</li><li>• older men</li><li>• Option D. Normally, the seminal vesicles are not palpable during a per rectal examination unless they are enlarged due to some pathology. When enlarged , they can be felt anteriorly . Tenderness of right lateral wall of rectum is suggestive of inflamed appendix .</li><li>• Option D.</li><li>• When enlarged</li><li>• felt anteriorly</li><li>• Tenderness</li><li>• right lateral</li><li>• wall</li><li>• rectum</li><li>• inflamed appendix</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The internal iliac nodes are a group of lymph nodes located in the pelvis along the internal iliac vessels . These nodes are not usually palpable during a per rectal examination due to their deeper location and the presence of bony and other soft tissue structures .</li><li>➤ The internal iliac nodes are a group of lymph nodes located in the pelvis along the internal iliac vessels . These nodes are not usually palpable during a per rectal examination due to their deeper location and the presence of bony and other soft tissue structures .</li><li>➤ group</li><li>➤ lymph nodes</li><li>➤ pelvis</li><li>➤ internal iliac vessels</li><li>➤ deeper location</li><li>➤ presence</li><li>➤ bony</li><li>➤ other soft tissue</li><li>➤ structures</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 276</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 276</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old female presents to the clinic with complaints of fecal incontinence, particularly noting difficulty controlling gas and occasional leakage of stool. She has no significant past medical history but reports that the symptoms have been progressively worsening over the past year. On examination, there is no visible external anal pathology. Anorectal manometry is planned to assess sphincter function. Understanding the anatomy of the anal sphincters is crucial for interpreting the results of this test. Which of the following components is the internal anal sphincter anatomically a part of?", "options": [{"label": "A", "text": "Puborectalis Muscle", "correct": false}, {"label": "B", "text": "Deep Perineal Muscle", "correct": false}, {"label": "C", "text": "Outer Longitudinal Fibres", "correct": false}, {"label": "D", "text": "Internal Circular Fibres", "correct": true}], "correct_answer": "D. Internal Circular Fibres", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture111.jpg"], "explanation": "<p><strong>Ans. D) Internal Circular Fibres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The puborectalis is part of the levator ani muscle group, a component of the pelvic floor muscles . Puborectalis fibres wind the posterior aspect of anorectal junction and with similar fibres of opposite side form the puborectalis sling which forms a component of anorectal ring for faecal continence . The puborectalis muscle is a skeletal muscle under voluntary control , whereas the internal anal sphincter is composed of smooth muscle and is under involuntary control.</li><li>• Option A.</li><li>• levator ani muscle</li><li>• pelvic floor muscles</li><li>• wind</li><li>• posterior aspect</li><li>• anorectal junction</li><li>• similar fibres</li><li>• opposite</li><li>• puborectalis sling</li><li>• anorectal ring</li><li>• faecal continence</li><li>• skeletal muscle</li><li>• voluntary control</li><li>• internal</li><li>• sphincter</li><li>• smooth muscle</li><li>• under involuntary control.</li><li>• Option B. The deep perineal muscles are a group of muscles in the perineum , primarily involved in supporting the pelvic floor and controlling the urogenital openings . These muscles are not part of the internal anal sphincter. Deep transverse perinei is a content of deep perineal pouch .</li><li>• Option B.</li><li>• group</li><li>• muscles</li><li>• perineum</li><li>• supporting</li><li>• pelvic floor</li><li>• controlling</li><li>• urogenital openings</li><li>• Deep transverse perinei</li><li>• content</li><li>• deep perineal pouch</li><li>• Option C. The outer longitudinal fibers are part of the muscular layer of the anal canal . They run longitudinally along the canal and are distinct from the internal anal sphincter . These fibers are more associated with the structure of the anal canal than with the sphincteric action . Outer longitudinal fibres blend with puborectalis sling at anorectal junction to form conjoint fibroelastic sheath .</li><li>• Option C.</li><li>• muscular layer</li><li>• anal canal</li><li>• longitudinally</li><li>• along</li><li>• canal</li><li>• distinct</li><li>• internal</li><li>• anal sphincter</li><li>• structure</li><li>• anal canal</li><li>• sphincteric action</li><li>• Outer longitudinal fibres</li><li>• puborectalis</li><li>• sling</li><li>• anorectal junction</li><li>• conjoint fibroelastic sheath</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The internal anal sphincter is primarily made up of internal circular fibers . These fibers are a continuation of the circular muscle layer of the rectum . The internal anal sphincter is an involuntary muscle , controlled by the autonomic nervous system , and is crucial for maintaining fecal continence .</li><li>➤ The internal anal sphincter is primarily made up of internal circular fibers . These fibers are a continuation of the circular muscle layer of the rectum .</li><li>➤ internal anal sphincter</li><li>➤ internal circular fibers</li><li>➤ continuation</li><li>➤ circular muscle layer</li><li>➤ rectum</li><li>➤ The internal anal sphincter is an involuntary muscle , controlled by the autonomic nervous system , and is crucial for maintaining fecal continence .</li><li>➤ internal anal sphincter</li><li>➤ involuntary muscle</li><li>➤ autonomic nervous system</li><li>➤ maintaining fecal continence</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 274</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 274</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old male with a history of atherosclerosis presents to the emergency department with sudden onset of abdominal pain, which he describes as sharp and severe. He also reports having not passed any stool or gas for the past 12 hours. His past medical history is significant for hypertension and hyperlipidemia. Physical examination reveals a distended abdomen with localized tenderness in the left upper quadrant. Laboratory tests show elevated white blood cells. An abdominal CT scan is suggestive of ischemic changes in a segment of the colon. Given the patient's presentation and the findings, which anatomical location is most likely affected by ischemia due to its vulnerable blood supply between the territories of the superior and inferior mesenteric arteries?", "options": [{"label": "A", "text": "Splenic Flexure", "correct": true}, {"label": "B", "text": "Hepatic Flexure", "correct": false}, {"label": "C", "text": "Ileocaecal Junction", "correct": false}, {"label": "D", "text": "Rectosigmoid Junction", "correct": false}], "correct_answer": "A. Splenic Flexure", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture112.jpg"], "explanation": "<p><strong>Ans. A) Splenic Flexure</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Hepatic flexure medially related to second part of duodenum and fundus of gallbladder. The hepatic flexure is the bend in the colon near the liver , where the transverse colon turns into the ascending colon . This area is primarily supplied by the right branch of the Middle Colic Artery (a branch of the SMA ) and is not a watershed area between the SMA and IMA.</li><li>• Option B.</li><li>• medially</li><li>• second part</li><li>• duodenum</li><li>• fundus</li><li>• gallbladder.</li><li>• bend</li><li>• colon near</li><li>• liver</li><li>• transverse colon</li><li>• ascending colon</li><li>• supplied</li><li>• right branch</li><li>• Middle Colic Artery</li><li>• SMA</li><li>• Option C. Ileocaecal junction, its orifice lies in the posteromedial wall of caecum . This is the junction of the ileum of the small intestine and the cecum of the large intestine . It is supplied by the ileocolic artery (a branch of the SMA ) and is not a watershed area between the SMA and IMA.</li><li>• Option C.</li><li>• orifice lies</li><li>• posteromedial wall</li><li>• caecum</li><li>• junction</li><li>• ileum</li><li>• small intestine</li><li>• cecum</li><li>• large intestine</li><li>• ileocolic artery</li><li>• branch</li><li>• SMA</li><li>• Option D. Rectosigmoid junction lies in front of the third sacral vertebra . This is the junction where the rectum and sigmoid colon meet . It is supplied by branches of the IMA , particularly the sigmoid arteries and the superior rectal artery , but it is not considered a watershed area between the SMA and IMA.</li><li>• Option D.</li><li>• front</li><li>• third sacral vertebra</li><li>• rectum</li><li>• sigmoid colon meet</li><li>• supplied</li><li>• branches</li><li>• IMA</li><li>• sigmoid arteries</li><li>• superior rectal artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The splenic flexure of the colon is the area where the transverse colon turns into the descending colon , near the spleen . It is supplied by the distal branches of the Superior Mesenteric Artery (SMA) and the proximal branches of the Inferior Mesenteric Artery (IMA) . This area, sometimes Referred to as Griffith's point , is a classic watershed area and is particularly susceptible to ischemia due to its relatively poor blood supply compared to other parts of the colon .</li><li>➤ The splenic flexure of the colon is the area where the transverse colon turns into the descending colon , near the spleen .</li><li>➤ splenic flexure</li><li>➤ colon</li><li>➤ area</li><li>➤ transverse colon</li><li>➤ descending colon</li><li>➤ spleen</li><li>➤ It is supplied by the distal branches of the Superior Mesenteric Artery (SMA) and the proximal branches of the Inferior Mesenteric Artery (IMA) . This area, sometimes Referred to as Griffith's point , is a classic watershed area and is particularly susceptible to ischemia due to its relatively poor blood supply compared to other parts of the colon .</li><li>➤ distal branches</li><li>➤ Superior Mesenteric Artery (SMA)</li><li>➤ proximal branches</li><li>➤ Inferior Mesenteric Artery (IMA)</li><li>➤ Griffith's point</li><li>➤ classic watershed area</li><li>➤ susceptible</li><li>➤ ischemia</li><li>➤ relatively poor blood supply</li><li>➤ other parts</li><li>➤ colon</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 185</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of chronic pelvic pain and urinary frequency undergoes diagnostic imaging to investigate the cause of his symptoms. The imaging study focuses on the pelvic vasculature to identify any abnormalities that might explain his clinical presentation. Understanding the anatomy of the internal iliac artery and its branches is crucial for interpreting the imaging findings. Which of the following branches of the internal iliac artery is typically NOT an anterior branch and therefore less likely to be directly involved in the patient's pelvic symptoms?", "options": [{"label": "A", "text": "Inferior Gluteal Artery", "correct": false}, {"label": "B", "text": "Middle Rectal Artery", "correct": false}, {"label": "C", "text": "Superior Gluteal Artery", "correct": true}, {"label": "D", "text": "Superior Vesical Artery", "correct": false}], "correct_answer": "C. Superior Gluteal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture113.jpg"], "explanation": "<p><strong>Ans. C) Superior Gluteal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The inferior gluteal artery is typically a branch of the anterior division of the internal iliac artery. It supplies the gluteal region .</li><li>• Option A.</li><li>• branch</li><li>• anterior division</li><li>• internal iliac artery.</li><li>• supplies</li><li>• gluteal region</li><li>• Option B. The middle rectal artery is an anterior branch of the internal iliac artery . It supplies blood to the rectum .</li><li>• Option B.</li><li>• anterior branch</li><li>• internal iliac artery</li><li>• blood</li><li>• rectum</li><li>• Option D. The superior vesical artery is an anterior branch of the internal iliac artery , arising from the umbilical artery . It supplies blood to the superior part of the bladder and, in males , to the ductus deferens and seminal vesicles .</li><li>• Option D.</li><li>• anterior branch</li><li>• internal iliac artery</li><li>• umbilical artery</li><li>• blood</li><li>• superior part</li><li>• bladder</li><li>• males</li><li>• ductus deferens</li><li>• seminal vesicles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior gluteal artery is a posterior branch of the internal iliac artery . It exits the pelvis through the greater sciatic foramen above the piriformis muscle and supplies the gluteal region . Therefore, this is the correct answer as it is not an anterior branch.</li><li>➤ The superior gluteal artery is a posterior branch of the internal iliac artery . It exits the pelvis through the greater sciatic foramen above the piriformis muscle and supplies the gluteal region . Therefore, this is the correct answer as it is not an anterior branch.</li><li>➤ The superior gluteal artery is a posterior branch of the internal iliac artery . It exits the pelvis through the greater sciatic foramen above the piriformis muscle and supplies the gluteal region . Therefore, this is the correct answer as it is not an anterior branch.</li><li>➤ posterior branch</li><li>➤ internal iliac artery</li><li>➤ exits</li><li>➤ pelvis</li><li>➤ greater sciatic foramen</li><li>➤ above</li><li>➤ piriformis muscle</li><li>➤ supplies</li><li>➤ gluteal region</li><li>➤ Branches from Internal Iliac Artery-Anterior Division</li><li>➤ Branches from Internal Iliac Artery-Anterior Division</li><li>➤ Obliterated Umbilical Artery Superior Vesical Artery Inferior Vesical Artery Middle Rectal Artery Obturator Artery Uterine Artery Vaginal Artery Inferior Gluteal Artery Internal Pudendal Artery</li><li>➤ Obliterated Umbilical Artery</li><li>➤ Obliterated Umbilical Artery</li><li>➤ Superior Vesical Artery</li><li>➤ Superior Vesical Artery</li><li>➤ Inferior Vesical Artery</li><li>➤ Inferior Vesical Artery</li><li>➤ Middle Rectal Artery</li><li>➤ Middle Rectal Artery</li><li>➤ Obturator Artery</li><li>➤ Obturator Artery</li><li>➤ Uterine Artery</li><li>➤ Uterine Artery</li><li>➤ Vaginal Artery</li><li>➤ Vaginal Artery</li><li>➤ Inferior Gluteal Artery</li><li>➤ Inferior Gluteal Artery</li><li>➤ Internal Pudendal Artery</li><li>➤ Internal Pudendal Artery</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 205</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 205</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All are branches of Inferior Mesenteric Artery except?", "options": [{"label": "A", "text": "Left Colic Artery", "correct": false}, {"label": "B", "text": "Sigmoidal", "correct": false}, {"label": "C", "text": "Middle Rectal", "correct": true}, {"label": "D", "text": "Superior Rectal", "correct": false}], "correct_answer": "C. Middle Rectal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture114.jpg"], "explanation": "<p><strong>Ans. C) Middle Rectal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Left colic artery arises from inferior mesenteric artery and divides into ascending and descending branch . It supplies the descending colon and part of the transverse colon .</li><li>• Option A.</li><li>• arises</li><li>• inferior mesenteric artery</li><li>• ascending</li><li>• descending branch</li><li>• supplies</li><li>• descending colon</li><li>• transverse colon</li><li>• Option B. Sigmoidal arteries are two to three in number , arise from inferior mesenteric arteries . The sigmoidal arteries, also known as sigmoid arteries , are branches of the inferior mesenteric artery . They supply the sigmoid colon .</li><li>• Option B.</li><li>• two</li><li>• three</li><li>• number</li><li>• inferior mesenteric arteries</li><li>• sigmoid arteries</li><li>• branches</li><li>• inferior mesenteric artery</li><li>• sigmoid colon</li><li>• Option D. The highest sigmoidal artery anastomoses with a descending branch of the left colic artery and lowest sigmoidal artery with superior rectal artery . The superior rectal artery is the terminal branch of the inferior mesenteric artery . It supplies the upper part of the rectum .</li><li>• Option D.</li><li>• highest sigmoidal artery</li><li>• descending branch</li><li>• left colic artery</li><li>• lowest sigmoidal artery</li><li>• superior rectal artery</li><li>• terminal branch</li><li>• inferior mesenteric artery</li><li>• supplies</li><li>• upper part</li><li>• rectum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle rectal artery is typically a branch of the internal iliac artery , not the inferior mesenteric artery. It supplies the rectum , which makes this the correct answer as it is not a branch of the IMA.</li><li>➤ The middle rectal artery is typically a branch of the internal iliac artery , not the inferior mesenteric artery. It supplies the rectum , which makes this the correct answer as it is not a branch of the IMA.</li><li>➤ The middle rectal artery is typically a branch of the internal iliac artery , not the inferior mesenteric artery. It supplies the rectum , which makes this the correct answer as it is not a branch of the IMA.</li><li>➤ branch</li><li>➤ internal iliac artery</li><li>➤ supplies</li><li>➤ rectum</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg179</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg179</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Inferior Mesenteric Vein lies over:", "options": [{"label": "A", "text": "Superior Duodenal Recess", "correct": false}, {"label": "B", "text": "Retroduodenal Recess", "correct": false}, {"label": "C", "text": "Inferior Duodenal Recess", "correct": false}, {"label": "D", "text": "Paraduodenal Recess", "correct": true}], "correct_answer": "D. Paraduodenal Recess", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture115.jpg"], "explanation": "<p><strong>Ans. D) Paraduodenal Recess</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior duodenal recess lies to the left upper end of fourth part of duodenum behind superior duodenojejunal peritoneal fold with its mouth looking downward . This recess is located superior to the duodenum and is not typically associated with the course of the inferior mesenteric vein.</li><li>• Option A.</li><li>• left upper end</li><li>• fourth part</li><li>• duodenum</li><li>• behind</li><li>• superior duodenojejunal peritoneal fold</li><li>• downward</li><li>• superior</li><li>• duodenum</li><li>• Option B. Retroduodenal recess is the largest of all duodenal recesses . The retroduodenal recess lies posterior to the duodenum . The IMV does not usually have a significant relationship with this recess, as it primarily drains the large intestine and courses in a different area .</li><li>• Option B.</li><li>• largest</li><li>• all duodenal recesses</li><li>• posterior</li><li>• duodenum</li><li>• drains</li><li>• large intestine</li><li>• courses</li><li>• different area</li><li>• Option C. Inferior duodenal recess lies behind inferior duodenojejunal peritoneal fold with its orifice looking upward . Similar to the superior duodenal recess , this recess is located in relation to the duodenum and is not specifically associated with the pathway of the inferior mesenteric vein.</li><li>• Option C.</li><li>• behind</li><li>• inferior duodenojejunal peritoneal fold</li><li>• orifice</li><li>• upward</li><li>• superior duodenal recess</li><li>• located</li><li>• duodenum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The paraduodenal recess, particularly the left paraduodenal recess , is related to the IMV . The left paraduodenal recess is formed by a fold of peritoneum caused by the left IMV as it ascends behind the peritoneum .</li><li>➤ The paraduodenal recess, particularly the left paraduodenal recess , is related to the IMV . The left paraduodenal recess is formed by a fold of peritoneum caused by the left IMV as it ascends behind the peritoneum .</li><li>➤ left paraduodenal recess</li><li>➤ IMV</li><li>➤ fold</li><li>➤ peritoneum</li><li>➤ left IMV</li><li>➤ ascends</li><li>➤ behind</li><li>➤ peritoneum</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 125</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 125</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-week-old male baby was brought to surgery OPD by his father after he noticed a swelling in his left groin. The swelling also extended down into the upper part of the scrotum. Whenever the baby cried, the swelling enlarged. On careful palpation it was possible to reduce the size of the swelling, and this procedure was accompanied by a gurgling noise. Which of the following statements regarding the above scenario is incorrect?", "options": [{"label": "A", "text": "The Child had a Left Indirect Inguinal Hernia.", "correct": false}, {"label": "B", "text": "The Swelling was situated Below and Medial to the Pubic Tubercle on the Left Side.", "correct": true}, {"label": "C", "text": "The contents of this Herniated Sac included Coils of Small Intestine, which were responsible for the Gurgling Noises that occurred as the Hernia was reduced.", "correct": false}, {"label": "D", "text": "The Processus Vaginalis in its Upper Part had Failed to become Obliterated before Birth", "correct": false}], "correct_answer": "B. The Swelling was situated Below and Medial to the Pubic Tubercle on the Left Side.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-115102.jpg"], "explanation": "<p><strong>Ans. B) The Swelling was situated Below and Medial to the Pubic Tubercle on the Left Side.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. An indirect inguinal hernia in infants often presents as a swelling in the groin that may extend into the scrotum . It is typically more pronounced when intra-abdominal pressure is increased , such as when the child cries , and can often be reduced manually , which is accompanied by a gurgling noise due to the movement of bowel contents .</li><li>• Option A.</li><li>• indirect inguinal hernia</li><li>• infants</li><li>• swelling</li><li>• groin</li><li>• extend</li><li>• scrotum</li><li>• pronounced</li><li>• intra-abdominal pressure</li><li>• increased</li><li>• child cries</li><li>• reduced manually</li><li>• accompanied</li><li>• gurgling noise</li><li>• movement</li><li>• bowel contents</li><li>• Option C. The gurgling noise , often referred to as a \" bowel sound ,\" is indicative of the presence of intestinal loops within the hernia sac. This is common in indirect inguinal hernias .</li><li>• Option C.</li><li>• gurgling noise</li><li>• bowel sound</li><li>• presence</li><li>• intestinal loops</li><li>• common</li><li>• indirect inguinal hernias</li><li>• Option D. The processus vaginalis is a peritoneal outpouching that typically obliterates before or shortly after birth . Failure of the processus vaginalis to obliterate can lead to the formation of an indirect inguinal hernia , as it allows abdominal contents to herniate into the inguinal canal and potentially into the scrotum .</li><li>• Option D.</li><li>• processus vaginalis</li><li>• peritoneal outpouching</li><li>• obliterates</li><li>• before</li><li>• shortly after birth</li><li>• Failure</li><li>• processus vaginalis</li><li>• obliterate</li><li>• formation</li><li>• indirect inguinal hernia</li><li>• allows abdominal</li><li>• herniate</li><li>• inguinal canal</li><li>• potentially</li><li>• scrotum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inguinal hernias , including indirect hernias , are generally located above and medial to the pubic tubercle . The description of the swelling's location as \" below and medial to the pubic tubercle \" would more accurately describe a femoral hernia , which is much less common in infants. The hernial sac in an indirect inguinal hernia emerges from the superficial inguinal ring . It is a triangular opening in the lower part of external oblique aponeurosis and situated above and lateral to pubic crest .</li><li>➤ Inguinal hernias , including indirect hernias , are generally located above and medial to the pubic tubercle . The description of the swelling's location as \" below and medial to the pubic tubercle \" would more accurately describe a femoral hernia , which is much less common in infants.</li><li>➤ Inguinal hernias</li><li>➤ indirect hernias</li><li>➤ above</li><li>➤ medial</li><li>➤ pubic tubercle</li><li>➤ swelling's location</li><li>➤ below</li><li>➤ medial to the pubic tubercle</li><li>➤ accurately</li><li>➤ femoral hernia</li><li>➤ The hernial sac in an indirect inguinal hernia emerges from the superficial inguinal ring . It is a triangular opening in the lower part of external oblique aponeurosis and situated above and lateral to pubic crest .</li><li>➤ hernial sac</li><li>➤ indirect inguinal hernia</li><li>➤ emerges</li><li>➤ superficial inguinal ring</li><li>➤ triangular opening</li><li>➤ lower part</li><li>➤ external oblique aponeurosis</li><li>➤ above</li><li>➤ lateral</li><li>➤ pubic crest</li><li>➤ Structures passing through Superficial Inguinal Ring</li><li>➤ Structures passing through Superficial Inguinal Ring</li><li>➤ Ilioinguinal Nerve Spermatic Cord or Round Ligament</li><li>➤ Ilioinguinal Nerve</li><li>➤ Spermatic Cord or Round Ligament</li><li>➤ Boundaries of Superficial Inguinal Ring</li><li>➤ Boundaries of Superficial Inguinal Ring</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1081</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1081</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old female applied for a receptionist job. While waiting for the interview date she decided to lose 15 kgs on a crash diet. Few days later she developed severe nausea and recurrent bilious vomiting. On examination her abdomen is tender and slightly distended with high pitched bowel sounds. A laparotomy was performed to identify small bowel obstruction. Intraoperatively it was observed that the angle between her superior mesenteric artery and aorta is significantly reduced. Which of the following structures is most likely to be obstructed by the artery?", "options": [{"label": "A", "text": "Duodenal bulb", "correct": false}, {"label": "B", "text": "Duodenojejunal flexure", "correct": false}, {"label": "C", "text": "Transverse portion of the duodenum", "correct": true}, {"label": "D", "text": "Ascending portion of the duodenum", "correct": false}], "correct_answer": "C. Transverse portion of the duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture116.jpg"], "explanation": "<p><strong>Ans. C) Transverse portion of the duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The scenario described suggests a case of Superior Mesenteric Artery (SMA) syndrome , a rare but serious condition where the transverse portion of the duodenum is compressed between the SMA and the aorta . SMA syndrome is also called Wilkie`s Syndrome</li><li>• Superior Mesenteric Artery (SMA) syndrome</li><li>• rare</li><li>• transverse portion</li><li>• duodenum</li><li>• between</li><li>• SMA</li><li>• aorta</li><li>• SMA syndrome is also called Wilkie`s Syndrome</li><li>• Option A. The duodenal bulb is the first part of the duodenum and is located just distal to the stomach . While it can be involved in various gastrointestinal conditions, it is not typically compressed in SMA syndrome. The first part of duodenum presents the duodenal cap -it’s the proximal part , intraperitoneal with absent plicae semicircularis</li><li>• Option A.</li><li>• first part</li><li>• duodenum</li><li>• distal</li><li>• stomach</li><li>• first part</li><li>• duodenum</li><li>• duodenal cap</li><li>• proximal part</li><li>• intraperitoneal</li><li>• absent plicae semicircularis</li><li>• Option B. Duodenojejunal Flexure is the junction between the duodenum and the jejunum . While it lies close to the SMA, it is not the site typically compressed in SMA syndrome. Duodenal jejunal flexure is situated on the left side of L2 vertebra , kept in position by suspensory muscle of duodenum ( ligament of treitz ).</li><li>• Option B.</li><li>• junction</li><li>• duodenum</li><li>• jejunum</li><li>• Duodenal jejunal flexure</li><li>• left side</li><li>• L2 vertebra</li><li>• suspensory muscle</li><li>• duodenum</li><li>• ligament</li><li>• treitz</li><li>• Option D. The ascending portion of the duodenum, or the fourth part , ascends to the level of the duodenojejunal flexure . It is not the portion that is typically compressed in SMA syndrome. It is separated from stomach by lesser sac and anteriorly related to transverse colon and its mesocolon .</li><li>• Option D.</li><li>• fourth part</li><li>• ascends</li><li>• level</li><li>• duodenojejunal flexure</li><li>• separated</li><li>• stomach</li><li>• lesser sac</li><li>• anteriorly</li><li>• transverse colon</li><li>• mesocolon</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In SMA syndrome (aka Wilkie`s Syndrome ) , the transverse ( third ) portion of the duodenum , which passes between the SMA and the aorta , is compressed . This condition can occur when the angle between these two vessels is significantly reduced , often due to rapid weight loss , leading to a decrease in mesenteric fat that normally cushions this part of the duodenum .</li><li>➤ In SMA syndrome (aka Wilkie`s Syndrome ) , the transverse ( third ) portion of the duodenum , which passes between the SMA and the aorta , is compressed . This condition can occur when the angle between these two vessels is significantly reduced , often due to rapid weight loss , leading to a decrease in mesenteric fat that normally cushions this part of the duodenum .</li><li>➤ SMA syndrome (aka</li><li>➤ Wilkie`s Syndrome</li><li>➤ )</li><li>➤ transverse</li><li>➤ third</li><li>➤ portion</li><li>➤ duodenum</li><li>➤ passes</li><li>➤ SMA</li><li>➤ aorta</li><li>➤ compressed</li><li>➤ angle</li><li>➤ two vessels</li><li>➤ reduced</li><li>➤ rapid weight loss</li><li>➤ leading</li><li>➤ decrease</li><li>➤ mesenteric fat</li><li>➤ normally</li><li>➤ cushions</li><li>➤ duodenum</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1124</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1124</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male, who is a cashier in the bank presented to the surgery OPD with complaints of fatigue, vague abdominal discomfort and bloody stools. Colonoscopy revealed a mass in the descending colon. Surgical removal of the mass requires proper ligation of:", "options": [{"label": "A", "text": "Coeliac Trunk", "correct": false}, {"label": "B", "text": "Superior Mesenteric Artery", "correct": false}, {"label": "C", "text": "Inferior Mesenteric Artery", "correct": true}, {"label": "D", "text": "Internal Iliac Artery", "correct": false}], "correct_answer": "C. Inferior Mesenteric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture117.jpg"], "explanation": "<p><strong>Ans. C) Inferior Mesenteric Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The coeliac trunk is a major artery that supplies foregut derivatives - stomach , duodenum upto opening of common bile duct , liver , spleen , pancreas . It is not primarily involved in the blood supply to the colon, especially not the descending colon.</li><li>• Option A.</li><li>• major artery</li><li>• foregut derivatives</li><li>• stomach</li><li>• duodenum</li><li>• opening</li><li>• common bile duct</li><li>• liver</li><li>• spleen</li><li>• pancreas</li><li>• Option B. The superior mesenteric artery (SMA) supplies midgut derivatives - duodenum distal to the opening of common bile duct , jejunum , ileum , ascending colon , right 2/3 of transverse colon pancreas . While the SMA is a critical artery in gastrointestinal surgery , it is not the primary artery supplying the descending colon.</li><li>• Option B.</li><li>• midgut derivatives</li><li>• duodenum distal</li><li>• opening</li><li>• common bile</li><li>• duct</li><li>• jejunum</li><li>• ileum</li><li>• ascending colon</li><li>• right 2/3</li><li>• transverse colon pancreas</li><li>• critical artery</li><li>• gastrointestinal surgery</li><li>• Option D. The internal iliac artery primarily supplies blood to the pelvic organs and the pelvic walls . It is not directly involved in the vascular supply to the descending colon.</li><li>• Option D.</li><li>• supplies</li><li>• blood</li><li>• pelvic organs</li><li>• pelvic walls</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior mesenteric artery (IMA) supplies blood to the latter parts of the large intestine , including the descending colon , sigmoid colon , and rectum . For a surgical resection of a mass in the descending colon , ligation of the IMA is typically required to properly manage the blood supply to the area of the tumor .</li><li>➤ The inferior mesenteric artery (IMA) supplies blood to the latter parts of the large intestine , including the descending colon , sigmoid colon , and rectum .</li><li>➤ The inferior mesenteric artery (IMA) supplies blood to the latter parts of the large intestine , including the descending colon , sigmoid colon , and rectum .</li><li>➤ inferior mesenteric artery (IMA)</li><li>➤ blood</li><li>➤ latter parts</li><li>➤ large intestine</li><li>➤ descending colon</li><li>➤ sigmoid colon</li><li>➤ rectum</li><li>➤ For a surgical resection of a mass in the descending colon , ligation of the IMA is typically required to properly manage the blood supply to the area of the tumor .</li><li>➤ For a surgical resection of a mass in the descending colon , ligation of the IMA is typically required to properly manage the blood supply to the area of the tumor .</li><li>➤ surgical resection</li><li>➤ mass</li><li>➤ descending colon</li><li>➤ ligation</li><li>➤ IMA</li><li>➤ properly manage</li><li>➤ blood supply</li><li>➤ area</li><li>➤ tumor</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1088</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1088</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A woman aged 50 years had a long history of periodic ulcer dyspepsia with a recent story of intractability, nocturnal waking and back pain. There was also a history of melena stools. She was admitted for elective surgery. A truncal vagotomy and two-layer pyloroplasty was carried out and her postoperative course was uneventful. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "The Left Vagus Nerve of Thorax continues into the Abdomen as Anterior Vagal Trunk", "correct": false}, {"label": "B", "text": "The Vagus Nerves accompany the Esophagus and pass through the Diaphragmatic opening opposite T10 Vertebra", "correct": false}, {"label": "C", "text": "The Right Vagus Nerve supplies the Prepyloric Stomach, Pyloric Sphincter and Duodenum", "correct": true}, {"label": "D", "text": "Criminal Nerve of Grassi arises from Posterior Vagal Trunk", "correct": false}], "correct_answer": "C. The Right Vagus Nerve supplies the Prepyloric Stomach, Pyloric Sphincter and Duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture118.jpg"], "explanation": "<p><strong>Ans. C) The Right Vagus Nerve supplies the Prepyloric Stomach, Pyloric Sphincter and Duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The left vagus nerve typically forms the anterior vagal trunk as it enters the abdomen . This trunk generally supplies the anterior surface of the stomach . The anterior vagal trunk will divide into hepatic and gastric branches .</li><li>• Option A.</li><li>• forms</li><li>• anterior vagal trunk</li><li>• enters</li><li>• abdomen</li><li>• supplies</li><li>• anterior surface</li><li>• stomach</li><li>• anterior vagal trunk</li><li>• divide</li><li>• hepatic</li><li>• gastric branches</li><li>• Option B. The vagus nerves descend alongside the esophagus through the esophageal hiatus of the diaphragm , which is located approximately at the level of the T10 vertebra.</li><li>• Option B.</li><li>• descend</li><li>• esophagus</li><li>• esophageal hiatus</li><li>• diaphragm</li><li>• approximately</li><li>• level</li><li>• T10 vertebra.</li><li>• Option D. The criminal nerve of Grassi is a branch of the posterior vagal trunk and is known for being a potential source of failure in vagotomy procedures due to its innervation of the fundus and body of the stomach .</li><li>• Option D.</li><li>• criminal nerve</li><li>• Grassi</li><li>• branch</li><li>• posterior vagal trunk</li><li>• potential source</li><li>• failure</li><li>• vagotomy</li><li>• innervation</li><li>• fundus</li><li>• body</li><li>• stomach</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right vagus nerve typically forms the posterior vagal trunk in the abdomen . It primarily supplies the posterior surface of the stomach . The celiac branch of the posterior vagal trunk may contribute to the innervation of the duodenum , but the primary innervation of the pyloric sphincter and duodenum is not from the right vagus nerve.</li><li>➤ The right vagus nerve typically forms the posterior vagal trunk in the abdomen . It primarily supplies the posterior surface of the stomach .</li><li>➤ right vagus nerve</li><li>➤ posterior vagal trunk</li><li>➤ abdomen</li><li>➤ supplies</li><li>➤ posterior surface</li><li>➤ stomach</li><li>➤ The celiac branch of the posterior vagal trunk may contribute to the innervation of the duodenum , but the primary innervation of the pyloric sphincter and duodenum is not from the right vagus nerve.</li><li>➤ celiac branch</li><li>➤ posterior vagal trunk</li><li>➤ innervation</li><li>➤ duodenum</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1118</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No. 1118</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old business executive was admitted to the hospital after visiting the emergency room complaining of severe epigastric pain and pain over her right shoulder. She had a history of gastric ulcer which had been treated previously with medication, but on questioning, she admitted that she had been so busy recently that she had forgotten to refill her prescription and had not taken her medication in some time. As a result of the history and physical findings, the physician suspected that she was suffering from a perforated gastric ulcer. Gastroscopy was performed which confirmed the diagnosis. When the surgeon examined the patient’s stomach during the surgery, she found a small perforation on the posterior aspect of the body of the stomach near the lesser curvature. The perforation was repaired and, in addition, a vagotomy was performed. During the vagotomy, the surgeon found it necessary to cut the left gastric artery and ligate it. Which of the following statements pertaining to the above case is incorrect?", "options": [{"label": "A", "text": "Perforated Ulcer on the Posterior Wall of the Stomach can Damage Splenic Artery", "correct": false}, {"label": "B", "text": "The Shoulder Pain was referred Pain due to Irritation of Diaphragm by Gastric Juices", "correct": false}, {"label": "C", "text": "Vagotomy Reduces Acid Secretion of Stomach", "correct": false}, {"label": "D", "text": "Collateral Circulation from Branches of Superior Mesenteric Artery will compensate o cclusion of Left Gastric Artery", "correct": true}], "correct_answer": "D. Collateral Circulation from Branches of Superior Mesenteric Artery will compensate o cclusion of Left Gastric Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture119.jpg"], "explanation": "<p><strong>Ans. D) Collateral Circulation from Branches of Superior Mesenteric Artery will compensate Occlusion of Left Gastric Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A perforated ulcer on the posterior wall of the stomach , especially near the lesser curvature , can lead to damage of the pancreas , left kidney , left suprarenal glandand splenic artery due to the proximity of these structures. However, this is more common with larger perforations or those that go untreated for longer periods .</li><li>• Option A.</li><li>• perforated ulcer</li><li>• posterior wall</li><li>• stomach</li><li>• lesser curvature</li><li>• damage</li><li>• pancreas</li><li>• left kidney</li><li>• left suprarenal glandand splenic artery</li><li>• proximity</li><li>• larger perforations</li><li>• go untreated</li><li>• longer periods</li><li>• Option B. The shoulder pain , particularly over the right shoulder , is likely referred pain via the phrenic nerve caused by irritation of the diaphragm due to leakage of gastric contents from the perforated ulcer . The diaphragm is innervated by the phrenic nerves which arise from cervical nerves 3 , 4 , and 5 . These cervical nerves also contain nerves that innervate the shoulder region ; thus, the shoulder is a common location for referred pain from the diaphragm .</li><li>• Option B.</li><li>• shoulder pain</li><li>• over</li><li>• right shoulder</li><li>• pain</li><li>• phrenic nerve</li><li>• irritation</li><li>• diaphragm</li><li>• leakage</li><li>• gastric contents</li><li>• perforated ulcer</li><li>• diaphragm</li><li>• innervated</li><li>• phrenic nerves</li><li>• arise</li><li>• cervical nerves</li><li>• 3</li><li>• 4</li><li>• 5</li><li>• nerves</li><li>• innervate</li><li>• shoulder region</li><li>• shoulder</li><li>• referred pain</li><li>• diaphragm</li><li>• Option C. A vagotomy involves cutting the vagus nerve , which reduces acid secretion in the stomach . A vagotomy involves severing some or all of the branches of the anterior and posterior vagal trunks . In severe cases of gastric ulcer , this procedure is sometimes performed to reduce the acid secretion of the stomach , which is stimulated, in part, by parasympathetic innervation provided by the vagus nerves .</li><li>• Option C.</li><li>• cutting</li><li>• vagus nerve</li><li>• reduces acid secretion</li><li>• stomach</li><li>• severing</li><li>• all</li><li>• branches</li><li>• anterior</li><li>• posterior vagal trunks</li><li>• gastric ulcer</li><li>• reduce</li><li>• acid secretion</li><li>• stomach</li><li>• parasympathetic innervation</li><li>• vagus nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While there is a Rich Network of collateral circulation within the Stomach , the Primary Compensation for occlusion of the Left Gastric Artery is not through the branches of the Superior Mesenteric Artery (SMA). Instead, the Right Gastric and Right Gastroepiploic Arteries , which are branches of the Hepatic Artery , along with the Left Gastroepiploic Artery (a branch of the Splenic Artery), play a more significant role in compensating for the loss of the Left Gastric Artery . The SMA primarily supplies the Midgut , and its branches do not significantly contribute to the Gastric Circulation.</li><li>➤ While there is a Rich Network of collateral circulation within the Stomach , the Primary Compensation for occlusion of the Left Gastric Artery is not through the branches of the Superior Mesenteric Artery (SMA).</li><li>➤ Rich Network</li><li>➤ collateral circulation</li><li>➤ Stomach</li><li>➤ Instead, the Right Gastric and Right Gastroepiploic Arteries , which are branches of the Hepatic Artery , along with the Left Gastroepiploic Artery (a branch of the Splenic Artery), play a more significant role in compensating for the loss of the Left Gastric Artery .</li><li>➤ Right Gastric</li><li>➤ Right Gastroepiploic Arteries</li><li>➤ branches</li><li>➤ Hepatic Artery</li><li>➤ Left Gastroepiploic Artery</li><li>➤ compensating</li><li>➤ loss</li><li>➤ Left Gastric Artery</li><li>➤ The SMA primarily supplies the Midgut , and its branches do not significantly contribute to the Gastric Circulation.</li><li>➤ supplies</li><li>➤ Midgut</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 97</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg 97</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Posteriorly perforating ulcer in the pyloric antrum of the stomach is likely to produce initial localised peritonitis in?", "options": [{"label": "A", "text": "Greater Sac", "correct": false}, {"label": "B", "text": "Right Subhepatic Recess", "correct": false}, {"label": "C", "text": "Left Subhepatic Recess", "correct": true}, {"label": "D", "text": "Left Suprahepatic Recess", "correct": false}], "correct_answer": "C. Left Subhepatic Recess", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture120.jpg"], "explanation": "<p><strong>Ans. C) Left Subhepatic Recess</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The greater sac is the main and larger part of the peritoneal cavity . It is not the initial location for localized peritonitis in this scenario. Greater sac extends from diaphragm to the pelvic floor and divided by greater omentum and transverse mesocolon into supracolic and infracolic compartment .</li><li>• Option A.</li><li>• greater sac</li><li>• main</li><li>• larger part</li><li>• peritoneal cavity</li><li>• Greater sac</li><li>• diaphragm</li><li>• pelvic floor</li><li>• divided</li><li>• greater omentum</li><li>• transverse mesocolon</li><li>• supracolic</li><li>• infracolic compartment</li><li>• Option B. The right subhepatic recess , also known as hepatorenal pouch of Morrison , most dependent part of peritoneal cavity in supine position . It is a potential space between the liver and the right kidney . However, it is more commonly associated with pathologies affecting the liver and right kidney , rather than localized peritonitis from a posteriorly perforating ulcer in the pyloric antrum .</li><li>• Option B.</li><li>• right subhepatic recess</li><li>• hepatorenal pouch</li><li>• Morrison</li><li>• peritoneal cavity</li><li>• supine position</li><li>• potential space</li><li>• liver</li><li>• right kidney</li><li>• affecting</li><li>• liver</li><li>• right kidney</li><li>• localized peritonitis</li><li>• posteriorly perforating ulcer</li><li>• pyloric antrum</li><li>• Option D. The left suprahepatic recess is located above the liver and is not directly associated with localized peritonitis resulting from a perforating ulcer in the pyloric antrum. Left suprahepatic recess lies to the left side of falciform ligament .</li><li>• Option D.</li><li>• left suprahepatic recess</li><li>• above</li><li>• liver</li><li>• Left suprahepatic recess</li><li>• left side</li><li>• falciform ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left subhepatic recess, also known as the lesser sac or omental bursa , is located posterior to the stomach and the lesser omentum . In the case of a posterior perforation in the pyloric antrum , this area is more likely to be affected initially , leading to localized peritonitis .</li><li>➤ The left subhepatic recess, also known as the lesser sac or omental bursa , is located posterior to the stomach and the lesser omentum . In the case of a posterior perforation in the pyloric antrum , this area is more likely to be affected initially , leading to localized peritonitis .</li><li>➤ lesser sac</li><li>➤ omental bursa</li><li>➤ posterior</li><li>➤ stomach</li><li>➤ lesser omentum</li><li>➤ posterior perforation</li><li>➤ pyloric antrum</li><li>➤ affected initially</li><li>➤ leading</li><li>➤ localized peritonitis</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg.84</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol. II, Abdomen Pg.84</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the clinic with a 6-month history of vague abdominal discomfort and early satiety. He denies any recent changes in bowel habits, weight loss, or night sweats. On examination, his abdomen is soft, non-tender, and there are no palpable masses. A computed tomography (CT) scan of the abdomen is ordered to further evaluate his symptoms, which shows an incidental finding related to the anatomy surrounding the stomach. Based on this scenario, which of the following structures is least likely to be involved in the observed anatomical findings at bed of the stomach?", "options": [{"label": "A", "text": "Right Crus of Diaphragm", "correct": true}, {"label": "B", "text": "Transverse Mesocolon", "correct": false}, {"label": "C", "text": "Left Colic Flexure", "correct": false}, {"label": "D", "text": "Pancreas Except Tail", "correct": false}], "correct_answer": "A. Right Crus of Diaphragm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture121.jpg"], "explanation": "<p><strong>Ans. A) Right Crus of Diaphragm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The transverse mesocolon is a peritoneal fold that connects the transverse colon to the posterior abdominal wall . It covers the anterior aspect of the stomach and contributes to the stomach bed .</li><li>• Option B.</li><li>• peritoneal fold</li><li>• connects</li><li>• transverse</li><li>• colon</li><li>• posterior abdominal wall</li><li>• covers</li><li>• anterior aspect</li><li>• stomach</li><li>• contributes</li><li>• stomach bed</li><li>• Option C. The left colic flexure, also known as the splenic flexure , is the junction between the transverse colon and the descending colon . It is not a direct contributor to the stomach bed. Left crus of diaphragm left suprarenal gland , anterior surface of left kidney , tortuous splenic artery also forms stomach bed .</li><li>• Option C.</li><li>• splenic flexure</li><li>• junction</li><li>• transverse colon</li><li>• descending colon</li><li>• Left crus</li><li>• diaphragm</li><li>• left suprarenal gland</li><li>• anterior surface</li><li>• left kidney</li><li>• tortuous splenic</li><li>• artery</li><li>• forms stomach bed</li><li>• Option D. The pancreas , except for its tail , lies adjacent to the stomach . The head of the pancreas , in particular, is closely related to the duodenum and the posterior surface of the stomach , contributing to the stomach bed .</li><li>• Option D.</li><li>• pancreas</li><li>• except</li><li>• tail</li><li>• stomach</li><li>• head</li><li>• pancreas</li><li>• duodenum</li><li>• posterior surface</li><li>• stomach</li><li>• stomach bed</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right crus of the diaphragm does not contribute to the stomach bed . It is a muscular structure of the diaphragm that is more closely associated with the esophagus and the hiatus through which the esophagus passes . While it is anatomically close to the stomach , it is not considered a part of the stomach bed.</li><li>➤ The right crus of the diaphragm does not contribute to the stomach bed .</li><li>➤ does not</li><li>➤ stomach bed</li><li>➤ It is a muscular structure of the diaphragm that is more closely associated with the esophagus and the hiatus through which the esophagus passes .</li><li>➤ muscular structure</li><li>➤ diaphragm</li><li>➤ esophagus</li><li>➤ hiatus</li><li>➤ esophagus passes</li><li>➤ While it is anatomically close to the stomach , it is not considered a part of the stomach bed.</li><li>➤ anatomically close</li><li>➤ stomach</li><li>➤ Ref : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 89</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Anatomy 3 rd Edition, Vol II, Abdomen Pg 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old married female patient presented to the ER with complaints of epigastric pain and nausea for 6 hours. She was a known case of peptic ulcer disease and has been erratically on oral proton pump inhibitors for the last two years. On examination there was mild tenderness and guarding in the upper abdomen. Chest X-ray and ultrasound showed nothing significant. Patient was admitted for further evaluation. On the 2nd day of admission, the patient deteriorated. Patient became unconscious, his pulse was weak and BP very low. USG revealed free fluid in the peritoneal cavity. Patient was shifted for an emergency laparotomy. Which of the following statements is not correct?", "options": [{"label": "A", "text": "Patient was Diagnosed with Peritonitis possibly due to Perforated Peptic Ulcer", "correct": false}, {"label": "B", "text": "Subphrenic Abscess can result as a complication of Perforated Peptic Ulcer", "correct": false}, {"label": "C", "text": "Gastroduodenal Artery lies on the Anterior Surface of First Part of Duodenum", "correct": true}, {"label": "D", "text": "The First Part of Duodenum is most susceptible for Peptic Ulcer", "correct": false}], "correct_answer": "C. Gastroduodenal Artery lies on the Anterior Surface of First Part of Duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture123.jpg"], "explanation": "<p><strong>Ans. C) Gastroduodenal Artery lies on the Anterior Surface of First Part of Duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The patient's presentation with epigastric pain , tenderness , guarding , and the subsequent finding of free fluid in the peritoneal cavity on ultrasound strongly suggests peritonitis , which can be caused by a perforated peptic ulcer .</li><li>• Option A.</li><li>• epigastric pain</li><li>• tenderness</li><li>• guarding</li><li>• subsequent finding</li><li>• free fluid</li><li>• peritoneal cavity</li><li>• ultrasound</li><li>• strongly</li><li>• peritonitis</li><li>• perforated peptic ulcer</li><li>• Option B. A subphrenic abscess can indeed develop as a complication of a perforated peptic ulcer . When gastric contents leak into the peritoneal cavity due to a perforation , they can lead to localized infections , such as a subphrenic abscess , especially in the area below the diaphragm . The infected fluid from perforated peptic ulcer can appear in the supracolic compartment and remain localized due to adhesion between the greater omentum and anterior abdominal wall . Later the pus will trickle around right free margin of lesser omentum and collect in the hepatorenal pouch and right subphrenic ( supra hepatic ) recess .</li><li>• Option B.</li><li>• complication</li><li>• perforated peptic</li><li>• ulcer</li><li>• leak</li><li>• peritoneal cavity</li><li>• perforation</li><li>• localized infections</li><li>• subphrenic abscess</li><li>• below</li><li>• diaphragm</li><li>• infected fluid</li><li>• perforated peptic</li><li>• ulcer</li><li>• supracolic compartment</li><li>• localized</li><li>• adhesion</li><li>• greater omentum</li><li>• anterior abdominal wall</li><li>• pus</li><li>• trickle</li><li>• right free margin</li><li>• lesser omentum</li><li>• collect</li><li>• hepatorenal pouch</li><li>• right subphrenic</li><li>• supra hepatic</li><li>• recess</li><li>• Option D. The first part of the duodenum is generally susceptible to peptic ulcers compared to the stomach and the duodenal bulb (the first part of the duodenum immediately distal to the stomach ). Peptic ulcers are more commonly found in the stomach and the duodenal bulb .</li><li>• Option D.</li><li>• susceptible</li><li>• peptic ulcers</li><li>• stomach</li><li>• duodenal bulb</li><li>• first part</li><li>• duodenum</li><li>• distal</li><li>• stomach</li><li>• stomach</li><li>• duodenal bulb</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The gastroduodenal artery typically does not lie on the anterior surface of the first part of the duodenum. Instead, the gastroduodenal artery typically runs posterior to the first part of the duodenum , where it gives off the anterior superior pancreaticoduodenal artery and the posterior superior pancreaticoduodenal artery . Perforated peptic ulcer can erode the posterior surface of first part of duodenum as well as gastroduodenal artery leading to bleeding , hence it is called as artery of duodenal hemorrhage .</li><li>➤ The gastroduodenal artery typically does not lie on the anterior surface of the first part of the duodenum. Instead, the gastroduodenal artery typically runs posterior to the first part of the duodenum , where it gives off the anterior superior pancreaticoduodenal artery and the posterior superior pancreaticoduodenal artery .</li><li>➤ gastroduodenal artery</li><li>➤ posterior</li><li>➤ first part</li><li>➤ duodenum</li><li>➤ gives off</li><li>➤ anterior superior pancreaticoduodenal</li><li>➤ artery</li><li>➤ posterior superior</li><li>➤ pancreaticoduodenal artery</li><li>➤ Perforated peptic ulcer can erode the posterior surface of first part of duodenum as well as gastroduodenal artery leading to bleeding , hence it is called as artery of duodenal hemorrhage .</li><li>➤ Perforated peptic ulcer</li><li>➤ erode</li><li>➤ posterior surface</li><li>➤ first part</li><li>➤ duodenum</li><li>➤ gastroduodenal artery</li><li>➤ bleeding</li><li>➤ artery</li><li>➤ duodenal hemorrhage</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 1124</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 1124</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old female was brought to ER with complaints of acute pain around the umbilicus, fever and vomiting. On examination the surgeon noted maximum tenderness over McBurney’s point. Which of the following statements pertaining to the above case is not true?", "options": [{"label": "A", "text": "Mcburney's Point is at the Junction of Medial 2/3 and Lateral 1/3 of a line which Extends from the Umbilicus to the Right Anterior Superior Iliac Spine", "correct": false}, {"label": "B", "text": "Inflammation of Appendix Pain is referred to Umbilicus along the Distribution of T9 Segment", "correct": true}, {"label": "C", "text": "In Appendicitis the Pain is often first felt in the Umbilical Region then later in the Right Iliac Area.", "correct": false}, {"label": "D", "text": "Submucosa of Appendix is studded with numerous Lymphoid Follicles", "correct": false}], "correct_answer": "B. Inflammation of Appendix Pain is referred to Umbilicus along the Distribution of T9 Segment", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/picture124.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/15/screenshot-2024-02-15-115431.jpg"], "explanation": "<p><strong>Ans. B) Inflammation of Appendix Pain is referred to Umbilicus along the Distribution of T9 Segment</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. McBurney's point is a clinically significant anatomical landmark located approximately one-third of the way along a line drawn from the umbilicus to the right Anterior Superior Iliac Spine (ASIS) . It is commonly used as a reference point for assessing tenderness in cases of suspected appendicitis .</li><li>• Option A. McBurney's point</li><li>• anatomical landmark</li><li>• one-third</li><li>• line</li><li>• drawn</li><li>• umbilicus</li><li>• right Anterior Superior Iliac Spine (ASIS)</li><li>• assessing tenderness</li><li>• suspected appendicitis</li><li>• Option C. The sequence of pain progression in appendicitis often starts with periumbilical pain , followed by the migration of pain to the right iliac area as the inflammation worsens . This pattern is characteristic of appendicitis .</li><li>• Option C.</li><li>• starts</li><li>• periumbilical pain</li><li>• migration</li><li>• pain</li><li>• right iliac area</li><li>• inflammation worsens</li><li>• appendicitis</li><li>• Option D. The appendix is a lymphoid-rich organ with a high concentration of lymphoid follicles in its submucosa . This feature is a part of its role in the immune system .</li><li>• Option D.</li><li>• lymphoid-rich</li><li>• organ</li><li>• high concentration</li><li>• lymphoid follicles</li><li>• submucosa</li><li>• role</li><li>• immune system</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Appendix Nerve Supply</li><li>➤ The Appendix Nerve Supply</li><li>➤ In cases of appendicitis , pain typically begins around the umbilicus ( periumbilical ) and then migrates to the right lower quadrant of the abdomen , where McBurney's point is located . The referred pain pattern is along the distribution of the T10 segment . In appendicitis the pain is often first felt in the umbilical region then later in the right iliac area due to local peritonitis . Submucosa of appendix is studded with numerous lymphoid follicles ; enlargement of these lymph nodes can obstruct blood supply and lead to inflammation of appendix</li><li>➤ In cases of appendicitis , pain typically begins around the umbilicus ( periumbilical ) and then migrates to the right lower quadrant of the abdomen , where McBurney's point is located . The referred pain pattern is along the distribution of the T10 segment .</li><li>➤ In cases of appendicitis , pain typically begins around the umbilicus ( periumbilical ) and then migrates to the right lower quadrant of the abdomen , where McBurney's point is located . The referred pain pattern is along the distribution of the T10 segment .</li><li>➤ appendicitis</li><li>➤ pain</li><li>➤ begins</li><li>➤ umbilicus</li><li>➤ periumbilical</li><li>➤ migrates</li><li>➤ right lower quadrant</li><li>➤ abdomen</li><li>➤ McBurney's point</li><li>➤ located</li><li>➤ distribution</li><li>➤ T10 segment</li><li>➤ In appendicitis the pain is often first felt in the umbilical region then later in the right iliac area due to local peritonitis .</li><li>➤ In appendicitis the pain is often first felt in the umbilical region then later in the right iliac area due to local peritonitis .</li><li>➤ appendicitis</li><li>➤ first felt</li><li>➤ umbilical region</li><li>➤ right iliac</li><li>➤ area</li><li>➤ local peritonitis</li><li>➤ Submucosa of appendix is studded with numerous lymphoid follicles ; enlargement of these lymph nodes can obstruct blood supply and lead to inflammation of appendix</li><li>➤ Submucosa of appendix is studded with numerous lymphoid follicles ; enlargement of these lymph nodes can obstruct blood supply and lead to inflammation of appendix</li><li>➤ Submucosa</li><li>➤ appendix</li><li>➤ numerous lymphoid follicles</li><li>➤ enlargement</li><li>➤ these lymph</li><li>➤ nodes</li><li>➤ obstruct</li><li>➤ blood supply</li><li>➤ lead</li><li>➤ inflammation</li><li>➤ appendix</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1142</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No. 1142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 157 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "In the anatomical arrangement of intermuscular spaces such as the cubital fossa, femoral triangle, anatomical snuff box, etc., what primarily forms the roof of these spaces? Skin Superficial fascia Subcutaneous fat, cutaneous nerves and vessels Deep fascia", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "1, 2, 3", "correct": false}, {"label": "C", "text": "1, 3, 4", "correct": false}, {"label": "D", "text": "1, 2, 3, 4", "correct": true}], "correct_answer": "D. 1, 2, 3, 4", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) 1,2,3,4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Intermuscular spaces , like the cubital fossa , femoral triangle , and anatomical snuff box , have a characteristic anatomical arrangement . The roof of these intermuscular space is formed layer by layer from following structures .</li><li>• Intermuscular spaces , like the cubital fossa , femoral triangle , and anatomical snuff box , have a characteristic anatomical arrangement .</li><li>• Intermuscular spaces</li><li>• cubital fossa</li><li>• femoral triangle</li><li>• anatomical snuff box</li><li>• characteristic anatomical arrangement</li><li>• The roof of these intermuscular space is formed layer by layer from following structures .</li><li>• roof</li><li>• intermuscular space</li><li>• layer by layer</li><li>• following structures</li><li>• Skin - In this layer hair &amp; skin appendages are present. Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present. Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Skin - In this layer hair &amp; skin appendages are present.</li><li>• Skin - In this layer hair &amp; skin appendages are present.</li><li>• Skin</li><li>• hair &amp; skin</li><li>• appendages</li><li>• Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present.</li><li>• Superficial fascia - In this layer subcutaneous fat , cutaneous nerves and vessels are present.</li><li>• Superficial fascia</li><li>• subcutaneous fat</li><li>• cutaneous nerves</li><li>• vessels</li><li>• Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Deep fascia - It is a dense , fibrous connective tissue layer , loaded with collagen , that surrounds and separates muscle groups , providing structural support and defining the boundaries of these anatomical regions .</li><li>• Deep fascia</li><li>• dense</li><li>• fibrous connective tissue layer</li><li>• loaded</li><li>• collagen</li><li>• surrounds</li><li>• separates muscle groups</li><li>• providing structural support</li><li>• defining</li><li>• boundaries</li><li>• anatomical regions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The primary structures forming the roof of intermuscular spaces , such as the cubital fossa, femoral triangle , and anatomical snuff box are skin , superficial fascia &amp; deep fascia .</li><li>➤ The primary structures forming the roof of intermuscular spaces , such as the cubital fossa, femoral triangle , and anatomical snuff box are skin , superficial fascia &amp; deep fascia .</li><li>➤ primary structures</li><li>➤ roof of intermuscular spaces</li><li>➤ cubital fossa, femoral triangle</li><li>➤ anatomical snuff box</li><li>➤ skin</li><li>➤ superficial fascia &amp; deep fascia</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference: Gray’s Anatomy, 42 nd Edition, International Edition, Page no - 872</li><li>↳ BD Chaurasia’s Human Anatomy, 9 th Edition, Volume 1, Page no - 107, 108</li><li>↳ BD Chaurasia’s Human Anatomy, 9 th Edition, Volume 1, Page no - 107, 108</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hilton's Law of Anatomy is most closely associated with which principle?", "options": [{"label": "A", "text": "The relationship between muscle innervation and joint function.", "correct": false}, {"label": "B", "text": "The correlation between blood supply and organ health.", "correct": false}, {"label": "C", "text": "The connection between the nerve supplying a joint and the muscles moving the joint.", "correct": true}, {"label": "D", "text": "The relationship between the size of a muscle and its strength.", "correct": false}], "correct_answer": "C. The connection between the nerve supplying a joint and the muscles moving the joint.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The connection between the nerve supplying a joint and the muscles moving the joint.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The relationship between muscle innervation and joint function is not the primary focus of Hilton's Law.</li><li>• Option A</li><li>• not</li><li>• Option B . The correlation between blood supply and organ health is unrelated to Hilton's Law.</li><li>• Option B</li><li>• unrelated</li><li>• Option D . The relationship between the size of a muscle and its strength is not a direct aspect of Hilton's Law.</li><li>• Option D</li><li>• not</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hilton's Law of Anatomy emphasizes the connection between the nerve supplying a joint and the muscles responsible for moving the joint .</li><li>➤ Hilton's Law of Anatomy emphasizes the connection between the nerve supplying a joint and the muscles responsible for moving the joint .</li><li>➤ Hilton's Law of Anatomy</li><li>➤ connection</li><li>➤ nerve supplying</li><li>➤ joint</li><li>➤ muscles</li><li>➤ moving the joint</li></ul>\n<p><strong>References:</strong></p><ul><li>↳ Reference:</li><li>↳ Gray’s Anatomy, 42 nd Edition, International Edition, Page no-104</li><li>↳ BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 109</li><li>↳ BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 109</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 12 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Extradural Haemorrhage", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture3_EEFUhFO.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture5.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Subarachnoid Hemorrhage occurs between the arachnoid mater and the pia mater , usually due to the rupture of cerebral aneurysms. The blood spreads over the surface of the brain , often leading to a sudden and severe headache .</li><li>• Option A.</li><li>• arachnoid mater</li><li>• pia mater</li><li>• rupture</li><li>• blood spreads</li><li>• surface of the brain</li><li>• leading</li><li>• sudden</li><li>• severe headache</li><li>• Option C. Subdural Hemorrhage occurs beneath the dura mater , above the arachnoid layer of the meninges, usually due to tearing of the bridging veins . It is more associated with venous bleeding and chronic in nature, especially in the elderly and in alcoholics .</li><li>• Option C.</li><li>• beneath</li><li>• dura mater</li><li>• tearing</li><li>• bridging veins</li><li>• venous bleeding</li><li>• chronic</li><li>• elderly</li><li>• alcoholics</li><li>• Option D. Intraparenchymal Hemorrhage refers to hemorrhage directly into the brain tissue and can result from various causes, including hypertension , cerebral amyloid angiopathy , and trauma .</li><li>• Option D.</li><li>• brain tissue</li><li>• hypertension</li><li>• cerebral amyloid angiopathy</li><li>• trauma</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Extradural Hemorrhage (Epidural Hemorrhage) :</li><li>➤ Extradural Hemorrhage (Epidural Hemorrhage)</li><li>➤ This hemorrhage occurs between the dura mater and the skull . It's often caused by trauma leading to a tear in an artery, most commonly the middle meningeal artery . This type of hemorrhage is characterized by a biconvex shape on imaging and can cause a lucid interval followed by rapid deterioration .</li><li>➤ This hemorrhage occurs between the dura mater and the skull . It's often caused by trauma leading to a tear in an artery, most commonly the middle meningeal artery .</li><li>➤ dura mater</li><li>➤ skull</li><li>➤ tear</li><li>➤ middle meningeal artery</li><li>➤ This type of hemorrhage is characterized by a biconvex shape on imaging and can cause a lucid interval followed by rapid deterioration .</li><li>➤ biconvex shape</li><li>➤ imaging</li><li>➤ lucid interval followed</li><li>➤ rapid deterioration</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 183, 188</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 183, 188</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following structures with the appropriate cross-section level of brainstem?", "options": [{"label": "A", "text": "A-1, B-4, C-5, D-6, E-3, F- 2", "correct": true}, {"label": "B", "text": "A-2, B-5, C-6 ,D-3, E-2, F-4", "correct": false}, {"label": "C", "text": "A-1, B-4, C-5, D-6, E-2, F-3", "correct": false}, {"label": "D", "text": "A-2, B-6, C-5, D-3, E-2, F-4", "correct": false}], "correct_answer": "A. A-1, B-4, C-5, D-6, E-3, F- 2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture1_0elBoIJ.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus: Responsible for controlling the muscles of the tongue , is located in the medulla .</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus: Responsible for controlling the muscles of the tongue , is located in the medulla .</li><li>• Medulla at the level of sensory decussation - Hypoglossal nucleus:</li><li>• controlling</li><li>• muscles of the tongue</li><li>• medulla</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle: The decussation of the superior cerebellar peduncle occurs at the level of the inferior colliculus in the midbrain .</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle: The decussation of the superior cerebellar peduncle occurs at the level of the inferior colliculus in the midbrain .</li><li>• Midbrain at level of inferior colliculus - Decussation of superior cerebellar peduncle:</li><li>• midbrain</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve: Which controls the muscles of mastication, is indeed located in the pons, specifically in its tegmentum .</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve: Which controls the muscles of mastication, is indeed located in the pons, specifically in its tegmentum .</li><li>• Tegmentum of upper pons - Motor nucleus of trigeminal nerve:</li><li>• tegmentum</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus: These nuclei are most dorsal and caudal in medulla at the level of pyramidal decussation . The dorsal column-medial lemniscus pathway synapse into second order neurons from their perspective dorsal root ganglia neurons at these nuclei.</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus: These nuclei are most dorsal and caudal in medulla at the level of pyramidal decussation . The dorsal column-medial lemniscus pathway synapse into second order neurons from their perspective dorsal root ganglia neurons at these nuclei.</li><li>• Medulla at level of motor decussation - Cuneate and Gracilias nucleus:</li><li>• most dorsal</li><li>• caudal</li><li>• medulla</li><li>• pyramidal decussation</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus: It is associated with the oculomotor nerve and controls the pupillary reflex and lens shape , is located in the midbrain, near the level of the superior colliculus.</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus: It is associated with the oculomotor nerve and controls the pupillary reflex and lens shape , is located in the midbrain, near the level of the superior colliculus.</li><li>• Midbrain at level of superior colliculus - Edinger westphal nucleus:</li><li>• oculomotor nerve</li><li>• pupillary reflex</li><li>• lens shape</li><li>• Tegmentum of lower pons - Facial colliculus: The facial colliculus, which is not actually a nucleus but a surface feature on the floor of the fourth ventricle created by the facial nerve fibers wrapping around the abducens nucleus , is located in the pons.</li><li>• Tegmentum of lower pons - Facial colliculus: The facial colliculus, which is not actually a nucleus but a surface feature on the floor of the fourth ventricle created by the facial nerve fibers wrapping around the abducens nucleus , is located in the pons.</li><li>• Tegmentum of lower pons - Facial colliculus:</li><li>• fourth ventricle</li><li>• facial nerve fibers</li><li>• abducens nucleus</li><li>• pons.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Each brainstem division is associated with specific nuclei or structures:</li><li>➤ The hypoglossal nucleus in the medulla controls tongue muscles ;</li><li>➤ The hypoglossal nucleus in the medulla controls tongue muscles ;</li><li>➤ medulla</li><li>➤ tongue muscles</li><li>➤ The decussation of the superior cerebellar peduncle occurs in the midbrain at the level of the inferior colliculus ;</li><li>➤ The decussation of the superior cerebellar peduncle occurs in the midbrain at the level of the inferior colliculus ;</li><li>➤ midbrain</li><li>➤ inferior colliculus</li><li>➤ The motor nucleus of the trigeminal nerve, controlling mastication muscles , is in the tegmentum of the upper pons ;</li><li>➤ The motor nucleus of the trigeminal nerve, controlling mastication muscles , is in the tegmentum of the upper pons ;</li><li>➤ mastication muscles</li><li>➤ tegmentum</li><li>➤ upper pons</li><li>➤ The cuneate and gracile nuclei, involved in the dorsal column-medial lemniscus pathway , are in the medulla at the level of motor decussation;</li><li>➤ The cuneate and gracile nuclei, involved in the dorsal column-medial lemniscus pathway , are in the medulla at the level of motor decussation;</li><li>➤ dorsal column-medial lemniscus pathway</li><li>➤ medulla</li><li>➤ The Edinger-Westphal nucleus, linked to the oculomotor nerve for pupillary reflex and lens shape , is near the superior colliculus in the midbrain;</li><li>➤ The Edinger-Westphal nucleus, linked to the oculomotor nerve for pupillary reflex and lens shape , is near the superior colliculus in the midbrain;</li><li>➤ oculomotor nerve</li><li>➤ pupillary reflex</li><li>➤ lens shape</li><li>➤ superior colliculus</li><li>➤ The facial colliculus, a structure created by facial nerve fibers around the abducens nucleus , is in the tegmentum of the lower pons.</li><li>➤ The facial colliculus, a structure created by facial nerve fibers around the abducens nucleus , is in the tegmentum of the lower pons.</li><li>➤ facial nerve fibers</li><li>➤ abducens nucleus</li><li>➤ tegmentum</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 74-86</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 74-86</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match each lesion with the corresponding condition it leads to:", "options": [{"label": "A", "text": "A-2, B-1, C-5, D-3, E-4", "correct": true}, {"label": "B", "text": "A-1, B-2, C-4, D-3, E-5", "correct": false}, {"label": "C", "text": "A-1, B-2, C-5, D-3, E-5", "correct": false}, {"label": "D", "text": "A-2, B-1, C-3, D-5, E-4", "correct": false}], "correct_answer": "A. A-2, B-1, C-5, D-3, E-4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture6.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture3_y0Licfu.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Pituitary tumour – Bitemporal hemianopia</li><li>• Pituitary tumour –</li><li>• Bilateral lateral constriction of optic chiasma - Binasal hemianopia</li><li>• Bilateral lateral constriction of optic chiasma -</li><li>• Tumor of right LGB - Left homonymous hemianopia</li><li>• Tumor of right LGB -</li><li>• Transection of left optic nerve – Left eye total blindness</li><li>• Transection of left optic nerve –</li><li>• Transection of right Meyer’s loop- Left upper homonymous quadrantanopia</li><li>• Binasal Hemianopia - 2. Bilateral lateral constriction of optic chiasma :</li><li>• Binasal Hemianopia - 2. Bilateral lateral constriction of optic chiasma :</li><li>• Binasal Hemianopia - 2. Bilateral lateral constriction of optic chiasma</li><li>• Binasal hemianopia refers to the loss of vision in the nasal fields of both eyes . This condition is typically caused by the compression of the lateral parts of the optic chiasma.</li><li>• Binasal hemianopia refers to the loss of vision in the nasal fields of both eyes . This condition is typically caused by the compression of the lateral parts of the optic chiasma.</li><li>• loss of vision</li><li>• nasal fields</li><li>• both eyes</li><li>• compression</li><li>• lateral parts</li><li>• optic chiasma.</li><li>• Bitemporal Hemianopia - 1. Pituitary Tumor :</li><li>• Bitemporal Hemianopia - 1. Pituitary Tumor :</li><li>• Bitemporal Hemianopia - 1. Pituitary Tumor</li><li>• Bitemporal hemianopia, the loss of the temporal halves of the field of vision in both eyes , is commonly caused by a pituitary tumor. This tumor compresses the optic chiasm from below , affecting the crossing fibers from each optic nerve responsible for peripheral vision .</li><li>• Bitemporal hemianopia, the loss of the temporal halves of the field of vision in both eyes , is commonly caused by a pituitary tumor.</li><li>• loss</li><li>• temporal halves</li><li>• field of vision</li><li>• both eyes</li><li>• This tumor compresses the optic chiasm from below , affecting the crossing fibers from each optic nerve responsible for peripheral vision .</li><li>• compresses</li><li>• optic chiasm</li><li>• below</li><li>• crossing fibers</li><li>• responsible</li><li>• peripheral vision</li><li>• Left Upper Homonymous Quadrantanopia - 5. Transection of Right Meyer's loop :</li><li>• Left Upper Homonymous Quadrantanopia - 5. Transection of Right Meyer's loop :</li><li>• Left Upper Homonymous Quadrantanopia - 5. Transection of Right Meyer's loop</li><li>• This condition, where there is a loss of vision in the upper quadrant of both left visual fields . A lesion in the right Meyer's loop , part of the optic radiation , can lead to this condition, as it carries visual information from the contralateral visual field .</li><li>• This condition, where there is a loss of vision in the upper quadrant of both left visual fields .</li><li>• loss of</li><li>• vision</li><li>• upper quadrant</li><li>• both left visual fields</li><li>• A lesion in the right Meyer's loop , part of the optic radiation , can lead to this condition, as it carries visual information from the contralateral visual field .</li><li>• right Meyer's loop</li><li>• optic radiation</li><li>• carries visual information</li><li>• contralateral visual field</li><li>• Left Homonymous Hemianopia - 3. Tumor of Right LGB (Lateral Geniculate Body) :</li><li>• Left Homonymous Hemianopia - 3. Tumor of Right LGB (Lateral Geniculate Body) :</li><li>• Left Homonymous Hemianopia - 3. Tumor of Right LGB (Lateral Geniculate Body)</li><li>• Left homonymous hemianopia is the loss of vision in the left halves of both visual fields . It can result from a lesion in the right lateral geniculate body . The LGB is a relay center in the thalamus for the visual pathway , and damage here can cause contralateral visual field loss .</li><li>• Left homonymous hemianopia is the loss of vision in the left halves of both visual fields .</li><li>• loss of vision</li><li>• left halves</li><li>• both visual fields</li><li>• It can result from a lesion in the right lateral geniculate body .</li><li>• right lateral geniculate body</li><li>• The LGB is a relay center in the thalamus for the visual pathway , and damage here can cause contralateral visual field loss .</li><li>• relay center</li><li>• thalamus</li><li>• visual pathway</li><li>• damage</li><li>• contralateral visual field loss</li><li>• Left Eye Total Blindness - 4. Transection of Left Optic Nerve :</li><li>• Left Eye Total Blindness - 4. Transection of Left Optic Nerve :</li><li>• Left Eye Total Blindness - 4. Transection of Left Optic Nerve</li><li>• Total blindness in the left eye is a direct consequence of transection or severe damage to the left optic nerve , which carries visual information from the left eye to the brain .</li><li>• Total blindness in the left eye is a direct consequence of transection or severe damage to the left optic nerve , which carries visual information from the left eye to the brain .</li><li>• direct consequence</li><li>• transection</li><li>• severe damage</li><li>• left optic nerve</li><li>• carries visual information</li><li>• left eye</li><li>• brain</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Each visual field defect aligns with a specific lesion: Binasal hemianopia with bilateral lateral constriction of the optic chiasma, bitemporal hemianopia with pituitary tumor, left upper homonymous quadrantanopia with transection of the right Meyer's loop, left homonymous hemianopia with a tumor of the right lateral geniculate body, and left eye total blindness with transection of the left optic nerve.</li><li>➤ Each visual field defect aligns with a specific lesion: Binasal hemianopia with bilateral lateral constriction of the optic chiasma, bitemporal hemianopia with pituitary tumor, left upper homonymous quadrantanopia with transection of the right Meyer's loop, left homonymous hemianopia with a tumor of the right lateral geniculate body, and left eye total blindness with transection of the left optic nerve.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 216</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 216</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Intracranial cerebrospinal fluid (CSF) circulates through various spaces and pathways. Which of the following accurately describes the pathway of CSF circulation within the central nervous system?", "options": [{"label": "A", "text": "CSF is produced in the lateral ventricles and flows through the third ventricle into the fourth ventricle.", "correct": true}, {"label": "B", "text": "CSF is produced in the fourth ventricle and flows through the lateral ventricles into the third ventricle.", "correct": false}, {"label": "C", "text": "CSF is produced in the third ventricle and flows through the lateral ventricles into the fourth ventricle.", "correct": false}, {"label": "D", "text": "CSF is produced in the fourth ventricle and flows directly into the subarachnoid space surrounding the brain and spinal cord.", "correct": false}], "correct_answer": "A. CSF is produced in the lateral ventricles and flows through the third ventricle into the fourth ventricle.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/whatsapp-image-2023-12-29-at-165444.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture43.jpg"], "explanation": "<p><strong>Ans. A) CSF is produced in the lateral ventricles and flows through the third ventricle into the fourth ventricle.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Understanding the circulation of cerebrospinal fluid (CSF) is essential in clinical anatomy.</li><li>• Option B) CSF is produced in the fourth ventricle and flows through the lateral ventricles into the third ventricle.</li><li>• Option B)</li><li>• This statement is not accurate . The primary production of CSF occurs in the lateral ventricles, and the flow is in direction described above.</li><li>• This statement is not accurate . The primary production of CSF occurs in the lateral ventricles, and the flow is in direction described above.</li><li>• not accurate</li><li>• Option C) CSF is produced in the third ventricle and flows through the lateral ventricles into the fourth ventricle.</li><li>• Option C)</li><li>• This is also not following the correct order of CSF flow.</li><li>• This is also not following the correct order of CSF flow.</li><li>• not following the correct order</li><li>• Option D) CSF is produced in the fourth ventricle and flows directly into the subarachnoid space surrounding the brain and spinal cord.</li><li>• Option D)</li><li>• This statement is not accurate . CSF does pass into the subarachnoid space, but it undergoes further circulation within the ventricular system before reaching this space.</li><li>• This statement is not accurate . CSF does pass into the subarachnoid space, but it undergoes further circulation within the ventricular system before reaching this space.</li><li>• not accurate</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The primary pathway of CSF circulation within the central nervous system involves its production in the choroid plexus of the lateral ventricles, followed by flow through the lateral ventricles, entry into the third ventricle, and continuation into the fourth ventricle.</li><li>➤ Ref : Gray’s Anatomy, 42 nd Edition, International Edition, Page no- 412</li><li>➤ Ref : Gray’s Anatomy, 42 nd Edition, International Edition, Page no- 412</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which sinus drains the superior surface of cerebellum?", "options": [{"label": "A", "text": "Inferior Petrosal Sinus", "correct": false}, {"label": "B", "text": "Inferior Sagittal Sinus", "correct": false}, {"label": "C", "text": "Straight Sinus", "correct": true}, {"label": "D", "text": "Sigmoid Sinus", "correct": false}], "correct_answer": "C. Straight Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture4_rENpJfy.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Inferior Petrosal Sinus runs in the petrosal part of the temporal bone . It drains blood from the cavernous sinus into the internal jugular vein .</li><li>• Option A.</li><li>• petrosal part</li><li>• temporal bone</li><li>• cavernous sinus</li><li>• internal jugular vein</li><li>• Option B. Inferior Sagittal Sinus sinus runs along the inferior edge of the falx cerebri , a fold of dura mater separating the two cerebral hemispheres . It mainly drains blood from the medial aspects of the cerebral hemispheres .</li><li>• Option B.</li><li>• inferior edge</li><li>• falx cerebri</li><li>• fold</li><li>• dura mater</li><li>• two cerebral hemispheres</li><li>• drains blood</li><li>• medial aspects</li><li>• cerebral hemispheres</li><li>• Option D. Sigmoid Sinus is a continuation of the transverse sinus and drains into the internal jugular vein . It follows a curved course within the posterior cranial fossa .</li><li>• Option D.</li><li>• continuation</li><li>• transverse sinus</li><li>• drains into</li><li>• internal jugular vein</li><li>• curved course</li><li>• posterior cranial fossa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Straight sinus drains the superior surface of the cerebellum, being situated at the junction of the falx cerebri and the tentorium cerebelli and receiving blood from deep midline structures of the brain , including the cerebellum.</li><li>➤ receiving blood</li><li>➤ deep midline structures of the brain</li><li>➤ cerebellum.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 189</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 189</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following provide the blood supply to the deep nuclei of the cerebellum?", "options": [{"label": "A", "text": "Superior Cerebellar Artery", "correct": true}, {"label": "B", "text": "Posteroinferior Cerebellar Artery", "correct": false}, {"label": "C", "text": "Anteroinferior Cerebellar Artery", "correct": false}, {"label": "D", "text": "Posterior Cerebral Artery", "correct": false}], "correct_answer": "A. Superior Cerebellar Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture5_6vSgiKG.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Posteroinferior Cerebellar Artery is the main artery that supplies the lower part of the cerebellum, including the inferior cerebellar vermis and the tonsils of the cerebellum. It is more involved in supplying the inferior and posterior parts of the cerebellum rather than the deep nuclei.</li><li>• Option B.</li><li>• supplies</li><li>• lower part</li><li>• inferior cerebellar vermis</li><li>• tonsils</li><li>• supplying</li><li>• inferior</li><li>• posterior parts</li><li>• cerebellum</li><li>• Option C. Anteroinferior Cerebellar Artery supplies the anterior part of the cerebellum , particularly the flocculus and parts of the pons . It plays a role in the blood supply to the deep cerebellar nuclei . However, its contribution is not as significant as that of the SCA.</li><li>• Option C.</li><li>• anterior part</li><li>• cerebellum</li><li>• flocculus</li><li>• parts</li><li>• pons</li><li>• role</li><li>• blood supply</li><li>• deep cerebellar nuclei</li><li>• Option D. Posterior Cerebral Artery is primarily responsible for supplying blood to the occipital lobes of the brain and the inferior and medial parts of the temporal lobes . It does not have a direct role in supplying the deep nuclei of the cerebellum. Its focus is more on the cerebral cortex and subcortical structures of the cerebrum .</li><li>• Option D.</li><li>• supplying blood</li><li>• occipital lobes</li><li>• brain</li><li>• inferior</li><li>• medial parts</li><li>• temporal lobes</li><li>• cerebral cortex</li><li>• subcortical structures</li><li>• cerebrum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superior Cerebellar Artery is the most directly involved in supplying blood to the deep nuclei of the cerebellum . The Superior Cerebellar Artery primarily supplies the upper part of the cerebellum, including the cerebellar hemispheres and the superior vermis . The deep nuclei receive blood from branches of both the SCA and the Anterior Inferior Cerebellar Artery .</li><li>➤ most directly</li><li>➤ supplying blood</li><li>➤ deep nuclei</li><li>➤ cerebellum</li><li>➤ upper part</li><li>➤ cerebellar hemispheres</li><li>➤ superior vermis</li><li>➤ deep nuclei</li><li>➤ blood</li><li>➤ branches</li><li>➤ both</li><li>➤ SCA</li><li>➤ Anterior Inferior Cerebellar Artery</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 174</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 174</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following condition is characterized by a loss of vibration sensation on the right side and a loss of pain and temperature sensation on the left side?", "options": [{"label": "A", "text": "Posterior Spinocerebellar Tract Transection", "correct": false}, {"label": "B", "text": "Hemisection of Spinal Cord", "correct": true}, {"label": "C", "text": "Anterior Horn Destruction", "correct": false}, {"label": "D", "text": "Lateral Corticospinal Tract Transection", "correct": false}], "correct_answer": "B. Hemisection of Spinal Cord", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture6_aCcZqkv.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture7.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The posterior spinocerebellar tract carries proprioceptive information from the lower body and legs to the cerebellum . Transecting this tract would lead to a loss of proprioceptive sensation from the same side of the body. However, it would not affect pain, temperature, or vibration sensations.</li><li>• Option A.</li><li>• proprioceptive information</li><li>• lower body</li><li>• legs</li><li>• cerebellum</li><li>• loss of proprioceptive sensation</li><li>• same side</li><li>• Option C. The anterior horn of the spinal cord contains motor neurons that control voluntary muscle movements . Damage to the anterior horn cells leads to muscle weakness or paralysis , muscle atrophy , and fasciculations on the same side of the body. It does not directly affect sensation.</li><li>• Option C.</li><li>• motor neurons</li><li>• control voluntary muscle movements</li><li>• muscle weakness</li><li>• paralysis</li><li>• muscle atrophy</li><li>• fasciculations</li><li>• same side</li><li>• Option D. The lateral corticospinal tract is primarily responsible for voluntary motor control , especially of the limbs . Transecting this tract would lead to paralysis or paresis (weakness) below the level of the lesion, predominantly affecting the same side of the body. Sensory functions would remain intact .</li><li>• Option D.</li><li>• responsible</li><li>• voluntary motor control</li><li>• limbs</li><li>• lead to paralysis</li><li>• paresis (weakness)</li><li>• level</li><li>• predominantly affecting</li><li>• same side</li><li>• Sensory functions</li><li>• intact</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hemisection of the spinal cord, also known as Brown-Séquard syndrome , involves cutting or damaging one half of the spinal cord . It results in contralateral loss of pain and temperature sensation starting one segment below the level of lesion ( lateral spinothalamic tract ) and ipsilateral loss of tactile discrimination, form, position and vibration sensation below the lesion. In this case it is right sided Brown Sequard syndrome .</li><li>➤ Brown-Séquard syndrome</li><li>➤ cutting</li><li>➤ damaging one half of the spinal cord</li><li>➤ contralateral loss of pain</li><li>➤ temperature sensation</li><li>➤ lateral spinothalamic tract</li><li>➤ ipsilateral loss</li><li>➤ tactile discrimination, form, position</li><li>➤ vibration sensation</li><li>➤ right sided Brown Sequard syndrome</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-68</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-68</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which group of thalamic nuclei receives projections from the globus pallidus?", "options": [{"label": "A", "text": "Centromedian, Ventral Anterior, Ventral Lateral Nuclei", "correct": true}, {"label": "B", "text": "Mediodorsal, VPL and VPM Nuclei", "correct": false}, {"label": "C", "text": "Ventral Anterior, Ventral lateral, Anterior Nuclei", "correct": false}, {"label": "D", "text": "Ventral Lateral, Anterior, Dorsal Medial Nuclei", "correct": false}], "correct_answer": "A. Centromedian, Ventral Anterior, Ventral Lateral Nuclei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture8.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture9.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Mediodorsal, VPL (Ventral Posterolateral), and VPM (Ventral Posteromedial) Nuclei: The mediodorsal nucleus is primarily associated with limbic functions , while the VPL and VPM are primarily involved in sensory processing . These nuclei are not the primary targets of projections from the globus pallidus.</li><li>• Option B. Mediodorsal, VPL (Ventral Posterolateral), and VPM (Ventral Posteromedial) Nuclei:</li><li>• limbic functions</li><li>• sensory processing</li><li>• not the primary targets</li><li>• Option C. Ventral Anterior, Ventral Lateral, Anterior Nuclei: The ventral anterior and ventral lateral nuclei are correct as they receive projections from the globus pallidus . However, the anterior nuclei of the thalamus are mainly involved in limbic functions and do not primarily receive input from the globus pallidus.</li><li>• Option C. Ventral Anterior, Ventral Lateral, Anterior Nuclei:</li><li>• receive projections from the globus pallidus</li><li>• do not primarily receive input</li><li>• Option D. Ventral Lateral, Anterior, Dorsal Medial Nuclei: The ventral lateral nucleus, the anterior and dorsal medial nuclei is involved in motor functions and does receive projections from the globus pallidus. The dorsal medial nucleus is more involved in cognitive and emotional functions.</li><li>• Option D. Ventral Lateral, Anterior, Dorsal Medial Nuclei:</li><li>• involved in motor functions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Centromedian, Ventral Anterior, Ventral Lateral Nuclei : The centromedian nucleus is involved in motor functions and arousal, the ventral anterior (VA) and ventral lateral (VL) nuclei are key recipients of projections from the globus pallidus and are involved in motor control.</li><li>➤ Centromedian, Ventral Anterior, Ventral Lateral Nuclei</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 129-130</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 129-130</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male presents to the emergency department with sudden-onset weakness and loss of sensation on the right side of his body. Neurological examination reveals contralateral hemiparesis and hemisensory loss affecting the face, arm, and leg. Which of the following is the most common cause of stroke involving the Internal Capsule?", "options": [{"label": "A", "text": "Anterior cerebral artery", "correct": false}, {"label": "B", "text": "Direct branches of internal carotid artery", "correct": false}, {"label": "C", "text": "Lateral striate branches of middle cerebral artery", "correct": true}, {"label": "D", "text": "Recurrent artery of Heubner", "correct": false}], "correct_answer": "C. Lateral striate branches of middle cerebral artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture10_H1ZCWSo.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterior Cerebral Artery (ACA) primarily supplies the medial surfaces of the frontal and parietal lobes , including the anterior four-fifths of the corpus callosum . Although important for the blood supply to the frontal lobes and superior medial parietal lobes , the ACA is not typically involved in supplying the internal capsule.</li><li>• Option A.</li><li>• medial surfaces</li><li>• frontal</li><li>• parietal lobes</li><li>• anterior four-fifths</li><li>• corpus callosum</li><li>• blood supply</li><li>• frontal lobes</li><li>• superior medial parietal lobes</li><li>• Option B. The internal carotid artery branches into several major arteries, including the middle cerebral artery and the anterior cerebral artery . While the internal carotid artery is a major supplier of blood to the brain, it does not directly supply the internal capsule.</li><li>• Option B.</li><li>• middle cerebral artery</li><li>• anterior cerebral artery</li><li>• major supplier</li><li>• Option D. Recurrent Artery of Heubner, a branch of the ACA , supplies the head of the caudate nucleus and the anterior limb of the internal capsule . While the recurrent artery of Heubner does supply a part of the internal capsule, its infarcts typically affect the head of the caudate and anterior limb, but it is not the most common source of strokes affecting the internal capsule overall.</li><li>• Option D.</li><li>• ACA</li><li>• head</li><li>• caudate nucleus</li><li>• anterior limb</li><li>• internal capsule</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lateral Striate Branches of Middle Cerebral Artery are small , deep penetrating arteries , also known as lenticulostriate arteries , which branch from the MCA . They supply blood to parts of the basal ganglia and the internal capsule . The lateral striate arteries are the primary suppliers of blood to the internal capsule . Due to their small size and critical location , these arteries are particularly susceptible to hypertension-induced damage , leading to lacunar strokes , which often occur in the internal capsule.</li><li>➤ small</li><li>➤ deep penetrating arteries</li><li>➤ lenticulostriate arteries</li><li>➤ MCA</li><li>➤ supply blood</li><li>➤ basal ganglia</li><li>➤ internal capsule</li><li>➤ primary suppliers</li><li>➤ blood</li><li>➤ internal capsule</li><li>➤ small size</li><li>➤ critical location</li><li>➤ susceptible</li><li>➤ hypertension-induced damage</li><li>➤ lacunar strokes</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 167-168</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 167-168</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure, when bilaterally ablated, leads to an inability to form long-term memories?", "options": [{"label": "A", "text": "Amygdala", "correct": false}, {"label": "B", "text": "Hippocampus", "correct": true}, {"label": "C", "text": "Cingulate gyrus", "correct": false}, {"label": "D", "text": "Dorsomedial Nucleus of Thalamus", "correct": false}], "correct_answer": "B. Hippocampus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Amygdala is primarily associated with processing emotions , especially fear and pleasure . It plays a role in memory consolidation, particularly in how emotions affect the memory of an event. While bilateral ablation of the amygdala can impact emotional memory and emotional processing , it does not typically result in an inability to form long-term memories in a general sense.</li><li>• Option A.</li><li>• processing emotions</li><li>• fear</li><li>• pleasure</li><li>• bilateral ablation</li><li>• impact emotional memory</li><li>• emotional processing</li><li>• Option C. Part of the limbic system, the cingulate gyrus is involved in emotion formation and processing , learning , and memory . It also plays a role in regulating autonomic motor function . Ablation of the cingulate gyrus may affect emotional processing and decision-making but is not known to directly cause an inability to form long-term memories.</li><li>• Option C.</li><li>• cingulate gyrus</li><li>• emotion formation</li><li>• processing</li><li>• learning</li><li>• memory</li><li>• regulating autonomic motor function</li><li>• Ablation</li><li>• affect emotional processing</li><li>• decision-making</li><li>• Option D. Dorsomedial Nucleus of Thalamus is involved in memory and emotion through its connections with the limbic system . It plays a role in the connectivity between different parts of the brain. Damage to this area can lead to memory deficits and changes in emotional behavior , but it is not as directly linked to the formation of long-term memories as the hippocampus.</li><li>• Option D.</li><li>• connections with the limbic system</li><li>• role</li><li>• connectivity between different parts</li><li>• lead to memory deficits</li><li>• changes in emotional behavior</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The hippocampus is critical for the consolidation of information from short-term to long-term memory and spatial navigation . It's involved in forming , organizing , and storing memories . Bilateral ablation of the hippocampus can lead to severe memory impairment , as famously observed in the case of patient H.M., who lost the ability to form new long-term memories after his hippocampi were surgically removed . This condition is known as anterograde amnesia .</li><li>➤ short-term</li><li>➤ long-term memory</li><li>➤ spatial navigation</li><li>➤ forming</li><li>➤ organizing</li><li>➤ storing memories</li><li>➤ lead</li><li>➤ severe memory impairment</li><li>➤ lost</li><li>➤ ability</li><li>➤ form new long-term memories</li><li>➤ hippocampi were surgically removed</li><li>➤ anterograde amnesia</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 228-232</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 228-232</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male presents with unsteady gait and slurred speech. On neurological examination, he demonstrates dysmetria, intention tremor, and dysarthria. Imaging reveals cerebellar atrophy. Dysfunction of which of the following nuclei receiving inhibitory input from Purkinje cells in the cerebellum is most likely contributing to his symptoms among given options?", "options": [{"label": "A", "text": "Arcuate Nucleus", "correct": false}, {"label": "B", "text": "Fastigial Nucleus", "correct": true}, {"label": "C", "text": "Superior Olivary Nucleus", "correct": false}, {"label": "D", "text": "Ventral Lateral Thalamic Nucleus", "correct": false}], "correct_answer": "B. Fastigial Nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Arcuate Nucleus is a collection of neurons in the hypothalamus, involved in releasing hormones that regulate pituitary function . There is no direct connection between Purkinje cells of the cerebellum and the arcuate nucleus. The primary function of the arcuate nucleus is in the endocrine system , not in the motor control or coordination associated with cerebellar functions.</li><li>• Option A.</li><li>• collection of neurons</li><li>• releasing hormones</li><li>• regulate pituitary function</li><li>• arcuate nucleus</li><li>• endocrine system</li><li>• Option C. Superior Olivary Nucleus is involved in auditory processing , particularly in localizing sound in the brainstem . Purkinje cells do not project directly to the superior olivary nucleus. The cerebellum and the superior olivary complex serve different functions ; the former in motor control and the latter in auditory processing .</li><li>• Option C.</li><li>• auditory processing</li><li>• localizing sound</li><li>• brainstem</li><li>• cerebellum</li><li>• superior olivary complex</li><li>• different functions</li><li>• former</li><li>• motor control</li><li>• latter</li><li>• auditory processing</li><li>• Option D. Ventral Lateral Thalamic Nucleus is a part of the thalamus involved in motor functions . While the cerebellum does communicate with the thalamus, particularly in the context of motor coordination , Purkinje cells specifically do not project directly to the ventral lateral thalamic nucleus. Instead, the output from cerebellar nuclei (including the fastigial nucleus ) reaches the thalamus .</li><li>• Option D.</li><li>• motor functions</li><li>• context of motor coordination</li><li>• output from cerebellar nuclei</li><li>• fastigial nucleus</li><li>• thalamus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The fastigial nucleus is one of the deep cerebellar nuclei . Purkinje cells project inhibitory signals to the fastigial nucleus. This projection is a key part of the cerebellar circuitry that influences motor control and balance . The output from the fastigial nucleus is crucial for postural adjustments and control of muscle tone , as part of the integrated motor control system .</li><li>➤ deep cerebellar nuclei</li><li>➤ inhibitory signals</li><li>➤ cerebellar circuitry</li><li>➤ influences</li><li>➤ motor control</li><li>➤ balance</li><li>➤ postural adjustments</li><li>➤ control</li><li>➤ muscle tone</li><li>➤ integrated motor control system</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 115</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 115</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following arteries on occlusion can result in motor aphasia?", "options": [{"label": "A", "text": "Angular Artery", "correct": false}, {"label": "B", "text": "Anterior Choroidal Artery", "correct": false}, {"label": "C", "text": "Pericallosal Artery", "correct": false}, {"label": "D", "text": "Operculo Frontal Artery", "correct": true}], "correct_answer": "D. Operculo Frontal Artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The angular artery is a branch of the middle cerebral artery . It supplies blood to the angular gyrus located in the parietal lobe . Occlusion of the angular artery can lead to a variety of symptoms, most commonly associated with Gerstmann syndrome (including acalculia , finger agnosia , left-right disorientation , and agraphia ) and visual field defects . It is typically not associated with motor aphasia.</li><li>• Option A.</li><li>• middle cerebral artery</li><li>• angular gyrus</li><li>• parietal lobe</li><li>• Gerstmann syndrome</li><li>• acalculia</li><li>• finger agnosia</li><li>• left-right disorientation</li><li>• agraphia</li><li>• visual field defects</li><li>• Option B. Anterior Choroidal Artery supplies blood to deep structures within the brain , including parts of the thalamus and internal capsule . Occlusion can result in a range of neurological deficits, primarily affecting sensory and motor functions due to its supply to the internal capsule . However, it is not commonly associated with motor aphasia, which is more related to cortical structures.</li><li>• Option B.</li><li>• blood</li><li>• deep structures</li><li>• brain</li><li>• thalamus</li><li>• internal capsule</li><li>• affecting sensory</li><li>• motor functions</li><li>• internal capsule</li><li>• Option C. The pericallosal artery is a part of the anterior cerebral artery system , running over the corpus callosum . Occlusion can lead to a variety of symptoms, including leg weakness and sensory loss due to its supply to the medial surfaces of the frontal and parietal lobes . It is not typically associated with motor aphasia.</li><li>• Option C.</li><li>• anterior cerebral artery system</li><li>• corpus callosum</li><li>• leg weakness</li><li>• sensory loss</li><li>• medial surfaces</li><li>• frontal</li><li>• parietal lobes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Operculo Frontal Artery , also known as the precentral branch of the middle cerebral artery , supplies the opercular part of the frontal lobe . The operculo frontal artery supplies blood to parts of the frontal lobe , including areas around Broca's area , which is critically involved in speech production . Occlusion of this artery can lead to motor aphasia as it can directly affect Broca's area or its surrounding regions , impairing the patient's ability to produce speech while generally sparing language comprehension.</li><li>➤ Operculo Frontal Artery</li><li>➤ precentral branch</li><li>➤ middle cerebral artery</li><li>➤ opercular part</li><li>➤ frontal lobe</li><li>➤ supplies blood</li><li>➤ frontal lobe</li><li>➤ Broca's area</li><li>➤ critically</li><li>➤ speech production</li><li>➤ motor aphasia</li><li>➤ directly affect Broca's area</li><li>➤ surrounding regions</li><li>➤ patient's ability</li><li>➤ produce speech</li><li>➤ generally sparing language</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 178</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 178</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 178</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which Sinus receives drainage from the greatest number of Arachnoid Granulations?", "options": [{"label": "A", "text": "Cavernous Sinus", "correct": false}, {"label": "B", "text": "Sigmoid Sinus", "correct": false}, {"label": "C", "text": "Straight Sinus", "correct": false}, {"label": "D", "text": "Superior Sagittal Sinus", "correct": true}], "correct_answer": "D. Superior Sagittal Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture11_dWVkfYd.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Cavernous Sinus is a large venous sinus located on each side of the sella turcica , housing several cranial nerves . The cavernous sinus does not receive drainage from a significant number of arachnoid granulations. It primarily serves as a venous drainage route for the brain and receives blood from various facial and cerebral veins .</li><li>• Option A.</li><li>• each side</li><li>• sella turcica</li><li>• several cranial nerves</li><li>• venous drainage route</li><li>• brain</li><li>• receives blood</li><li>• facial</li><li>• cerebral veins</li><li>• Option B. Sigmoid Sinus is a continuation of the transverse sinus and leads to the internal jugular vein . The sigmoid sinus does not receive drainage from arachnoid granulations. Its main function is venous drainage .</li><li>• Option B.</li><li>• continuation</li><li>• transverse sinus</li><li>• leads</li><li>• internal jugular vein</li><li>• venous drainage</li><li>• Option C. Straight Sinus is located at the junction of the falx cerebri and tentorium cerebelli . While it is near some arachnoid granulations, the straight sinus is not a primary site for the drainage of arachnoid granulations.</li><li>• Option C.</li><li>• falx cerebri</li><li>• tentorium cerebelli</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superior Sagittal Sinus: The superior sagittal sinus receives drainage from the greatest number of arachnoid granulations . The superior sagittal sinus receives drainage from a significant number of arachnoid granulations . These granulations serve as one of the primary routes for the cerebrospinal fluid (CSF) to return to the venous system . Arachnoid granulations are protrusions of the arachnoid mater into the venous sinuses , and the superior sagittal sinus is a major site for their drainage . Understanding the drainage pathways of CSF, including the role of arachnoid granulations , is important in the context of cerebrospinal fluid dynamics and can have clinical significance in conditions related to CSF flow , such as hydrocephalus and intracranial hypertension .</li><li>➤ Superior Sagittal Sinus:</li><li>➤ drainage</li><li>➤ greatest number</li><li>➤ arachnoid granulations</li><li>➤ arachnoid granulations</li><li>➤ primary routes</li><li>➤ cerebrospinal fluid (CSF)</li><li>➤ return</li><li>➤ venous system</li><li>➤ protrusions</li><li>➤ arachnoid mater</li><li>➤ venous sinuses</li><li>➤ major site</li><li>➤ drainage</li><li>➤ drainage pathways</li><li>➤ role of arachnoid granulations</li><li>➤ context</li><li>➤ cerebrospinal fluid dynamics</li><li>➤ clinical significance</li><li>➤ CSF flow</li><li>➤ hydrocephalus</li><li>➤ intracranial hypertension</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 189-192</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 189-192</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male presents with a visual field defect, particularly bitemporal hemianopia. Further evaluation suggests a lesion involving the optic chiasm. Which of the following arteries primarily supplies blood to the optic chiasm?", "options": [{"label": "A", "text": "Middle cerebral artery", "correct": false}, {"label": "B", "text": "Posterior cerebral artery", "correct": false}, {"label": "C", "text": "Posterior communicating artery", "correct": false}, {"label": "D", "text": "Anterior cerebral artery", "correct": true}], "correct_answer": "D. Anterior cerebral artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Middle Cerebral Artery is one of the major arteries supplying blood to the brain and is located in the lateral sulcus of the brain . The middle cerebral artery is not directly related to the blood supply of the optic chiasm. It primarily serves other regions of the brain, particularly the lateral convexity of the cerebral hemisphere .</li><li>• Option A.</li><li>• lateral sulcus</li><li>• brain</li><li>• lateral convexity of the cerebral hemisphere</li><li>• Option B. Posterior Cerebral Artery is one of the branches of the basilar artery , supplying the posterior part of the brain. The posterior cerebral artery does not directly supply the optic chiasma. Its distribution is primarily in the posterior brain regions , including the occipital lobes .</li><li>• Option B.</li><li>• basilar artery</li><li>• posterior part</li><li>• posterior brain regions</li><li>• including the occipital lobes</li><li>• Option C. The posterior communicating artery is part of the circle of Willis and connects the posterior cerebral artery to the internal carotid artery . While the posterior communicating artery is in the vicinity of the optic chiasm , it is not the primary blood supply to the optic chiasm itself.</li><li>• Option C.</li><li>• circle of Willis</li><li>• posterior cerebral artery</li><li>• internal carotid artery</li><li>• vicinity</li><li>• optic chiasm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Cerebral Artery: It is one of the major arteries supplying blood to the brain and is located in the medial cerebral hemisphere . The anterior cerebral artery contributes to the blood supply of the optic chiasm . It sends branches that supply the anterior part of the chiasm , helping to ensure adequate blood flow to this important structure.</li><li>➤ Anterior Cerebral Artery:</li><li>➤ medial cerebral hemisphere</li><li>➤ optic chiasm</li><li>➤ anterior part of the chiasm</li><li>➤ adequate blood flow</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 175-178</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 175-178</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nucleus in the cerebellum is responsible for controlling saccadic eye movements?", "options": [{"label": "A", "text": "Dentate Nucleus", "correct": false}, {"label": "B", "text": "Fastigial Nucleus", "correct": true}, {"label": "C", "text": "Emboliform Nucleus", "correct": false}, {"label": "D", "text": "Globose Nucleus", "correct": false}], "correct_answer": "B. Fastigial Nucleus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture12_uBSzUH1.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The dentate nucleus is the largest of the deep cerebellar nuclei and is primarily involved in the planning and initiation of voluntary movements . It plays a role in motor coordination and control but is not the primary nucleus responsible for saccadic eye movements.</li><li>• Option A.</li><li>• largest</li><li>• planning</li><li>• initiation of voluntary movements</li><li>• role</li><li>• motor coordination</li><li>• control</li><li>• Option C. The emboliform nucleus is one of the deep cerebellar nuclei, and it is involved in motor coordination and limb control . It is not the primary nucleus responsible for saccadic eye movements.</li><li>• Option C.</li><li>• motor coordination and limb control</li><li>• Option D. The globose nucleus is another deep cerebellar nucleus that plays a role in motor coordination and limb movements . It is not primarily associated with saccadic eye movements.</li><li>• Option D.</li><li>• motor coordination</li><li>• limb movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fastigial Nucleus: The fastigial nucleus is one of the deep cerebellar nuclei , and it is primarily responsible for controlling saccadic eye movements . It is involved in coordinating rapid , precise eye movements (saccades) to redirect the line of sight and focus on different objects or points of interest .</li><li>➤ Fastigial Nucleus:</li><li>➤ deep cerebellar nuclei</li><li>➤ controlling saccadic eye movements</li><li>➤ coordinating rapid</li><li>➤ precise eye movements</li><li>➤ redirect the line of sight</li><li>➤ focus</li><li>➤ different objects</li><li>➤ points of interest</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 115,119</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 115,119</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with symptoms of obstructive hydrocephalus, including headaches, altered mental status, and visual disturbances. Imaging reveals an enlarged third ventricle. Which boundary of the third ventricle is affected in this patient due to compression by an enlarged pineal gland?", "options": [{"label": "A", "text": "Floor of Third Ventricle", "correct": false}, {"label": "B", "text": "Anterior Wall of Third Ventricle", "correct": false}, {"label": "C", "text": "Posterior Wall of Third Ventricle", "correct": true}, {"label": "D", "text": "Roof of Third Ventricle", "correct": false}], "correct_answer": "C. Posterior Wall of Third Ventricle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture13_izkGM6W.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Floor of Third Ventricle from before backwards formed by</li><li>• Option A:</li><li>• Floor</li><li>• Optic chiasma Tuber cinereum and infundibulum Mammillary bodies Posterior perforated substance Tegmentum of midbrain</li><li>• Optic chiasma</li><li>• Tuber cinereum and infundibulum</li><li>• Mammillary bodies</li><li>• Posterior perforated substance</li><li>• Tegmentum of midbrain</li><li>• Option B : Anterior wall of third ventricle from above downwards by</li><li>• Option B</li><li>• Anterior wall</li><li>• Anterior column of fornix Anterior commissure Lamina terminalis</li><li>• Anterior column of fornix</li><li>• Anterior commissure</li><li>• Lamina terminalis</li><li>• Option D : Roof of third ventricle formed by ependymal that stretches across the upper limits of two thalami . It extends from interventricular foramen to habenular commissure .</li><li>• Option D</li><li>• Roof</li><li>• ependymal</li><li>• upper limits of two thalami</li><li>• extends</li><li>• interventricular foramen</li><li>• habenular commissure</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The third ventricle is one of the four interconnected cavities within the brain responsible for the production and circulation of cerebrospinal fluid . It is a narrow , slit-like cavity situated in the diencephalon, between the two lateral ventricles and the fourth ventricle .</li><li>➤ one</li><li>➤ four interconnected cavities</li><li>➤ production</li><li>➤ circulation of cerebrospinal fluid</li><li>➤ narrow</li><li>➤ slit-like cavity</li><li>➤ two lateral ventricles</li><li>➤ fourth ventricle</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 137</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 137</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with a sudden, severe headache, visual disturbances, and difficulty moving the left eye outward. Imaging reveals an aneurysm near the Circle of Willis. Which cranial nerve is most likely to be compressed between the superior cerebellar artery and posterior cerebral artery due to the aneurysm?", "options": [{"label": "A", "text": "Oculomotor Nerve", "correct": true}, {"label": "B", "text": "Optic Nerve", "correct": false}, {"label": "C", "text": "Abducens Nerve", "correct": false}, {"label": "D", "text": "Trigeminal Nerve", "correct": false}], "correct_answer": "A. Oculomotor Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Optic Nerve is responsible for vision . It transmits visual information from the retina to the brain. The optic nerve does not typically run between the superior cerebellar artery and posterior cerebral artery. It is primarily associated with the visual pathway and does not course through the same region as the oculomotor nerve.</li><li>• Option B.</li><li>• vision</li><li>• visual information</li><li>• retina</li><li>• visual pathway</li><li>• Option C. Abducens Nerve controls the lateral rectus muscle of the eye, which is responsible for moving the eye laterally . The abducens nerve has a different course within the brainstem and is not typically situated between the superior cerebellar artery and posterior cerebral artery.</li><li>• Option C.</li><li>• lateral rectus muscle</li><li>• moving</li><li>• eye laterally</li><li>• different course</li><li>• brainstem</li><li>• Option D. Trigeminal Nerve is responsible for sensory functions in the face, including touch, temperature , and pain , and controls the muscles of mastication . The trigeminal nerve has a different course and location in the brainstem compared to the oculomotor nerve, and it does not typically run between the superior cerebellar artery and posterior cerebral artery.</li><li>• Option D.</li><li>• sensory functions</li><li>• touch, temperature</li><li>• pain</li><li>• controls</li><li>• muscles of mastication</li><li>• different course</li><li>• location</li><li>• brainstem</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Occulomotor Nerve :</li><li>➤ Occulomotor Nerve</li><li>➤ The oculomotor nerve (CN III) is responsible for controlling several eye muscles that move the eye and control the size of the pupil. It also plays a role in raising the eyelid . It is the cranial nerve that runs between the superior cerebellar artery and posterior cerebral artery as it courses through the interpeduncular fossa within the brainstem .</li><li>➤ The oculomotor nerve (CN III) is responsible for controlling several eye muscles that move the eye and control the size of the pupil.</li><li>➤ controlling several eye muscles</li><li>➤ control the size</li><li>➤ It also plays a role in raising the eyelid .</li><li>➤ raising the eyelid</li><li>➤ It is the cranial nerve that runs between the superior cerebellar artery and posterior cerebral artery as it courses through the interpeduncular fossa within the brainstem .</li><li>➤ interpeduncular fossa within the brainstem</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 82-83</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 82-83</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure is compressed by the berry aneurysm of posterior communicating artery?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Oculomotor nerve", "correct": true}, {"label": "C", "text": "Trochlear nerve", "correct": false}, {"label": "D", "text": "Hypophysis cerebri", "correct": false}], "correct_answer": "B. Oculomotor nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture1.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Optic Nerve is responsible for transmitting visual information from the retina to the brain. While the optic nerve is in close proximity to the circle of Willis , where berry aneurysms commonly occur, it is less likely to be compressed by an aneurysm of the posterior communicating artery. More anteriorly located aneurysms, like those of the anterior communicating artery, are more likely to affect the optic nerve.</li><li>• Option A.</li><li>• transmitting visual information</li><li>• retina</li><li>• close proximity</li><li>• circle of Willis</li><li>• Option C. Trochlear Nerve (IV) innervates the superior oblique muscle of the eye, which helps in downward and inward movement of the eyeball. The trochlear nerve is less likely to be directly compressed by a posterior communicating artery aneurysm due to its location. It courses along a path that is typically superior and medial to the posterior communicating artery.</li><li>• Option C.</li><li>• superior oblique muscle</li><li>• downward</li><li>• inward movement</li><li>• typically superior</li><li>• medial</li><li>• posterior communicating artery.</li><li>• Option D . Hypophysis Cerebri located at the base of the brain in the sella turcica , it secretes various hormones that regulate critical body functions . The pituitary gland is not typically compressed by a berry aneurysm of the posterior communicating artery. It's more commonly affected by aneurysms of the internal carotid artery , especially if they occur near the cavernous sinus.</li><li>• Option D</li><li>• base</li><li>• sella turcica</li><li>• regulate critical body functions</li><li>• aneurysms</li><li>• internal carotid artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oculomotor Nerve (III):</li><li>➤ Oculomotor Nerve (III):</li><li>➤ This nerve controls the eye movements , including constriction of the pupil and maintaining an open eyelid . The oculomotor nerve runs adjacent to the posterior communicating artery . A berry aneurysm in this artery can compress the oculomotor nerve, leading to symptoms such as ptosis, anisocoria , and diplopia . This is the most commonly affected cranial nerve in the case of a posterior communicating artery aneurysm.</li><li>➤ This nerve controls the eye movements , including constriction of the pupil and maintaining an open eyelid . The oculomotor nerve runs adjacent to the posterior communicating artery .</li><li>➤ eye movements</li><li>➤ constriction</li><li>➤ pupil</li><li>➤ open eyelid</li><li>➤ adjacent</li><li>➤ posterior communicating artery</li><li>➤ A berry aneurysm in this artery can compress the oculomotor nerve, leading to symptoms such as ptosis, anisocoria , and diplopia .</li><li>➤ ptosis, anisocoria</li><li>➤ diplopia</li><li>➤ This is the most commonly affected cranial nerve in the case of a posterior communicating artery aneurysm.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 172-173</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 172-173</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the type of fibre marked in the given diagram:", "options": [{"label": "A", "text": "Long Association Fibres", "correct": false}, {"label": "B", "text": "Short Association Fibres", "correct": false}, {"label": "C", "text": "Projection Fibres", "correct": true}, {"label": "D", "text": "Commissural Fibres", "correct": false}], "correct_answer": "C. Projection Fibres", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture16_VlxNR5X.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture15_pjDo8Cu.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/27/picture17_ZYdNZMW.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Long Association Fibers connect different lobes within the same hemisphere of the brain. They include tracts like the superior longitudinal fasciculus , which links the frontal lobe to the posterior parts of the brain.</li><li>• Option A.</li><li>• different lobes</li><li>• same hemisphere</li><li>• superior longitudinal fasciculus</li><li>• frontal lobe</li><li>• posterior parts</li><li>• Option B. Short Association Fibers, also known as U-fibers , connect adjacent gyri within the same cerebral hemisphere .</li><li>• Option B.</li><li>• U-fibers</li><li>• adjacent gyri</li><li>• same cerebral hemisphere</li><li>• Option D. Commissural fibers, such as those in the corpus callosum , connect corresponding areas of the two cerebral hemispheres .</li><li>• Option D.</li><li>• corpus callosum</li><li>• corresponding areas</li><li>• two cerebral hemispheres</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The posterior limb of the internal capsule contains projection fibers, which are crucial for conveying motor and sensory information between the cerebral cortex and the brainstem or spinal cord .</li><li>➤ conveying motor</li><li>➤ sensory information</li><li>➤ cerebral cortex</li><li>➤ brainstem</li><li>➤ spinal cord</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 162-165</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 162-165</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a likely consequence of occlusion of the artery supplying the indicated area?", "options": [{"label": "A", "text": "Urinary Incontinence", "correct": false}, {"label": "B", "text": "Rectal Incontinence", "correct": false}, {"label": "C", "text": "Astereognosis", "correct": true}, {"label": "D", "text": "Perianal Anaesthesia", "correct": false}], "correct_answer": "C. Astereognosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture6_WAMXK7S.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Urinary Incontinence: The paracentral lobule, particularly the anterior part of the medial frontal lobe , is involved in the control of the bladder . Damage to this area can lead to urinary incontinence due to the inability to control the urinary sphincter .</li><li>• Option A.</li><li>• anterior part</li><li>• medial frontal lobe</li><li>• control of the bladder</li><li>• lead</li><li>• urinary incontinence</li><li>• inability</li><li>• control</li><li>• urinary sphincter</li><li>• Option B. Similar to urinary incontinence, rectal incontinence can also be a result of damage to the paracentral lobule . This area plays a role in controlling the muscles involved in bowel movements , and impairment here could lead to loss of control over rectal sphincters .</li><li>• Option B.</li><li>• result of damage</li><li>• paracentral lobule</li><li>• plays</li><li>• role in controlling</li><li>• bowel movements</li><li>• loss of control</li><li>• rectal sphincters</li><li>• Option D. The paracentral lobule is involved in the sensory and motor innervation of the lower extremities and perineal area . Occlusion of the artery supplying this area could lead to loss of sensation in the perianal region .</li><li>• Option D.</li><li>• sensory</li><li>• motor innervation</li><li>• lower extremities</li><li>• perineal area</li><li>• loss of sensation</li><li>• perianal region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Astereognosis is the inability to recognize objects by touch alone, without visual aid. This condition is typically associated with damage to the sensory cortex in the parietal lobe , not the paracentral lobule. The paracentral lobule is more involved in motor function and somatic sensation rather than the complex integration of sensory information required for astereognosis .</li><li>➤ inability</li><li>➤ recognize objects</li><li>➤ touch</li><li>➤ typically associated</li><li>➤ damage</li><li>➤ sensory cortex</li><li>➤ parietal lobe</li><li>➤ paracentral lobule</li><li>➤ motor function</li><li>➤ somatic sensation</li><li>➤ complex integration</li><li>➤ sensory information</li><li>➤ astereognosis</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 145</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 145</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is incorrectly marked?", "options": [{"label": "A", "text": "Genu of Corpus Callosum", "correct": false}, {"label": "B", "text": "Columns of Fornix", "correct": false}, {"label": "C", "text": "Cerebellum", "correct": false}, {"label": "D", "text": "Hypothalamus", "correct": true}], "correct_answer": "D. Hypothalamus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture8_Eejeu33.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture9.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Corpus Callosum is the largest commissural fiber in the brain , connecting the left and right cerebral hemispheres , thereby facilitating interhemispheric communication . From anterior to posterior, the Corpus Callosum comprises the rostrum, genu, body , and splenium . Lesions or abnormalities in the Corpus Callosum can lead to a range of cognitive, motor , and sensory deficits , including split-brain syndrome and interhemispheric disconnection .</li><li>• Option A.</li><li>• largest commissural fiber</li><li>• brain</li><li>• connecting</li><li>• left</li><li>• right cerebral hemispheres</li><li>• facilitating interhemispheric communication</li><li>• rostrum, genu, body</li><li>• splenium</li><li>• range of cognitive, motor</li><li>• sensory deficits</li><li>• split-brain syndrome</li><li>• interhemispheric disconnection</li><li>• Option B. The Fornix is a C-shaped bundle of nerve fibers in the brain that acts as a major output tract of the hippocampus . It consists of the alveus, fimbria, crus of fornix, body of fornix , and columns of fornix . Damage to the Fornix can result in memory impairments , given its role in hippocampal connectivity and memory processing circuits .</li><li>• Option B.</li><li>• C-shaped bundle</li><li>• nerve fibers</li><li>• major output tract</li><li>• hippocampus</li><li>• alveus, fimbria, crus of fornix, body of fornix</li><li>• columns of fornix</li><li>• Damage</li><li>• memory impairments</li><li>• hippocampal connectivity</li><li>• memory processing circuits</li><li>• Option C. Cerebellum is a part of the hindbrain , known for its role in motor control . It does not initiate movement but contributes to coordination, precision, and accurate timing of movements. Cerebellar disorders can cause ataxia, dysmetria , and tremors , impacting the smooth execution of voluntary movements .</li><li>• Option C.</li><li>• hindbrain</li><li>• motor control</li><li>• Cerebellar disorders</li><li>• ataxia, dysmetria</li><li>• tremors</li><li>• smooth execution</li><li>• voluntary movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pituitary gland is located at the base of the brain , nestled in the Sella Turcica . This cavity is part of the Sphenoid bone , situated just below the Hypothalamus . The gland is connected to the Hypothalamus by a thin stalk called the Infundibulum . The pituitary gland's position at the base of the brain places it near important structures such as the Optic Chiasm, making its disorders potentially significant for a variety of Bodily functions.</li><li>➤ The pituitary gland is located at the base of the brain , nestled in the Sella Turcica . This cavity is part of the Sphenoid bone , situated just below the Hypothalamus .</li><li>➤ base of the brain</li><li>➤ Sella Turcica</li><li>➤ Sphenoid bone</li><li>➤ below</li><li>➤ Hypothalamus</li><li>➤ The gland is connected to the Hypothalamus by a thin stalk called the Infundibulum . The pituitary gland's position at the base of the brain places it near important structures such as the Optic Chiasm, making its disorders potentially significant for a variety of Bodily functions.</li><li>➤ thin stalk</li><li>➤ Infundibulum</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 134</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 134</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the image given below, the structure marked with the arrow is an important area related to motor function. All of the following gives afferent fibres to this structure except?", "options": [{"label": "A", "text": "Thalamus", "correct": false}, {"label": "B", "text": "Cerebral Cortex", "correct": false}, {"label": "C", "text": "Substantia Nigra", "correct": false}, {"label": "D", "text": "Spinal Cord", "correct": true}], "correct_answer": "D. Spinal Cord", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/screenshot-2023-12-29-180923.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture11.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Thalamus, located in the forebrain . It processes and transmits sensory information to the appropriate areas of the cerebral cortex. Damage to the thalamus can lead to sensory deficits , altered consciousness , and thalamic pain syndrome .</li><li>• Option A.</li><li>• forebrain</li><li>• sensory information</li><li>• appropriate areas</li><li>• lead</li><li>• sensory deficits</li><li>• altered consciousness</li><li>• thalamic pain syndrome</li><li>• Option B. Cerebral Cortex, the brain's outer layer , is involved in numerous high-level functions , including sensation , perception , memory, association, thought , and voluntary physical action . Damage to different areas of the cortex can lead to a variety of deficits , such as aphasia ( language disorders ), apraxia ( impaired movement planning ), or agnosia ( impaired recognition of objects, people, sounds, shapes, or smells ).</li><li>• Option B.</li><li>• brain's outer layer</li><li>• numerous high-level functions</li><li>• sensation</li><li>• perception</li><li>• memory, association, thought</li><li>• voluntary physical action</li><li>• variety of deficits</li><li>• aphasia</li><li>• language disorders</li><li>• apraxia</li><li>• impaired movement planning</li><li>• agnosia</li><li>• impaired recognition of objects, people, sounds, shapes, or smells</li><li>• Option C. Substantia Nigra: Located in the midbrain , the substantia nigra is crucial for movement control . It produces dopamine , a neurotransmitter that helps regulate movement and emotional responses . Degeneration of neurons in the substantia nigra is a hallmark of Parkinson's disease , leading to symptoms such as tremors, rigidity , and bradykinesia .</li><li>• Option C.</li><li>• midbrain</li><li>• crucial</li><li>• movement control</li><li>• dopamine</li><li>• neurotransmitter</li><li>• regulate movement</li><li>• emotional responses</li><li>• Degeneration of neurons</li><li>• hallmark of Parkinson's disease</li><li>• tremors, rigidity</li><li>• bradykinesia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Spinal Cord : It extends from the brainstem down the vertebral column. It facilitates the transmission of neural signals between the brain and the rest of the body and is involved in various reflex actions. Damage to the spinal cord can lead to paralysis, loss of sensation , and autonomic dysregulation below the level of injury. Caudate Nucleus: They largely control voluntary skeletal movement . The caudate nucleus functions not only in planning the execution of movement, but also in learning, memory, reward, motivation, emotion, and romantic interaction. Understanding the distinct roles and clinical significance of the thalamus (sensory relay), cerebral cortex (higher-level functions), substantia nigra (movement control), and spinal cord (neural signal transmission and reflexes) is essential for diagnosing and managing various neurological conditions.</li><li>➤ Spinal Cord : It extends from the brainstem down the vertebral column. It facilitates the transmission of neural signals between the brain and the rest of the body and is involved in various reflex actions. Damage to the spinal cord can lead to paralysis, loss of sensation , and autonomic dysregulation below the level of injury.</li><li>➤ Spinal Cord</li><li>➤ transmission</li><li>➤ neural signals</li><li>➤ brain</li><li>➤ rest of the body</li><li>➤ Damage</li><li>➤ paralysis, loss of sensation</li><li>➤ autonomic dysregulation</li><li>➤ Caudate Nucleus: They largely control voluntary skeletal movement . The caudate nucleus functions not only in planning the execution of movement, but also in learning, memory, reward, motivation, emotion, and romantic interaction.</li><li>➤ Caudate Nucleus:</li><li>➤ voluntary skeletal movement</li><li>➤ Understanding the distinct roles and clinical significance of the thalamus (sensory relay), cerebral cortex (higher-level functions), substantia nigra (movement control), and spinal cord (neural signal transmission and reflexes) is essential for diagnosing and managing various neurological conditions.</li><li>➤ diagnosing</li><li>➤ managing</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 156</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 156</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following disease pathogenesis primarily involves the marked structures?", "options": [{"label": "A", "text": "Pendular Knee Jerk", "correct": false}, {"label": "B", "text": "Visual Agnosia", "correct": false}, {"label": "C", "text": "Paralysis Agitans", "correct": true}, {"label": "D", "text": "Huntington’s Chorea", "correct": false}], "correct_answer": "C. Paralysis Agitans", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture12.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture13.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The pendular knee jerk is a type of reflex characterized by oscillating movements of the leg in response to the knee jerk reflex test . Unlike the normal reflex, which is a single downward movement followed by an immediate cessation of motion, a pendular reflex involves back-and-forth movements . It is often seen in conditions with decreased muscle tone or demyelinating diseases , such as multiple sclerosis.</li><li>• Option A.</li><li>• reflex</li><li>• oscillating movements</li><li>• leg</li><li>• knee jerk reflex test</li><li>• single downward movement</li><li>• immediate cessation</li><li>• pendular reflex</li><li>• back-and-forth movements</li><li>• decreased muscle tone</li><li>• demyelinating diseases</li><li>• Option B. Visual Agnosia is the inability to recognize or interpret visual information despite having normal eyesight . Patients can see objects but cannot understand or name them . It usually results from damage to the occipital or posterior temporal lobes of the brain , often due to stroke , head injury , or dementia . It reflects a disconnection between visual perception and higher-order cognitive processing .</li><li>• Option B.</li><li>• inability</li><li>• recognize or interpret visual information</li><li>• normal eyesight</li><li>• can see objects</li><li>• cannot understand</li><li>• name them</li><li>• damage</li><li>• occipital</li><li>• posterior temporal lobes</li><li>• brain</li><li>• due to stroke</li><li>• head injury</li><li>• dementia</li><li>• disconnection</li><li>• visual perception</li><li>• higher-order cognitive processing</li><li>• Option D. Huntington's chorea is an inherited disorder characterized by chorea ( irregular, rapid, involuntary movements ), psychiatric problems , and dementia . It is caused by a genetic mutation leading to the progressive breakdown of nerve cells in the brain. Symptoms usually start between 30 and 50 years of age and worsen over a 10 to 25-year period until the individual succumbs to the disease .</li><li>• Option D.</li><li>• inherited disorder</li><li>• chorea</li><li>• irregular, rapid, involuntary movements</li><li>• psychiatric problems</li><li>• dementia</li><li>• genetic mutation</li><li>• progressive breakdown</li><li>• nerve cells</li><li>• between 30 and 50 years of age</li><li>• 10 to 25-year</li><li>• individual succumbs</li><li>• disease</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Paralysis Agitans (Parkinson’s Disease) : Paralysis agitans, more commonly known as Parkinson's disease, is a chronic and progressive movement disorder . It is characterized by tremor at rest , bradykinesia, rigidity , and postural instability . It results from the degeneration of dopamine-producing neurons in the substantia nigra , part of the midbrain. While the exact cause is unknown, it involves a combination of genetic and environmental factors . Understanding the distinct characteristics and underlying pathologies of neurological conditions like pendular knee jerk (indicative of demyelinating diseases), visual agnosia (resulting from occipital/temporal lobe damage), paralysis agitans (Parkinson's disease, caused by substantia nigra degeneration), and Huntington’s chorea (a genetic disorder causing involuntary movements and cognitive decline) is crucial for diagnosis and management in neurology.</li><li>➤ Paralysis Agitans (Parkinson’s Disease) : Paralysis agitans, more commonly known as Parkinson's disease, is a chronic and progressive movement disorder .</li><li>➤ Paralysis Agitans (Parkinson’s Disease)</li><li>➤ chronic</li><li>➤ progressive movement disorder</li><li>➤ It is characterized by tremor at rest , bradykinesia, rigidity , and postural instability . It results from the degeneration of dopamine-producing neurons in the substantia nigra , part of the midbrain.</li><li>➤ tremor</li><li>➤ rest</li><li>➤ bradykinesia, rigidity</li><li>➤ postural instability</li><li>➤ degeneration</li><li>➤ dopamine-producing neurons</li><li>➤ substantia nigra</li><li>➤ While the exact cause is unknown, it involves a combination of genetic and environmental factors .</li><li>➤ combination</li><li>➤ genetic</li><li>➤ environmental factors</li><li>➤ Understanding the distinct characteristics and underlying pathologies of neurological conditions like pendular knee jerk (indicative of demyelinating diseases), visual agnosia (resulting from occipital/temporal lobe damage), paralysis agitans (Parkinson's disease, caused by substantia nigra degeneration), and Huntington’s chorea (a genetic disorder causing involuntary movements and cognitive decline) is crucial for diagnosis and management in neurology.</li><li>➤ distinct characteristics</li><li>➤ underlying pathologies</li><li>➤ neurological conditions</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg. 82, 119, 159, 153, 160</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg. 82, 119, 159, 153, 160</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The marked cells inhibit which of the following:", "options": [{"label": "A", "text": "Golgi Cell", "correct": false}, {"label": "B", "text": "Basket Cell", "correct": false}, {"label": "C", "text": "Vestibular Nuclei", "correct": false}, {"label": "D", "text": "Deep Cerebellar Nuclei", "correct": true}], "correct_answer": "D. Deep Cerebellar Nuclei", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture14.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A : Golgi cells lie in the inner granular layer of cerebellar cortex . Larger in size but fewer in number .</li><li>• Option A</li><li>• inner granular layer</li><li>• cerebellar cortex</li><li>• Larger in size</li><li>• fewer in number</li><li>• Option B: Basket cells are present in outer molecular layer . The transverse axons of these cells synapse through numerous baskets like nets of collaterals with dendrites of about 500 purkinje cells .</li><li>• Option B:</li><li>• outer molecular layer</li><li>• transverse axons</li><li>• cells synapse</li><li>• numerous baskets</li><li>• dendrites</li><li>• about 500 purkinje cells</li><li>• Option C: Vestibular nuclei partly situated in medulla , partly in pons , beneath lateral part of floor of fourth ventricle called vestibular area arranged as four groups inferior , lateral ( Dieter’s nuclei ), superior and medial group .</li><li>• Option C:</li><li>• situated in medulla</li><li>• pons</li><li>• beneath lateral part</li><li>• floor of fourth ventricle</li><li>• vestibular area</li><li>• four groups inferior</li><li>• lateral</li><li>• Dieter’s nuclei</li><li>• superior</li><li>• medial group</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Purkinje cells are located in the middle layer of the cerebellar cortex, which is called the Purkinje cell layer . This layer is situated between the molecular layer and the granular layer . The cell body of a Purkinje cell is large and flask-shaped . From it, a single primary dendrite emerges , which then branches extensively . Purkinje cells receive two types of input : climbing fibers and mossy fibers . Climbing fibers, originating from the inferior olivary nucleus , make powerful excitatory synapses with the Purkinje cells. Mossy fibers indirectly synapse with Purkinje cells via granule cells , which extend parallel fibers that synapse with the dendrites of the Purkinje cells . The primary function of Purkinje cells is to integrate the vast array of sensory and motor information being relayed through the cerebellum and to modulate the output of the deep cerebellar nuclei , which are the sole output channels of the cerebellar cortex . This modulation is crucial for coordination and precision of movements . Purkinje cells are susceptible to damage due to various causes, including genetic disorders , alcohol abuse, and autoimmune diseases . Loss or dysfunction of these cells can lead to cerebellar ataxia , characterized by uncoordinated and imprecise movements .</li><li>➤ Purkinje cells are located in the middle layer of the cerebellar cortex, which is called the Purkinje cell layer . This layer is situated between the molecular layer and the granular layer . The cell body of a Purkinje cell is large and flask-shaped . From it, a single primary dendrite emerges , which then branches extensively .</li><li>➤ Purkinje cell layer</li><li>➤ molecular layer</li><li>➤ granular layer</li><li>➤ large</li><li>➤ flask-shaped</li><li>➤ single primary dendrite emerges</li><li>➤ branches extensively</li><li>➤ Purkinje cells receive two types of input : climbing fibers and mossy fibers . Climbing fibers, originating from the inferior olivary nucleus , make powerful excitatory synapses with the Purkinje cells. Mossy fibers indirectly synapse with Purkinje cells via granule cells , which extend parallel fibers that synapse with the dendrites of the Purkinje cells .</li><li>➤ two types of input</li><li>➤ climbing fibers</li><li>➤ mossy fibers</li><li>➤ inferior olivary nucleus</li><li>➤ powerful excitatory synapses</li><li>➤ Mossy fibers indirectly synapse</li><li>➤ granule cells</li><li>➤ parallel fibers</li><li>➤ dendrites</li><li>➤ Purkinje cells</li><li>➤ The primary function of Purkinje cells is to integrate the vast array of sensory and motor information being relayed through the cerebellum and to modulate the output of the deep cerebellar nuclei , which are the sole output channels of the cerebellar cortex . This modulation is crucial for coordination and precision of movements .</li><li>➤ integrate</li><li>➤ sensory</li><li>➤ motor information</li><li>➤ cerebellum</li><li>➤ output</li><li>➤ deep cerebellar nuclei</li><li>➤ sole output channels</li><li>➤ cerebellar cortex</li><li>➤ crucial</li><li>➤ coordination</li><li>➤ precision of movements</li><li>➤ Purkinje cells are susceptible to damage due to various causes, including genetic disorders , alcohol abuse, and autoimmune diseases . Loss or dysfunction of these cells can lead to cerebellar ataxia , characterized by uncoordinated and imprecise movements .</li><li>➤ susceptible</li><li>➤ damage</li><li>➤ genetic disorders</li><li>➤ alcohol abuse,</li><li>➤ autoimmune diseases</li><li>➤ Loss or dysfunction</li><li>➤ cerebellar ataxia</li><li>➤ uncoordinated and imprecise movements</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg. 114-115</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg. 114-115</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following speech disorders is caused by the injury of the structure shown in the histological image?", "options": [{"label": "A", "text": "Apraxia", "correct": false}, {"label": "B", "text": "Aphasia", "correct": false}, {"label": "C", "text": "Dysarthria", "correct": true}, {"label": "D", "text": "Dysprosody", "correct": false}], "correct_answer": "C. Dysarthria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture15.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A : Apraxia is inability to perform motor activities in the presence of intact motor and sensory systems and normal comprehension. Ideomotor apraxia , Ideational apraxia seen in lesion of sensory speech area . Constructional apraxia is due to lesion of inferior parietal lobule</li><li>• Option A</li><li>• inability</li><li>• perform motor activities</li><li>• presence</li><li>• intact motor</li><li>• sensory systems</li><li>• Ideomotor apraxia</li><li>• sensory speech area</li><li>• Constructional apraxia</li><li>• lesion</li><li>• inferior parietal lobule</li><li>• Option B : Aphasia is impaired/absent communication by speech, writing, signs due to lesion in dominant hemisphere . Eg motor aphasia, sensory aphasia, conduction aphasia, global aphasia, thalamic aphasia</li><li>• Option B</li><li>• impaired/absent communication</li><li>• speech, writing, signs</li><li>• lesion</li><li>• dominant hemisphere</li><li>• Option D : Dysprosody is Non dominant hemispheric language deficits that affect the emotionality of speech</li><li>• Option D</li><li>• Non dominant hemispheric language deficits</li><li>• emotionality</li><li>• speech</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system . It is characterized by poor articulation of phonemes , which means the clarity of speech is affected . While it does not initiate speech, it coordinates the timing and force of muscle movements required for smooth , clear , and rapid speech . Cerebellar Dysarthria: When the cerebellum is damaged, it can lead to a specific type of dysarthria, often characterized by the following: Slurred Speech: Speech may be slurred and sound 'drunken'. Irregular Speech Rhythm and Rate: Speech may be excessively slow or fast, and the rhythm may be irregular. Variable Tone: The voice might have a monotonous tone or fluctuate excessively. Difficulty with Coordination of Speech Movements: There may be problems with the coordination of lip, tongue, and jaw movements, affecting articulation. Volume Control Issues: The speech might be unusually loud or soft.</li><li>➤ Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system . It is characterized by poor articulation of phonemes , which means the clarity of speech is affected . While it does not initiate speech, it coordinates the timing and force of muscle movements required for smooth , clear , and rapid speech .</li><li>➤ motor speech disorder</li><li>➤ neurological injury</li><li>➤ motor component</li><li>➤ motor-speech system</li><li>➤ poor articulation</li><li>➤ phonemes</li><li>➤ clarity of speech is affected</li><li>➤ coordinates the timing</li><li>➤ force of muscle</li><li>➤ movements</li><li>➤ smooth</li><li>➤ clear</li><li>➤ rapid speech</li><li>➤ Cerebellar Dysarthria: When the cerebellum is damaged, it can lead to a specific type of dysarthria, often characterized by the following: Slurred Speech: Speech may be slurred and sound 'drunken'. Irregular Speech Rhythm and Rate: Speech may be excessively slow or fast, and the rhythm may be irregular. Variable Tone: The voice might have a monotonous tone or fluctuate excessively. Difficulty with Coordination of Speech Movements: There may be problems with the coordination of lip, tongue, and jaw movements, affecting articulation. Volume Control Issues: The speech might be unusually loud or soft.</li><li>➤ Cerebellar Dysarthria:</li><li>➤ cerebellum</li><li>➤ Slurred Speech: Speech may be slurred and sound 'drunken'. Irregular Speech Rhythm and Rate: Speech may be excessively slow or fast, and the rhythm may be irregular. Variable Tone: The voice might have a monotonous tone or fluctuate excessively. Difficulty with Coordination of Speech Movements: There may be problems with the coordination of lip, tongue, and jaw movements, affecting articulation. Volume Control Issues: The speech might be unusually loud or soft.</li><li>➤ Slurred Speech: Speech may be slurred and sound 'drunken'.</li><li>➤ Slurred Speech:</li><li>➤ Irregular Speech Rhythm and Rate: Speech may be excessively slow or fast, and the rhythm may be irregular.</li><li>➤ Irregular Speech Rhythm and Rate:</li><li>➤ Variable Tone: The voice might have a monotonous tone or fluctuate excessively.</li><li>➤ Variable Tone:</li><li>➤ Difficulty with Coordination of Speech Movements: There may be problems with the coordination of lip, tongue, and jaw movements, affecting articulation.</li><li>➤ Difficulty with Coordination of Speech Movements:</li><li>➤ Volume Control Issues: The speech might be unusually loud or soft.</li><li>➤ Volume Control Issues:</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 150-151</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 150-151</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following features are seen by the lesion of the marked structure in the given image?", "options": [{"label": "A", "text": "Ataxia", "correct": false}, {"label": "B", "text": "Vertigo", "correct": false}, {"label": "C", "text": "Ipsilateral Facial Nerve Palsy", "correct": false}, {"label": "D", "text": "Contralateral Hemiplegia", "correct": true}], "correct_answer": "D. Contralateral Hemiplegia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture16.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Ataxia refers to a lack of muscle coordination that can affect speech , eye movements , the ability to swallow, walking , and other voluntary movements . It is commonly associated with lesions in the cerebellum or in the sensory pathways .</li><li>• Option A</li><li>• lack</li><li>• muscle coordination</li><li>• affect speech</li><li>• eye movements</li><li>• ability to swallow, walking</li><li>• other voluntary movements</li><li>• lesions</li><li>• cerebellum</li><li>• sensory pathways</li><li>• Option B . Vertigo is a sense of spinning or dizziness , often related to problems in the inner ear or vestibular system . Lesions in the vestibular nuclei in the brainstem, the vestibulocochlear nerve , or the inner ear can lead to vertigo .</li><li>• Option B</li><li>• sense</li><li>• spinning</li><li>• dizziness</li><li>• problems</li><li>• inner ear</li><li>• vestibular system</li><li>• vestibulocochlear nerve</li><li>• inner ear</li><li>• lead to vertigo</li><li>• Option C . Ipsilateral Facial Nerve Palsy refers to weakness or paralysis of the facial muscles on the same side as the lesion. It is commonly associated with lesions affecting the facial nerve ( Cranial Nerve VII ), which could be at the level of the brainstem or the nerve itself.</li><li>• Option C</li><li>• weakness</li><li>• paralysis</li><li>• facial muscles</li><li>• same side</li><li>• lesions affecting the facial nerve</li><li>• Cranial Nerve VII</li><li>• level</li><li>• brainstem</li><li>• nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Contralateral Hemiplegia : This is paralysis on the side of the body opposite to the side of the brain where the lesion is located. Lesions in the motor pathways , especially in the cerebral cortex or internal capsule , can lead to contralateral hemiplegia because motor fibers decussate (cross over) in the medulla . When considering neurological symptoms such as ataxia, vertigo, facial nerve palsy , and hemiplegia , it is essential to identify the location of the lesion in the brain, as the symptoms can provide key insights into the affected area . Ataxia typically indicates cerebellar or sensory pathway lesions , vertigo suggests vestibular system involvement , ipsilateral facial nerve palsy points to facial nerve or brainstem involvement , and contralateral hemiplegia is indicative of motor pathway lesions , often in the cerebral cortex or internal capsule .</li><li>➤ Contralateral Hemiplegia : This is paralysis on the side of the body opposite to the side of the brain where the lesion is located.</li><li>➤ Contralateral Hemiplegia</li><li>➤ paralysis</li><li>➤ side</li><li>➤ body opposite</li><li>➤ side</li><li>➤ brain</li><li>➤ Lesions in the motor pathways , especially in the cerebral cortex or internal capsule , can lead to contralateral hemiplegia because motor fibers decussate (cross over) in the medulla .</li><li>➤ motor pathways</li><li>➤ cerebral cortex</li><li>➤ internal capsule</li><li>➤ contralateral hemiplegia</li><li>➤ motor fibers</li><li>➤ decussate (cross over)</li><li>➤ medulla</li><li>➤ When considering neurological symptoms such as ataxia, vertigo, facial nerve palsy , and hemiplegia , it is essential to identify the location of the lesion in the brain, as the symptoms can provide key insights into the affected area .</li><li>➤ neurological symptoms</li><li>➤ ataxia, vertigo, facial nerve palsy</li><li>➤ hemiplegia</li><li>➤ identify</li><li>➤ location</li><li>➤ key insights into the affected area</li><li>➤ Ataxia typically indicates cerebellar or sensory pathway lesions , vertigo suggests vestibular system involvement , ipsilateral facial nerve palsy points to facial nerve or brainstem involvement , and contralateral hemiplegia is indicative of motor pathway lesions , often in the cerebral cortex or internal capsule .</li><li>➤ indicates cerebellar</li><li>➤ sensory pathway lesions</li><li>➤ vertigo</li><li>➤ vestibular system</li><li>➤ involvement</li><li>➤ ipsilateral facial nerve palsy</li><li>➤ facial nerve</li><li>➤ brainstem involvement</li><li>➤ indicative</li><li>➤ motor pathway lesions</li><li>➤ cerebral cortex</li><li>➤ internal capsule</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 73-75</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 73-75</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correctly matched pair:", "options": [{"label": "A", "text": "A-Projection fibre", "correct": false}, {"label": "B", "text": "B- Association fibre", "correct": false}, {"label": "C", "text": "C- Projection fibre", "correct": true}, {"label": "D", "text": "D- Association fibre", "correct": false}], "correct_answer": "C. C- Projection fibre", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture17.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C- Projection fibre</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Projection Fibers : Projection fibers in the brain are axons that project out of the brain to the spinal cord , or from the spinal cord to the brain. They are involved in transmitting sensory and motor information between the brain and the rest of the body . The most well-known projection fibers are the corticospinal tract and the spinothalamic tract . Association Fibers : Association fibers are axons that connect different parts of the same cerebral hemisphere . They play a crucial role in integrating information within a single hemisphere . The arcuate fasciculus , which connects Wernicke's and Broca's areas , is a classic example of an association fiber. If A and C represent tracts that connect different regions of the brain to the body or vice versa, they would be projection fibers . If B and D represent tracts that connect different areas within the same cerebral hemisphere , they would be association fibers .</li><li>• Projection Fibers : Projection fibers in the brain are axons that project out of the brain to the spinal cord , or from the spinal cord to the brain. They are involved in transmitting sensory and motor information between the brain and the rest of the body . The most well-known projection fibers are the corticospinal tract and the spinothalamic tract .</li><li>• Projection Fibers</li><li>• axons</li><li>• project out</li><li>• spinal cord</li><li>• transmitting sensory</li><li>• motor information</li><li>• brain</li><li>• rest of the body</li><li>• corticospinal tract</li><li>• spinothalamic tract</li><li>• Association Fibers : Association fibers are axons that connect different parts of the same cerebral hemisphere . They play a crucial role in integrating information within a single hemisphere . The arcuate fasciculus , which connects Wernicke's and Broca's areas , is a classic example of an association fiber.</li><li>• Association Fibers</li><li>• different parts</li><li>• same cerebral hemisphere</li><li>• crucial role</li><li>• integrating information</li><li>• single hemisphere</li><li>• arcuate fasciculus</li><li>• connects Wernicke's</li><li>• Broca's areas</li><li>• If A and C represent tracts that connect different regions of the brain to the body or vice versa, they would be projection fibers .</li><li>• A and C represent tracts</li><li>• different regions</li><li>• projection fibers</li><li>• If B and D represent tracts that connect different areas within the same cerebral hemisphere , they would be association fibers .</li><li>• B and D represent tracts</li><li>• different areas</li><li>• same cerebral hemisphere</li><li>• association fibers</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The identification of brain white matter tracts as either projection fibers ( connecting the brain to the body and vice versa) or association fibers ( connecting different regions within the same hemisphere ) is crucial for understanding the organization and functional connectivity of the brain.</li><li>➤ identification of brain</li><li>➤ white matter tracts</li><li>➤ either projection fibers</li><li>➤ connecting the brain</li><li>➤ body</li><li>➤ association fibers</li><li>➤ connecting different regions</li><li>➤ same hemisphere</li><li>➤ understanding</li><li>➤ organization</li><li>➤ functional connectivity</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 164, 168, 232</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 164, 168, 232</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presented to OPD with Ballistic movements of arm. Which part of the brain is involved?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture18.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture19.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: A - Head of caudate nucleus. Lesion of caudate nucleus results in chorea which is characterized by quick , jerky irregular purposeless involuntary movements which involve primarily the tongue, face and limbs .</li><li>• Option A:</li><li>• A - Head of caudate nucleus.</li><li>• chorea</li><li>• quick</li><li>• jerky irregular purposeless</li><li>• involuntary</li><li>• movements</li><li>• primarily</li><li>• tongue, face</li><li>• limbs</li><li>• Option B: B - Putamen – Lesion of putamen can lead to reduce GPi discharge and enhance the response of thalamocortical neurons .</li><li>• Option B: B</li><li>• - Putamen</li><li>• reduce GPi discharge</li><li>• thalamocortical neurons</li><li>• Option C: C - Globus Pallidus - Lesion of Globus pallidus results in athetosis it consists of slow, sinuous, writhing movements involving mainly distal segments of limbs .</li><li>• Option C: C -</li><li>• Globus Pallidus</li><li>• athetosis</li><li>• slow, sinuous, writhing movements</li><li>• mainly distal segments</li><li>• limbs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Subthalamic Nucleus:</li><li>➤ Subthalamic Nucleus:</li><li>➤ The subthalamic nucleus (STN) is a small, lens-shaped structure located in the diencephalon . It is a part of the basal ganglia circuitry , which plays a crucial role in regulating voluntary motor control , procedural learning , routine behaviors or habits , and motor planning . The STN provides excitatory input to the Globus Pallidus internus (GPi) and substantia nigra pars reticulata (SNr) , which are the main output nuclei of the basal ganglia. It modulates the inhibitory effects of these structures on the thalamus and thus indirectly influences movement initiation.</li><li>➤ The subthalamic nucleus (STN) is a small, lens-shaped structure located in the diencephalon . It is a part of the basal ganglia circuitry , which plays a crucial role in regulating voluntary motor control , procedural learning , routine behaviors or habits , and motor planning .</li><li>➤ small, lens-shaped</li><li>➤ diencephalon</li><li>➤ basal ganglia circuitry</li><li>➤ crucial role</li><li>➤ voluntary motor control</li><li>➤ procedural learning</li><li>➤ routine behaviors</li><li>➤ habits</li><li>➤ motor planning</li><li>➤ The STN provides excitatory input to the Globus Pallidus internus (GPi) and substantia nigra pars reticulata (SNr) , which are the main output nuclei of the basal ganglia. It modulates the inhibitory effects of these structures on the thalamus and thus indirectly influences movement initiation.</li><li>➤ excitatory input</li><li>➤ Globus Pallidus internus (GPi)</li><li>➤ substantia nigra pars reticulata (SNr)</li><li>➤ main output nuclei</li><li>➤ inhibitory effects</li><li>➤ thalamus</li><li>➤ indirectly influences</li><li>➤ Lesion of the Subthalamic Nucleus:</li><li>➤ Lesion of the Subthalamic Nucleus:</li><li>➤ A lesion in the STN, such as from a stroke or hemorrhage, disrupts this normal circuitry. The most notable clinical manifestation of a subthalamic nucleus lesion is hemiballismus , characterized by sudden, wild, flinging movements of one side of the body ( contralateral to the lesion ). These movements are often violent and can involve the proximal limb muscles of one side of the body .</li><li>➤ A lesion in the STN, such as from a stroke or hemorrhage, disrupts this normal circuitry.</li><li>➤ The most notable clinical manifestation of a subthalamic nucleus lesion is hemiballismus , characterized by sudden, wild, flinging movements of one side of the body ( contralateral to the lesion ). These movements are often violent and can involve the proximal limb muscles of one side of the body .</li><li>➤ subthalamic nucleus lesion</li><li>➤ hemiballismus</li><li>➤ sudden, wild, flinging movements</li><li>➤ one side of the body</li><li>➤ contralateral to the lesion</li><li>➤ violent</li><li>➤ proximal limb muscles</li><li>➤ one side</li><li>➤ body</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 160.</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 160.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which area of the cerebrum, if affected, would result in a patient knowing what they want to speak but being unable to do so?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture7_KkMVUg6.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B- Inferior Frontal Gyrus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior Frontal Gyrus - Posterior Part - Motor Association Area/Premotor ( Area 6 of Brodmann ): This area is part of the premotor cortex , located anterior to the primary motor cortex . It plays a crucial role in the planning of complex movements and the coordination of movements based on external cues . Damage to this area can result in apraxia , a disorder characterized by the inability to perform learned movements despite having the desire and physical ability to perform them .</li><li>• Option A. Superior Frontal Gyrus - Posterior Part -</li><li>• Area 6 of Brodmann</li><li>• premotor cortex</li><li>• anterior</li><li>• primary motor cortex</li><li>• planning</li><li>• complex movements</li><li>• coordination</li><li>• external cues</li><li>• result</li><li>• apraxia</li><li>• inability</li><li>• perform learned movements</li><li>• desire</li><li>• physical ability</li><li>• perform them</li><li>• Option C. Superior Temporal Gyrus - Superior Surface - Anterior Transverse Temporal Gyrus ( Heschl’s Gyrus ) - Brodmann’s Area 41 and 42 - Primary Auditory Cortex: This area is responsible for processing auditory information . It is where sound is initially processed and interpreted . Damage to this area can lead to various forms of auditory processing disorders , including difficulties in recognizing sounds or understanding speech .</li><li>• Option C. Superior Temporal Gyrus - Superior Surface -</li><li>• Heschl’s Gyrus</li><li>• Brodmann’s Area 41 and 42</li><li>• processing auditory information</li><li>• initially processed</li><li>• interpreted</li><li>• auditory processing disorders</li><li>• recognizing sounds</li><li>• understanding speech</li><li>• Option D . Occipital Lobe with Primary Visual Cortex (Area 17) and Visual Association Cortex (Area 18, 19): Area 17 is the primary visual cortex , responsible for processing visual information . Areas 18 and 19 are involved in higher-order processing of visual information . Damage to the primary visual cortex can result in cortical blindness , where the eyes are normal, but the brain cannot process visual information. Lesions in the visual association cortex can result in visual agnosia , the inability to recognize objects, faces, or colors .</li><li>• Option D</li><li>• Area 17</li><li>• primary visual cortex</li><li>• processing visual information</li><li>• Areas 18 and 19</li><li>• higher-order processing</li><li>• visual</li><li>• information</li><li>• Damage</li><li>• primary visual cortex</li><li>• cortical blindness</li><li>• Lesions</li><li>• visual association cortex</li><li>• visual agnosia</li><li>• inability</li><li>• recognize objects, faces, or colors</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior Frontal Gyrus - Pars Opercularis (Area 44), Proximal to B is Pars Triangularis (Area 45) - Motor Speech Area of Broca :</li><li>➤ Inferior Frontal Gyrus - Pars Opercularis (Area 44), Proximal to B is Pars Triangularis (Area 45) - Motor Speech Area of Broca</li><li>➤ These areas constitute Broca's area , crucial for speech production . The pars opercularis and pars triangularis are involved in the motor aspects of speech and language processing . Damage to Broca's area results in Broca's aphasia , characterized by difficulty in speech production , non-fluent aphasia , and often right-sided weakness . Understanding the functions and clinical significance of different cerebral cortex regions, including the premotor area ( Area 6 ), Broca's area ( Areas 44 and 45 ), Primary Auditory Cortex ( Areas 41 and 42 ), and the visual cortex ( Areas 17, 18, 19 ), is essential for diagnosing and managing various neurological disorders .</li><li>➤ These areas constitute Broca's area , crucial for speech production . The pars opercularis and pars triangularis are involved in the motor aspects of speech and language processing .</li><li>➤ Broca's area</li><li>➤ speech production</li><li>➤ motor aspects</li><li>➤ speech</li><li>➤ language processing</li><li>➤ Damage to Broca's area results in Broca's aphasia , characterized by difficulty in speech production , non-fluent aphasia , and often right-sided weakness .</li><li>➤ Damage</li><li>➤ Broca's aphasia</li><li>➤ difficulty</li><li>➤ speech production</li><li>➤ non-fluent aphasia</li><li>➤ right-sided weakness</li><li>➤ Understanding the functions and clinical significance of different cerebral cortex regions, including the premotor area ( Area 6 ), Broca's area ( Areas 44 and 45 ), Primary Auditory Cortex ( Areas 41 and 42 ), and the visual cortex ( Areas 17, 18, 19 ), is essential for diagnosing and managing various neurological disorders .</li><li>➤ functions</li><li>➤ clinical significance</li><li>➤ premotor area</li><li>➤ Area 6</li><li>➤ Broca's area</li><li>➤ Areas 44 and 45</li><li>➤ Primary Auditory Cortex</li><li>➤ Areas 41 and 42</li><li>➤ visual cortex</li><li>➤ Areas 17, 18, 19</li><li>➤ diagnosing</li><li>➤ managing</li><li>➤ neurological disorders</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 148-152</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 148-152</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "MRI of 60-year-old female reveals a defect in the territory served by the artery marked in given MRA. Which of the following features is not a component of the syndrome related to the vessel indicated by the yellow arrows:", "options": [{"label": "A", "text": "Contralateral loss of pain &amp; temperature in trunk and limbs", "correct": false}, {"label": "B", "text": "Contralateral loss of position and vibration sense", "correct": true}, {"label": "C", "text": "Ipsilateral loss of pain and temperature sensation from face", "correct": false}, {"label": "D", "text": "Ipsilateral paralysis of muscles of palate", "correct": false}], "correct_answer": "B. Contralateral loss of position and vibration sense", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture20.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Contralateral Loss of Pain &amp; Temperature in Trunk and Limbs is a classic feature of Lateral Medullary Syndrome . The lesion affects the spinothalamic tract in the medulla , which carries pain and temperature sensations . Since these fibers decussate ( cross over ) at the level of the spinal cord , the deficit is observed on the side opposite the lesion.</li><li>• Option A</li><li>• classic feature</li><li>• Lateral Medullary Syndrome</li><li>• affects</li><li>• spinothalamic tract</li><li>• medulla</li><li>• carries pain</li><li>• temperature sensations</li><li>• fibers decussate</li><li>• cross over</li><li>• spinal cord</li><li>• side opposite</li><li>• Option C. Ipsilateral Loss of Pain and Temperature Sensation from Face is consistent with Lateral Medullary Syndrome . The lesion affects the descending tract and nucleus of the trigeminal nerve , leading to loss of pain and temperature sensation on the same side of the face as the lesion.</li><li>• Option C.</li><li>• Lateral Medullary Syndrome</li><li>• affects</li><li>• descending tract</li><li>• nucleus</li><li>• trigeminal nerve</li><li>• loss of pain</li><li>• temperature sensation</li><li>• same side</li><li>• Option D . Ipsilateral Paralysis of Muscles of Palate is also a feature of Lateral Medullary Syndrome . The lesion can affect the nucleus ambiguus , resulting in ipsilateral paralysis of the palate , pharynx , and larynx , leading to dysphagia , hoarseness , and possibly a deviation of the uvula away from the side of the lesion.</li><li>• Option D</li><li>• Lateral Medullary Syndrome</li><li>• nucleus ambiguus</li><li>• ipsilateral paralysis</li><li>• palate</li><li>• pharynx</li><li>• larynx</li><li>• dysphagia</li><li>• hoarseness</li><li>• deviation</li><li>• uvula</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Contralateral Loss of Position and Vibration Sense :</li><li>➤ Contralateral Loss of Position and Vibration Sense</li><li>➤ This is NOT typically seen in Lateral Medullary Syndrome . The medial lemniscus, which carries proprioception and vibration sense, is usually spared in PICA territory lesions as it is located more medially in the brainstem and is supplied by other arteries. In the context of Lateral Medullary Syndrome due to a lesion in the territory of the Posterior Inferior Cerebellar Artery , expect to find contralateral loss of pain and temperature sensation in the body, ipsilateral loss of pain and temperature sensation in the face , and ipsilateral paralysis of the palate , but not contralateral loss of position and vibration sense, which is typically preserved.</li><li>➤ This is NOT typically seen in Lateral Medullary Syndrome . The medial lemniscus, which carries proprioception and vibration sense, is usually spared in PICA territory lesions as it is located more medially in the brainstem and is supplied by other arteries.</li><li>➤ NOT typically seen in Lateral Medullary Syndrome</li><li>➤ In the context of Lateral Medullary Syndrome due to a lesion in the territory of the Posterior Inferior Cerebellar Artery , expect to find contralateral loss of pain and temperature sensation in the body, ipsilateral loss of pain and temperature sensation in the face , and ipsilateral paralysis of the palate , but not contralateral loss of position and vibration sense, which is typically preserved.</li><li>➤ Lateral Medullary Syndrome</li><li>➤ lesion</li><li>➤ territory</li><li>➤ Posterior Inferior Cerebellar Artery</li><li>➤ contralateral loss of pain</li><li>➤ temperature sensation</li><li>➤ ipsilateral loss of pain</li><li>➤ temperature sensation</li><li>➤ face</li><li>➤ ipsilateral paralysis</li><li>➤ palate</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 78</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 78</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure projects into which thalamic nucleus?", "options": [{"label": "A", "text": "Ventrolateral", "correct": false}, {"label": "B", "text": "Anterior", "correct": true}, {"label": "C", "text": "Ventral Anterior", "correct": false}, {"label": "D", "text": "Ventral Posterolateral", "correct": false}], "correct_answer": "B. Anterior", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture24_MtwBmwN.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture25_w4HM85M.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The ventrolateral nucleus of the thalamus is involved in motor functions . It receives inputs primarily from the basal ganglia and the cerebellum. The mammillary bodies do not project to the ventrolateral nucleus.</li><li>• Option A.</li><li>• motor functions</li><li>• receives</li><li>• primarily</li><li>• basal ganglia</li><li>• cerebellum.</li><li>• Option C. The ventral anterior nucleus of the thalamus is also involved in motor functions . It receives inputs from the basal ganglia and is involved in the initiation and planning of movements . The mammillary bodies do not project to the ventral anterior nucleus.</li><li>• Option C.</li><li>• motor functions</li><li>• receives inputs</li><li>• basal ganglia</li><li>• initiation</li><li>• planning of movements</li><li>• Option D. The ventral posterolateral nucleus is involved in sensory processing , particularly conveying somatosensory information from the body to the sensory cortex . There is no direct projection from the mammillary bodies to the ventral posterolateral nucleus.</li><li>• Option D.</li><li>• sensory processing</li><li>• conveying somatosensory information</li><li>• body</li><li>• sensory cortex</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Nucleus : The anterior nucleus of the thalamus is part of the limbic system and is involved in memory and emotional responses . The mammillary bodies project to the anterior nucleus via the mammillothalamic tract . This connection is a key component of the Papez circuit , which is important in the formation of memory . Understand that the mammillary bodies project to the anterior nucleus of the thalamus, a key part of the Papez circuit involved in memory processing and emotional responses , distinguishing this connection from those involved in motor and sensory functions .</li><li>➤ Anterior Nucleus : The anterior nucleus of the thalamus is part of the limbic system and is involved in memory and emotional responses . The mammillary bodies project to the anterior nucleus via the mammillothalamic tract . This connection is a key component of the Papez circuit , which is important in the formation of memory .</li><li>➤ Anterior Nucleus</li><li>➤ limbic system</li><li>➤ involved</li><li>➤ memory</li><li>➤ emotional responses</li><li>➤ mammillary bodies</li><li>➤ anterior nucleus</li><li>➤ mammillothalamic tract</li><li>➤ key component</li><li>➤ Papez circuit</li><li>➤ formation of memory</li><li>➤ Understand that the mammillary bodies project to the anterior nucleus of the thalamus, a key part of the Papez circuit involved in memory processing and emotional responses , distinguishing this connection from those involved in motor and sensory functions .</li><li>➤ anterior nucleus</li><li>➤ Papez circuit</li><li>➤ memory processing</li><li>➤ emotional responses</li><li>➤ connection</li><li>➤ involved</li><li>➤ motor</li><li>➤ sensory functions</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 130, 232.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 130, 232.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male patient presents with a history of sudden onset of sensory disturbance. He complains of intense, burning pain and altered sensation on the left side of his body, including the face, arm, and leg. His medical history is significant for hypertension and diabetes mellitus. Neurological examination reveals mild hemiparesis on the left side and exaggerated pain response to light touch in the same areas. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Diabetic Neuropathy", "correct": false}, {"label": "B", "text": "Multiple Sclerosis", "correct": false}, {"label": "C", "text": "Thalamic Syndrome (Dejerine-Roussy Syndrome)", "correct": true}, {"label": "D", "text": "Peripheral Neuropathy", "correct": false}], "correct_answer": "C. Thalamic Syndrome (Dejerine-Roussy Syndrome)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Thalamic Syndrome (Dejerine-Roussy Syndrome)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Diabetic neuropathy typically presents as a distal symmetric polyneuropathy affecting the lower extremities , with sensory loss and sometimes burning pain , but it would not cause hemiparesis or localized sensory disturbances as described.</li><li>• Option A.</li><li>• distal symmetric polyneuropathy</li><li>• lower extremities</li><li>• sensory loss</li><li>• burning pain</li><li>• Option B . Multiple sclerosis could present with varied neurological symptoms , but the sudden onset of intense , burning pain and hemisensory disturbances with hemiparesis is less characteristic of multiple sclerosis.</li><li>• Option B</li><li>• varied neurological symptoms</li><li>• sudden onset</li><li>• intense</li><li>• burning pain</li><li>• hemisensory disturbances</li><li>• hemiparesis</li><li>• less characteristic</li><li>• Option D . Peripheral neuropathy typically involves sensory changes in a \"stocking-glove\" distribution and is not associated with central neurological signs like hemiparesis.</li><li>• Option D</li><li>• sensory changes</li><li>• \"stocking-glove\" distribution</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thalamic syndrome , or Dejerine-Roussy syndrome , occurs following a thalamic stroke . It is characterized by contralateral hemisensory loss , and patients often experience severe , persistent pain and unpleasant sensations ( thalamic pain ), which can be exacerbated by light touch . The presence of mild hemiparesis also supports a thalamic lesion. It should be suspected in patients who present with sudden onset of contralateral hemisensory loss , severe pain and unpleasant sensations following a light touch , and mild hemiparesis , as these are indicative of a thalamic lesion , often due to stroke.</li><li>➤ Thalamic syndrome , or Dejerine-Roussy syndrome , occurs following a thalamic stroke . It is characterized by contralateral hemisensory loss , and patients often experience severe , persistent pain and unpleasant sensations ( thalamic pain ), which can be exacerbated by light touch . The presence of mild hemiparesis also supports a thalamic lesion.</li><li>➤ Thalamic syndrome</li><li>➤ Dejerine-Roussy syndrome</li><li>➤ thalamic stroke</li><li>➤ contralateral hemisensory loss</li><li>➤ experience severe</li><li>➤ persistent pain</li><li>➤ unpleasant sensations</li><li>➤ thalamic pain</li><li>➤ exacerbated by light touch</li><li>➤ mild hemiparesis</li><li>➤ It should be suspected in patients who present with sudden onset of contralateral hemisensory loss , severe pain and unpleasant sensations following a light touch , and mild hemiparesis , as these are indicative of a thalamic lesion , often due to stroke.</li><li>➤ sudden onset</li><li>➤ contralateral hemisensory loss</li><li>➤ severe pain</li><li>➤ unpleasant sensations</li><li>➤ light touch</li><li>➤ mild hemiparesis</li><li>➤ indicative</li><li>➤ thalamic lesion</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 130.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 130.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following nerve fibre is present in the following marked structure?", "options": [{"label": "A", "text": "III", "correct": false}, {"label": "B", "text": "IV", "correct": true}, {"label": "C", "text": "V", "correct": false}, {"label": "D", "text": "VI", "correct": false}], "correct_answer": "B. IV", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture26_tCcI7b5.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Oculomotor nerve emerges from the ventral aspect of midbrain ( level of superior colliculus ) through the sulcus on the medial aspect of midbrain .</li><li>• Option A.</li><li>• emerges</li><li>• ventral aspect</li><li>• midbrain</li><li>• level of superior colliculus</li><li>• sulcus</li><li>• medial aspect of midbrain</li><li>• Option C. The fibers of the trigeminal nerve are attached to the ventral surface of upper pons by two roots , a small motor and a large sensory root .</li><li>• Option C.</li><li>• ventral surface</li><li>• upper pons</li><li>• two roots</li><li>• small motor</li><li>• large sensory root</li><li>• Option D. The abducent nerve emerges from the ventral surface of lower pons at the pontomedullary junction just lateral to midline .</li><li>• Option D.</li><li>• abducent nerve</li><li>• ventral surface</li><li>• lower pons</li><li>• pontomedullary junction</li><li>• lateral to midline</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Superior Medullary Velum:</li><li>• Superior Medullary Velum:</li><li>• The superior medullary velum is a thin layer of white matter located in the brainstem , at the level of the upper part of the fourth ventricle forming the roof of the fourth ventricle . It stretches between the two superior cerebellar peduncles , which are large bundles of fibers connecting the cerebellum to the midbrain . Conditions that cause pressure or distortion in the region of the fourth ventricle (like tumors, hemorrhages , or edema ) can impact the superior medullary velum and affect its function. Hydrocephalus , or the accumulation of cerebrospinal fluid in the brain's ventricles , can also affect the fourth ventricle and potentially impact the surrounding structures, including the superior medullary velum .</li><li>• The superior medullary velum is a thin layer of white matter located in the brainstem , at the level of the upper part of the fourth ventricle forming the roof of the fourth ventricle .</li><li>• thin layer</li><li>• white matter</li><li>• brainstem</li><li>• level</li><li>• upper part</li><li>• fourth ventricle</li><li>• roof of the fourth ventricle</li><li>• It stretches between the two superior cerebellar peduncles , which are large bundles of fibers connecting the cerebellum to the midbrain .</li><li>• two superior cerebellar peduncles</li><li>• large bundles</li><li>• fibers</li><li>• cerebellum</li><li>• midbrain</li><li>• Conditions that cause pressure or distortion in the region of the fourth ventricle (like tumors, hemorrhages , or edema ) can impact the superior medullary velum and affect its function.</li><li>• cause pressure</li><li>• distortion</li><li>• region</li><li>• fourth ventricle</li><li>• tumors, hemorrhages</li><li>• edema</li><li>• impact</li><li>• superior medullary velum</li><li>• affect</li><li>• Hydrocephalus , or the accumulation of cerebrospinal fluid in the brain's ventricles , can also affect the fourth ventricle and potentially impact the surrounding structures, including the superior medullary velum .</li><li>• Hydrocephalus</li><li>• accumulation</li><li>• cerebrospinal fluid</li><li>• brain's ventricles</li><li>• also affect</li><li>• fourth ventricle</li><li>• potentially impact</li><li>• superior medullary velum</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 74-85</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 74-85</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure’s compression results in the following visual field defect?", "options": [{"label": "A", "text": "Optic Nerve", "correct": false}, {"label": "B", "text": "Optic Chiasma Central Part", "correct": true}, {"label": "C", "text": "Optic Chiasm-Lateral Part", "correct": false}, {"label": "D", "text": "Optic Tract", "correct": false}], "correct_answer": "B. Optic Chiasma Central Part", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture27_xJo3i4A.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Optic Nerve: The optic nerve carries visual information from the retina to the optic chiasm .</li><li>• Option A.</li><li>• Optic Nerve:</li><li>• visual information</li><li>• retina</li><li>• optic chiasm</li><li>• A lesion in the optic nerve causes unilateral blindness or anopsia in the eye ipsilateral to the lesion. A lesion in the optic nerve would not cause bitemporal hemianopia.</li><li>• A lesion in the optic nerve causes unilateral blindness or anopsia in the eye ipsilateral to the lesion.</li><li>• unilateral blindness</li><li>• anopsia</li><li>• eye ipsilateral</li><li>• A lesion in the optic nerve would not cause bitemporal hemianopia.</li><li>• Option C . Optic Chiasm-Lateral Part: The lateral part of the optic chiasm contains uncrossed fibers .</li><li>• Option C</li><li>• . Optic Chiasm-Lateral Part:</li><li>• uncrossed fibers</li><li>• A lesion affecting the lateral part of the chiasm would lead to a junctional scotoma , which involves an ipsilateral central scotoma ( blind spot in the field of vision ) and contralateral superior temporal quadrantanopia . A lesion here would not typically result in bitemporal hemianopia.</li><li>• A lesion affecting the lateral part of the chiasm would lead to a junctional scotoma , which involves an ipsilateral central scotoma ( blind spot in the field of vision ) and contralateral superior temporal quadrantanopia .</li><li>• junctional scotoma</li><li>• ipsilateral central scotoma</li><li>• blind spot</li><li>• field of vision</li><li>• contralateral superior temporal quadrantanopia</li><li>• A lesion here would not typically result in bitemporal hemianopia.</li><li>• Optic D . Optic Tract: The optic tract carries visual information from the optic chiasm to the lateral geniculate nucleus of the thalamus.</li><li>• Optic D</li><li>• . Optic Tract:</li><li>• visual information</li><li>• optic chiasm</li><li>• lateral geniculate nucleus</li><li>• A lesion in the optic tract causes contralateral homonymous hemianopia ( loss of the same side of the visual field in both eyes ). A lesion in the optic tract would not cause bitemporal hemianopia.</li><li>• A lesion in the optic tract causes contralateral homonymous hemianopia ( loss of the same side of the visual field in both eyes ).</li><li>• contralateral homonymous hemianopia</li><li>• loss</li><li>• same side</li><li>• visual field</li><li>• both eyes</li><li>• A lesion in the optic tract would not cause bitemporal hemianopia.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that a lesion in the central part of the optic chiasm , such as from a pituitary tumor, leads to bitemporal heteronymous hemianopia, a condition characterized by the loss of the temporal visual field in both eyes. This contrasts with lesions in other parts of the optic pathway , which lead to different patterns of visual field loss .</li><li>➤ Understand that a lesion in the central part of the optic chiasm , such as from a pituitary tumor, leads to bitemporal heteronymous hemianopia, a condition characterized by the loss of the temporal visual field in both eyes. This contrasts with lesions in other parts of the optic pathway , which lead to different patterns of visual field loss .</li><li>➤ Understand</li><li>➤ lesion</li><li>➤ central part</li><li>➤ optic chiasm</li><li>➤ leads to bitemporal heteronymous hemianopia,</li><li>➤ characterized</li><li>➤ loss</li><li>➤ temporal visual field</li><li>➤ lesions</li><li>➤ optic pathway</li><li>➤ patterns</li><li>➤ visual field</li><li>➤ loss</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 214-216</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 214-216</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following mentioned is not a modification of which, the pointed structure in the given image is derived from?", "options": [{"label": "A", "text": "Filum Terminale", "correct": false}, {"label": "B", "text": "Cauda Equina", "correct": true}, {"label": "C", "text": "Subarachnoid Septum", "correct": false}, {"label": "D", "text": "Linea Splendens", "correct": false}], "correct_answer": "B. Cauda Equina", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture28_4OBKtzb.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A .</li><li>• Option A</li><li>• The filum terminale is a slender filament of connective tissue that extends from the tip of the conus medullaris (the tapered end of the spinal cord ) to the coccyx . It is a modification of the pia mater . It helps anchor the spinal cord within the spinal canal .</li><li>• The filum terminale is a slender filament of connective tissue that extends from the tip of the conus medullaris (the tapered end of the spinal cord ) to the coccyx . It is a modification of the pia mater .</li><li>• slender filament</li><li>• connective tissue</li><li>• tip</li><li>• conus medullaris</li><li>• tapered end</li><li>• spinal cord</li><li>• coccyx</li><li>• pia mater</li><li>• It helps anchor the spinal cord within the spinal canal .</li><li>• anchor</li><li>• spinal cord</li><li>• within</li><li>• spinal canal</li><li>• Option C.</li><li>• Option C.</li><li>• The subarachnoid septum is a delicate partition of pia mater that extends into the subarachnoid space of the spinal cord. It helps to subdivide and stabilize the subarachnoid space and is considered a modification of the spinal pia mater .</li><li>• The subarachnoid septum is a delicate partition of pia mater that extends into the subarachnoid space of the spinal cord.</li><li>• delicate partition</li><li>• pia mater</li><li>• extends</li><li>• subarachnoid space</li><li>• It helps to subdivide and stabilize the subarachnoid space and is considered a modification of the spinal pia mater .</li><li>• subdivide</li><li>• stabilize</li><li>• subarachnoid space</li><li>• modification</li><li>• spinal pia mater</li><li>• Option D .</li><li>• Option D</li><li>• The linea splendens is a thickened longitudinal band of pia mater that runs along the dorsal surface of the spinal cord . It provides additional support to the spinal cord and is a modification of the pia mater .</li><li>• The linea splendens is a thickened longitudinal band of pia mater that runs along the dorsal surface of the spinal cord .</li><li>• thickened longitudinal band</li><li>• pia mater</li><li>• along</li><li>• dorsal surface</li><li>• spinal cord</li><li>• It provides additional support to the spinal cord and is a modification of the pia mater .</li><li>• additional support</li><li>• spinal cord</li><li>• modification</li><li>• pia mater</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cauda Equina : The cauda equina is a bundle of spinal nerves and spinal nerve rootlets . It consists of the second to fifth lumbar nerve pairs , all sacral nerve pairs , and the coccygeal nerve .</li><li>➤ Cauda Equina</li><li>➤ bundle</li><li>➤ spinal nerves</li><li>➤ spinal nerve rootlets</li><li>➤ second to fifth lumbar nerve pairs</li><li>➤ sacral nerve pairs</li><li>➤ coccygeal nerve</li><li>➤ These nerves and rootlets resemble a horse's tail and provide motor and sensory function to the legs and the bladder . It is not a modification of the spinal pia mater , but rather a collection of nerve roots . Recognize that the cauda equina , a collection of nerve roots at the lower end of the vertebral canal , is not a modification of the spinal pia mater, in contrast to structures like the filum terminale, subarachnoid septum, and linea splendens, which are specialized adaptations of the pia mater associated with the spinal cord .</li><li>➤ These nerves and rootlets resemble a horse's tail and provide motor and sensory function to the legs and the bladder .</li><li>➤ nerves</li><li>➤ rootlets</li><li>➤ horse's tail</li><li>➤ provide motor</li><li>➤ sensory function</li><li>➤ legs</li><li>➤ bladder</li><li>➤ It is not a modification of the spinal pia mater , but rather a collection of nerve roots .</li><li>➤ not</li><li>➤ modification</li><li>➤ spinal pia mater</li><li>➤ collection of nerve roots</li><li>➤ Recognize that the cauda equina , a collection of nerve roots at the lower end of the vertebral canal , is not a modification of the spinal pia mater, in contrast to structures like the filum terminale, subarachnoid septum, and linea splendens, which are specialized adaptations of the pia mater associated with the spinal cord .</li><li>➤ cauda equina</li><li>➤ collection</li><li>➤ nerve roots</li><li>➤ lower end</li><li>➤ vertebral canal</li><li>➤ specialized adaptations</li><li>➤ pia mater</li><li>➤ spinal cord</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 52-53</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 52-53</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the lesion of spinal cord in the given image?", "options": [{"label": "A", "text": "Poliomyelitis", "correct": false}, {"label": "B", "text": "Tabes Dorsalis", "correct": false}, {"label": "C", "text": "Anterior Spinal Artery Occlusion Syndrome", "correct": false}, {"label": "D", "text": "Syringomyelia", "correct": true}], "correct_answer": "D. Syringomyelia", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture29_6IDdx0H.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture30_l0dlQ9J.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Poliomyelitis is a viral disease that affects the motor neurons of the anterior horn of the spinal cord , leading to muscle weakness and acute flaccid paralysis . On imaging, poliomyelitis would show atrophy or damage in the anterior horn regions of the spinal cord . However, the changes might not be distinct in the early stages of the disease.</li><li>• Poliomyelitis is a viral disease that affects the motor neurons of the anterior horn of the spinal cord , leading to muscle weakness and acute flaccid paralysis .</li><li>• viral disease</li><li>• motor neurons</li><li>• anterior horn</li><li>• spinal cord</li><li>• muscle weakness</li><li>• acute flaccid paralysis</li><li>• On imaging, poliomyelitis would show atrophy or damage in the anterior horn regions of the spinal cord . However, the changes might not be distinct in the early stages of the disease.</li><li>• atrophy</li><li>• damage</li><li>• anterior horn regions</li><li>• spinal cord</li><li>• Option B.</li><li>• Option B.</li><li>• Tabes dorsalis is a form of neurosyphilis that primarily affects the dorsal columns of the spinal cord , leading to impaired proprioception and locomotor ataxia . On imaging, tabes dorsalis typically shows degeneration or atrophy of the dorsal columns of the spinal cord .</li><li>• Tabes dorsalis is a form of neurosyphilis that primarily affects the dorsal columns of the spinal cord , leading to impaired proprioception and locomotor ataxia .</li><li>• neurosyphilis</li><li>• dorsal columns</li><li>• spinal cord</li><li>• impaired proprioception</li><li>• locomotor ataxia</li><li>• On imaging, tabes dorsalis typically shows degeneration or atrophy of the dorsal columns of the spinal cord .</li><li>• degeneration</li><li>• atrophy</li><li>• dorsal columns</li><li>• spinal cord</li><li>• Option C .</li><li>• Option C</li><li>• Anterior Spinal Artery Occlusion Syndrome occurs due to occlusion of the anterior spinal artery , leading to ischemia and infarction in the anterior two-thirds of the spinal cord. This results in loss of motor function, pain , and temperature sensation below the level of the lesion. Imaging would typically show an area of increased signal intensity in the anterior portion of the spinal cord on T2-weighted MRI images , consistent with infarction .</li><li>• Anterior Spinal Artery Occlusion Syndrome occurs due to occlusion of the anterior spinal artery , leading to ischemia and infarction in the anterior two-thirds of the spinal cord. This results in loss of motor function, pain , and temperature sensation below the level of the lesion.</li><li>• occlusion</li><li>• anterior spinal artery</li><li>• ischemia</li><li>• infarction</li><li>• anterior two-thirds</li><li>• loss</li><li>• motor function, pain</li><li>• temperature sensation</li><li>• Imaging would typically show an area of increased signal intensity in the anterior portion of the spinal cord on T2-weighted MRI images , consistent with infarction .</li><li>• area</li><li>• increased signal intensity</li><li>• anterior portion</li><li>• spinal cord</li><li>• T2-weighted MRI images</li><li>• infarction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize different spinal cord lesions based on imaging characteristics: poliomyelitis shows anterior horn damage, tabes dorsalis shows degeneration of the dorsal columns, anterior spinal artery occlusion syndrome shows infarction in the anterior spinal cord, and syringomyelia is characterized by a fluid-filled cavity within the spinal cord.</li><li>➤ Recognize different spinal cord lesions based on imaging characteristics: poliomyelitis shows anterior horn damage, tabes dorsalis shows degeneration of the dorsal columns, anterior spinal artery occlusion syndrome shows infarction in the anterior spinal cord, and syringomyelia is characterized by a fluid-filled cavity within the spinal cord.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg. 67-68</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg. 67-68</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which artery provides the blood supply to the structure indicated in the provided image?", "options": [{"label": "A", "text": "Middle Cerebral Artery", "correct": false}, {"label": "B", "text": "Internal Carotid Artery", "correct": false}, {"label": "C", "text": "Anterior Cerebral Artery", "correct": true}, {"label": "D", "text": "Vertebral Artery", "correct": false}], "correct_answer": "C. Anterior Cerebral Artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture31_FUmo8Cg.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture32.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Middle cerebral artery lodges over the posterior ramus of lateral sulcus and major source of blood supply on the superolateral surface .</li><li>• Option A</li><li>• posterior ramus</li><li>• lateral sulcus</li><li>• superolateral surface</li><li>• Option B . Internal carotid artery lies in the floor of cavernous sinus along with Abducent nerve , then it pierces the roof of cavernous sinus to supply the cerebral hemispheres .</li><li>• Option B</li><li>• floor</li><li>• cavernous sinus</li><li>• Abducent nerve</li><li>• pierces</li><li>• roof of cavernous sinus</li><li>• supply</li><li>• cerebral hemispheres</li><li>• Option D. The fourth part of vertebral artery enters cranial cavity through foramen magnum and the arteries of both sides unite to form basilar artery .</li><li>• Option D.</li><li>• cranial cavity</li><li>• foramen magnum</li><li>• arteries</li><li>• both sides</li><li>• basilar artery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Understand that while the anterior cerebral artery supplies parts of the medial brain and adjacent structures, the blood supply of the fornix is not exclusively dependent on the ACA and can involve various cerebral arteries. Knowledge of cerebral vasculature is crucial for localizing brain lesions and understanding their clinical manifestations.</li><li>• Understand that while the anterior cerebral artery supplies parts of the medial brain and adjacent structures, the blood supply of the fornix is not exclusively dependent on the ACA and can involve various cerebral arteries. Knowledge of cerebral vasculature is crucial for localizing brain lesions and understanding their clinical manifestations.</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 176-178</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 176-178</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures is related to Great cerebral vein of Galen in the given image?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture33.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Body of Lateral Ventricle: The lateral ventricles are the two largest cavities of the ventricular system in the brain and are located within the cerebral hemispheres . The body is the central part of each lateral ventricle.</li><li>• Option A</li><li>• . Body of Lateral Ventricle:</li><li>• two largest cavities</li><li>• ventricular system</li><li>• within</li><li>• cerebral hemispheres</li><li>• central part</li><li>• The lateral ventricles contain cerebrospinal fluid (CSF) and are lined with ependymal cells . They play a role in cushioning and supporting the brain, as well as in the circulation of CSF .</li><li>• The lateral ventricles contain cerebrospinal fluid (CSF) and are lined with ependymal cells . They play a role in cushioning and supporting the brain, as well as in the circulation of CSF .</li><li>• cerebrospinal fluid (CSF)</li><li>• lined with ependymal cells</li><li>• cushioning</li><li>• supporting</li><li>• circulation of CSF</li><li>• Option B. Interventricular Foramen of Monro: The interventricular foramen , also known as the foramen of Monro , is a channel that connects each lateral ventricle with the third ventricle .</li><li>• Option B.</li><li>• Interventricular Foramen of Monro:</li><li>• interventricular foramen</li><li>• foramen of Monro</li><li>• connects</li><li>• each lateral ventricle</li><li>• third ventricle</li><li>• This foramen allows the flow of CSF from the lateral ventricles to the third ventricle , and it is a key component of the CSF circulation pathway within the brain .</li><li>• This foramen allows the flow of CSF from the lateral ventricles to the third ventricle , and it is a key component of the CSF circulation pathway within the brain .</li><li>• flow of CSF</li><li>• lateral ventricles</li><li>• third ventricle</li><li>• key component</li><li>• CSF circulation pathway within the brain</li><li>• Option D. Fourth Ventricle: The fourth ventricle is part of the ventricular system located within the hindbrain . It lies anterior to the cerebellum and posterior to the pons and upper medulla .</li><li>• Option D.</li><li>• Fourth Ventricle:</li><li>• ventricular system</li><li>• hindbrain</li><li>• anterior</li><li>• cerebellum</li><li>• posterior</li><li>• pons</li><li>• upper medulla</li><li>• The cisterna magna, or cerebellomedullary cistern, is one of the largest subarachnoid cisterns . It lies behind the fourth ventricle , between the cerebellum and the dorsal surface of the medulla . It serves as a major reservoir of CSF . Cisternal puncture , a procedure to withdraw CSF for diagnostic purposes, is often performed in this area.</li><li>• The cisterna magna, or cerebellomedullary cistern, is one of the largest subarachnoid cisterns . It lies behind the fourth ventricle , between the cerebellum and the dorsal surface of the medulla .</li><li>• largest subarachnoid cisterns</li><li>• behind</li><li>• fourth ventricle</li><li>• cerebellum</li><li>• dorsal surface</li><li>• medulla</li><li>• It serves as a major reservoir of CSF . Cisternal puncture , a procedure to withdraw CSF for diagnostic purposes, is often performed in this area.</li><li>• major reservoir of CSF</li><li>• Cisternal puncture</li><li>• withdraw CSF</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Cisterna Ambiens/Superior Cistern : The cisterna ambiens, or superior cistern, is a subarachnoid space located between the splenium and the superior surface of the cerebellum.</li><li>➤ Cisterna Ambiens/Superior Cistern</li><li>➤ subarachnoid space</li><li>➤ splenium</li><li>➤ superior surface</li><li>➤ It contains important vascular structures, including the great cerebral vein of Galen . This cistern is an important landmark in neurosurgery , especially in procedures involving the posterior fossa or midbrain.</li><li>➤ It contains important vascular structures, including the great cerebral vein of Galen .</li><li>➤ great cerebral vein of Galen</li><li>➤ This cistern is an important landmark in neurosurgery , especially in procedures involving the posterior fossa or midbrain.</li><li>➤ important landmark</li><li>➤ neurosurgery</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 192-193</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 192-193</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following artery is not the branch of the pointed structure in the given image?", "options": [{"label": "A", "text": "Anterior Cerebral Artery", "correct": false}, {"label": "B", "text": "Posterior Communicating Artery", "correct": false}, {"label": "C", "text": "Posterior Choroid Artery", "correct": true}, {"label": "D", "text": "Superior Hypophyseal Artery", "correct": false}], "correct_answer": "C. Posterior Choroid Artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture34.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The ACA is indeed a branch of the internal carotid artery . It primarily supplies blood to the medial surfaces of the frontal and parietal lobes of the brain.</li><li>• Option A.</li><li>• branch</li><li>• internal carotid artery</li><li>• medial surfaces</li><li>• frontal</li><li>• parietal lobes</li><li>• Option B. The posterior communicating artery is a branch of the internal carotid artery . It forms part of the Circle of Willis by connecting the internal carotid artery system with the posterior cerebral artery , which is usually a branch of the basilar artery . This artery is important for providing collateral circulation between the anterior and posterior parts of the brain.</li><li>• Option B.</li><li>• branch</li><li>• internal carotid artery</li><li>• Circle of Willis</li><li>• internal carotid artery system</li><li>• posterior cerebral artery</li><li>• branch</li><li>• basilar artery</li><li>• providing collateral circulation</li><li>• anterior</li><li>• posterior parts</li><li>• Option D. The superior hypophyseal artery is a small branch of the internal carotid artery . It supplies blood to the pituitary gland , particularly its superior part . This artery is important for the vascular supply of the pituitary gland and surrounding structures.</li><li>• Option D.</li><li>• small branch</li><li>• internal carotid artery</li><li>• supplies blood</li><li>• pituitary gland</li><li>• superior part</li><li>• vascular supply</li><li>• pituitary gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior Choroid Artery : The posterior choroidal arteries are branches of the posterior cerebral artery , not the internal carotid artery. They supply blood to the choroid plexus of the third and lateral ventricles and to parts of the thalamus and midbrain. Recognize that the posterior choroid artery , a branch of the posterior cerebral artery , is not a branch of the internal carotid artery, unlike the anterior cerebral artery , posterior communicating artery , and superior hypophyseal artery , which are important branches of the internal carotid artery essential for cerebral circulation .</li><li>➤ Posterior Choroid Artery : The posterior choroidal arteries are branches of the posterior cerebral artery , not the internal carotid artery. They supply blood to the choroid plexus of the third and lateral ventricles and to parts of the thalamus and midbrain.</li><li>➤ Posterior Choroid Artery</li><li>➤ branches</li><li>➤ posterior cerebral artery</li><li>➤ supply blood</li><li>➤ choroid plexus</li><li>➤ third</li><li>➤ lateral ventricles</li><li>➤ thalamus</li><li>➤ midbrain.</li><li>➤ Recognize that the posterior choroid artery , a branch of the posterior cerebral artery , is not a branch of the internal carotid artery, unlike the anterior cerebral artery , posterior communicating artery , and superior hypophyseal artery , which are important branches of the internal carotid artery essential for cerebral circulation .</li><li>➤ posterior choroid artery</li><li>➤ posterior cerebral artery</li><li>➤ anterior cerebral artery</li><li>➤ posterior communicating artery</li><li>➤ superior hypophyseal artery</li><li>➤ important branches</li><li>➤ internal carotid artery</li><li>➤ cerebral circulation</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 174-176</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 174-176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the tributary of the great cerebral vein of Galen?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture35.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A .</li><li>• Option A</li><li>• Superficial Middle Cerebral Vein drains the lateral surface of the cerebral hemisphere and runs along the lateral sulcus . It typically drains into the cavernous sinus or the sphenoparietal sinus . The superficial middle cerebral vein is not a direct tributary of the great cerebral vein of Galen.</li><li>• Superficial Middle Cerebral Vein drains the lateral surface of the cerebral hemisphere and runs along the lateral sulcus . It typically drains into the cavernous sinus or the sphenoparietal sinus .</li><li>• lateral surface</li><li>• cerebral hemisphere</li><li>• lateral sulcus</li><li>• cavernous sinus</li><li>• sphenoparietal sinus</li><li>• The superficial middle cerebral vein is not a direct tributary of the great cerebral vein of Galen.</li><li>• Option C.</li><li>• Option C.</li><li>• The great cerebral vein of Galen is a large venous structure that drains blood from deep areas of the brain . It is not a tributary but rather the main vein that is formed by the confluence of its tributaries.</li><li>• The great cerebral vein of Galen is a large venous structure that drains blood from deep areas of the brain . It is not a tributary but rather the main vein that is formed by the confluence of its tributaries.</li><li>• large venous structure</li><li>• drains blood</li><li>• deep areas</li><li>• brain</li><li>• Option D.</li><li>• Option D.</li><li>• The straight sinus is a dural venous sinus situated within the dura mater of the brain. It is formed by the confluence of the great cerebral vein of Galen and the inferior sagittal sinus . The great cerebral vein of Galen drains into the straight sinus; hence, the straight sinus is not a tributary but a drainage pathway for the great cerebral vein of Galen.</li><li>• The straight sinus is a dural venous sinus situated within the dura mater of the brain. It is formed by the confluence of the great cerebral vein of Galen and the inferior sagittal sinus .</li><li>• dural venous sinus</li><li>• dura mater</li><li>• confluence</li><li>• great cerebral vein</li><li>• Galen</li><li>• inferior sagittal sinus</li><li>• The great cerebral vein of Galen drains into the straight sinus; hence, the straight sinus is not a tributary but a drainage pathway for the great cerebral vein of Galen.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Basal Vein of Rosenthal :</li><li>➤ Basal Vein of Rosenthal</li><li>➤ The basal vein of Rosenthal is a significant vein in the brain that drains the deep structures of the cerebral hemispheres , including parts of the basal ganglia, diencephalon , and midbrain . It is one of the tributaries of the great cerebral vein of Galen . Understand that the basal vein of Rosenthal is a tributary of the great cerebral vein of Galen , which is a major venous channel in the brain that drains into the straight sinus . Recognizing the tributaries and drainage pathways of the cerebral veins is crucial for understanding cerebral venous circulation and its clinical implications.</li><li>➤ The basal vein of Rosenthal is a significant vein in the brain that drains the deep structures of the cerebral hemispheres , including parts of the basal ganglia, diencephalon , and midbrain .</li><li>➤ significant vein</li><li>➤ drains</li><li>➤ deep structures</li><li>➤ cerebral hemispheres</li><li>➤ basal ganglia, diencephalon</li><li>➤ midbrain</li><li>➤ It is one of the tributaries of the great cerebral vein of Galen . Understand that the basal vein of Rosenthal is a tributary of the great cerebral vein of Galen , which is a major venous channel in the brain that drains into the straight sinus .</li><li>➤ one</li><li>➤ tributaries</li><li>➤ great cerebral vein</li><li>➤ Galen</li><li>➤ basal vein</li><li>➤ tributary</li><li>➤ great cerebral vein</li><li>➤ Galen</li><li>➤ major venous channel</li><li>➤ straight sinus</li><li>➤ Recognizing the tributaries and drainage pathways of the cerebral veins is crucial for understanding cerebral venous circulation and its clinical implications.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 180-182</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 180-182</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the marked structures, if injured, would result in Contralateral Hemiplegia?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture36.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Mammillary Body:</li><li>• Option A. Mammillary Body:</li><li>• The mammillary bodies are part of the hypothalamus and are involved in memory and emotional responses . Injury to the mammillary bodies can lead to memory disorders , such as Korsakoff syndrome , but it does not cause hemiplegia.</li><li>• The mammillary bodies are part of the hypothalamus and are involved in memory and emotional responses .</li><li>• part</li><li>• hypothalamus</li><li>• memory</li><li>• emotional responses</li><li>• Injury to the mammillary bodies can lead to memory disorders , such as Korsakoff syndrome , but it does not cause hemiplegia.</li><li>• memory disorders</li><li>• Korsakoff syndrome</li><li>• Option B. Substantia Nigra:</li><li>• Option B. Substantia Nigra:</li><li>• Substantia Nigra, located in the midbrain , plays a critical role in movement control and is involved in the production of dopamine . Degeneration of neurons in the substantia nigra is a hallmark of Parkinson's disease , which leads to motor symptoms like tremors, rigidity , and bradykinesia . However, it does not directly cause hemiplegia.</li><li>• Substantia Nigra, located in the midbrain , plays a critical role in movement control and is involved in the production of dopamine .</li><li>• midbrain</li><li>• movement control</li><li>• production of dopamine</li><li>• Degeneration of neurons in the substantia nigra is a hallmark of Parkinson's disease , which leads to motor symptoms like tremors, rigidity , and bradykinesia . However, it does not directly cause hemiplegia.</li><li>• hallmark</li><li>• Parkinson's disease</li><li>• leads</li><li>• motor symptoms</li><li>• tremors, rigidity</li><li>• bradykinesia</li><li>• Option C . Optic Tract:</li><li>• Option C</li><li>• Optic Tract:</li><li>• The optic tract carries visual information from the retina to the occipital lobe . Damage to the optic tract leads to visual field defects ( contralateral homonymous hemianopia ) but does not cause hemiplegia.</li><li>• The optic tract carries visual information from the retina to the occipital lobe .</li><li>• visual information</li><li>• retina</li><li>• occipital lobe</li><li>• Damage to the optic tract leads to visual field defects ( contralateral homonymous hemianopia ) but does not cause hemiplegia.</li><li>• Damage</li><li>• optic tract</li><li>• visual field defects</li><li>• contralateral homonymous hemianopia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Crus Cerebri : The crus cerebri, part of the cerebral peduncles , contains the corticospinal tracts , which carry motor signals from the brain to the spinal cord .</li><li>➤ Crus Cerebri</li><li>➤ cerebral peduncles</li><li>➤ corticospinal tracts</li><li>➤ carry</li><li>➤ motor signals</li><li>➤ brain</li><li>➤ spinal cord</li><li>➤ Injury to the crus cerebri, especially the corticospinal fibers within it, can lead to contralateral hemiplegia . This is because the motor fibers originating from the cerebral cortex decussate ( cross over ) in the medulla , leading to control of the opposite side of the body. This contrasts with the mammillary bodies , substantia nigra , and optic tract , which, when injured, lead to memory deficits , Parkinsonian symptoms, and visual field defects , respectively.</li><li>➤ Injury to the crus cerebri, especially the corticospinal fibers within it, can lead to contralateral hemiplegia . This is because the motor fibers originating from the cerebral cortex decussate ( cross over ) in the medulla , leading to control of the opposite side of the body.</li><li>➤ corticospinal fibers</li><li>➤ contralateral hemiplegia</li><li>➤ motor fibers</li><li>➤ cerebral cortex decussate</li><li>➤ cross over</li><li>➤ medulla</li><li>➤ control</li><li>➤ opposite side</li><li>➤ This contrasts with the mammillary bodies , substantia nigra , and optic tract , which, when injured, lead to memory deficits , Parkinsonian symptoms, and visual field defects , respectively.</li><li>➤ mammillary bodies</li><li>➤ substantia nigra</li><li>➤ optic tract</li><li>➤ memory deficits</li><li>➤ Parkinsonian symptoms,</li><li>➤ visual field defects</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg82- 87, 232</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg82- 87, 232</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old woman presents with a sudden, severe headache followed by loss of consciousness. She has a past medical history of hypertension. A CT scan shows subarachnoid hemorrhage. Angiography is most likely to show an aneurysm in which component of the Circle of Willis?", "options": [{"label": "A", "text": "Anterior Cerebral Artery", "correct": false}, {"label": "B", "text": "Anterior Communicating Artery", "correct": true}, {"label": "C", "text": "Posterior Cerebral Artery", "correct": false}, {"label": "D", "text": "Posterior Communicating Artery", "correct": false}], "correct_answer": "B. Anterior Communicating Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture46.jpg"], "explanation": "<p><strong>Ans. B) Anterior Communicating Artery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterior cerebral artery aneurysms can occur but are less commonly associated with subarachnoid hemorrhage compared to aneurysms in the posterior communicating artery.</li><li>• Option A.</li><li>• less commonly</li><li>• Option C. Posterior cerebral artery aneurysms are less commonly a source of subarachnoid hemorrhage when compared to the posterior communicating artery.</li><li>• Option C.</li><li>• less commonly</li><li>• Option D . Posterior communicating artery aneurysms are common site that can lead to subarachnoid hemorrhage; however it is seen in 30-35% of cases .</li><li>• Option D</li><li>• subarachnoid hemorrhage;</li><li>• 30-35% of cases</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Anterior communicating artery aneurysms are a common site of aneurysms that can lead to subarachnoid hemorrhage . They are more often associated with bitemporal hemianopia due to the close proximity to the optic chiasm . Saccular aneurysms occur at the bifurcations of the large – to medium - sized intracranial arteries : rupture into the subarachnoid space in the basal cisterns and sometimes into the parenchyma of the adjacent brain . Approximately 85% of the aneurysm occur in the anterior circulation , mostly on the circle of willis . The sudden \"thunderclap\" headache followed by loss of consciousness is a classic presentation of subarachnoid hemorrhage due to rupture of such an aneurysm. Recognizing the clinical presentation and common locations for aneurysms is important for the prompt diagnosis and treatment of this condition.</li><li>➤ Anterior communicating artery aneurysms are a common site of aneurysms that can lead to subarachnoid hemorrhage . They are more often associated with bitemporal hemianopia due to the close proximity to the optic chiasm .</li><li>➤ subarachnoid hemorrhage</li><li>➤ bitemporal hemianopia</li><li>➤ close proximity</li><li>➤ optic chiasm</li><li>➤ Saccular aneurysms occur at the bifurcations of the large – to medium - sized intracranial arteries : rupture into the subarachnoid space in the basal cisterns and sometimes into the parenchyma of the adjacent brain . Approximately 85% of the aneurysm occur in the anterior circulation , mostly on the circle of willis .</li><li>➤ Saccular aneurysms</li><li>➤ large – to medium - sized intracranial arteries</li><li>➤ subarachnoid space</li><li>➤ basal cisterns</li><li>➤ parenchyma</li><li>➤ adjacent brain</li><li>➤ 85% of the aneurysm</li><li>➤ anterior circulation</li><li>➤ circle of willis</li><li>➤ The sudden \"thunderclap\" headache followed by loss of consciousness is a classic presentation of subarachnoid hemorrhage due to rupture of such an aneurysm.</li><li>➤ \"thunderclap\" headache</li><li>➤ loss of consciousness</li><li>➤ subarachnoid hemorrhage</li><li>➤ rupture</li><li>➤ Recognizing the clinical presentation and common locations for aneurysms is important for the prompt diagnosis and treatment of this condition.</li><li>➤ Ref : Harrison’s: principles of internal medicine, 21 st edition pg 3353.</li><li>➤ Ref : Harrison’s: principles of internal medicine, 21 st edition pg 3353.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements best describes the function of the grey rami communicantes in the autonomic nervous system?", "options": [{"label": "A", "text": "They carry preganglionic parasympathetic fibers to the visceral organs.", "correct": false}, {"label": "B", "text": "They contain postganglionic sympathetic fibers that innervate sweat glands.", "correct": true}, {"label": "C", "text": "They transmit preganglionic sympathetic fibers from the spinal cord to the sympathetic chain ganglia.", "correct": false}, {"label": "D", "text": "They carry sensory information from the periphery to the spinal cord.", "correct": false}], "correct_answer": "B. They contain postganglionic sympathetic fibers that innervate sweat glands.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Preganglionic parasympathetic fibers typically originate in the brainstem or the sacral spinal cord ( S2-S4 ) and travel to ganglia close to or within the target organs . Grey rami communicantes do not carry these fibers.</li><li>• Option A</li><li>• originate</li><li>• brainstem</li><li>• sacral spinal cord</li><li>• S2-S4</li><li>• ganglia close</li><li>• within the target organs</li><li>• Option C. Preganglionic sympathetic fibers travel from the spinal cord to the sympathetic chain ganglia through the white rami communicantes , not the grey rami communicantes.</li><li>• Option C.</li><li>• spinal cord</li><li>• sympathetic chain ganglia</li><li>• white rami communicantes</li><li>• Option D. Sensory information from the periphery travels to the spinal cord through the dorsal roots of the spinal nerves , not through the grey rami communicantes.</li><li>• Option D.</li><li>• periphery travels</li><li>• spinal cord</li><li>• dorsal roots</li><li>• spinal nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that grey rami communicantes contain postganglionic sympathetic fibers returning from the sympathetic chain ganglia to the spinal nerves , which innervate targets such as sweat glands, piloerector muscles, and blood vessels in the skin and skeletal muscles. This is distinct from the function of white rami communicantes and the pathways for parasympathetic and sensory fibers .</li><li>➤ Understand that grey rami communicantes contain postganglionic sympathetic fibers returning from the sympathetic chain ganglia to the spinal nerves , which innervate targets such as sweat glands, piloerector muscles, and blood vessels in the skin and skeletal muscles. This is distinct from the function of white rami communicantes and the pathways for parasympathetic and sensory fibers .</li><li>➤ grey rami communicantes</li><li>➤ postganglionic sympathetic fibers</li><li>➤ sympathetic chain ganglia</li><li>➤ spinal nerves</li><li>➤ innervate targets</li><li>➤ function of white rami communicantes</li><li>➤ pathways</li><li>➤ parasympathetic</li><li>➤ sensory fibers</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 23.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 23.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with a loss of fine touch and proprioception on the left side of his body. A lesion in which of the following structures is most likely responsible for the decussation of the fibers that form the medial lemniscus and account for this patient's deficits?", "options": [{"label": "A", "text": "Anterior White Commissure", "correct": false}, {"label": "B", "text": "Internal Arcuate Fibers", "correct": true}, {"label": "C", "text": "Lateral Corticospinal Tract", "correct": false}, {"label": "D", "text": "Spinocerebellar Tract", "correct": false}], "correct_answer": "B. Internal Arcuate Fibers", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Internal Arcuate Fibers</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The anterior white commissure is where the spinothalamic tract fibers cross the midline . While these fibers carry pain and temperature information , they are not involved in the formation of the medial lemniscus.</li><li>• Option A.</li><li>• spinothalamic tract fibers</li><li>• cross the midline</li><li>• carry pain</li><li>• temperature information</li><li>• Option C . The lateral corticospinal tract is involved in the voluntary motor control pathway , carrying motor signals from the cerebral cortex to the spinal cord , and its lesion would result in motor deficits rather than sensory loss.</li><li>• Option C</li><li>• voluntary motor control pathway</li><li>• carrying motor signals</li><li>• cerebral cortex</li><li>• spinal cord</li><li>• result</li><li>• motor deficits</li><li>• Option D. The spinocerebellar tract carries proprioceptive information to the cerebellum for the coordination of movement , but it is not involved in the conscious perception of proprioception and fine touch and does not contribute to the formation of the medial lemniscus.</li><li>• Option D.</li><li>• proprioceptive information</li><li>• cerebellum</li><li>• coordination</li><li>• movement</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that the decussation of the internal arcuate fibers in the medulla oblongata forms the medial lemniscus , which is responsible for carrying fine touch and proprioceptive information to the contralateral thalamus . Damage to these fibers can lead to loss of these sensations on the opposite side of the body.</li><li>➤ internal arcuate fibers</li><li>➤ medulla oblongata</li><li>➤ medial lemniscus</li><li>➤ responsible</li><li>➤ carrying</li><li>➤ fine touch</li><li>➤ proprioceptive information</li><li>➤ contralateral thalamus</li><li>➤ lead to loss</li><li>➤ sensations</li><li>➤ opposite side</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-65.</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-65.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old male is brought to the emergency department following a motorcycle accident. He was initially conscious and alert at the scene but has become increasingly drowsy over the past hour. His Glasgow Coma Scale score is 13. A CT scan of the head shows a biconvex, lens-shaped hematoma that does not cross suture lines. Which of the following is the most likely source of bleeding in this patient?", "options": [{"label": "A", "text": "Rupture of Bridging Veins", "correct": false}, {"label": "B", "text": "Rupture of the Middle Meningeal Artery", "correct": true}, {"label": "C", "text": "Rupture of Cerebral Veins", "correct": false}, {"label": "D", "text": "Rupture of the Anterior Cerebral Artery", "correct": false}], "correct_answer": "B. Rupture of the Middle Meningeal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture44.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture45.jpg"], "explanation": "<p><strong>Ans. B) Rupture of the Middle Meningeal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Rupture of bridging veins typically causes a subdural hematoma , which appears as a crescent-shaped collection crossing suture lines on CT.</li><li>• Option A</li><li>• subdural hematoma</li><li>• crescent-shaped</li><li>• crossing suture lines</li><li>• Option C . Rupture of cerebral veins can also lead to subdural hematoma but is not typically associated with a biconvex, lens-shaped hematoma on CT.</li><li>• Option C</li><li>• subdural hematoma</li><li>• Option D . Rupture of the anterior cerebral artery is more likely to cause subarachnoid or intraparenchymal hemorrhage , not an extradural hemorrhage.</li><li>• Option D</li><li>• subarachnoid</li><li>• intraparenchymal hemorrhage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Rupture of the middle meningeal artery is the most common cause of extradural hemorrhage (also known as epidural hemorrhage ), which is indicated by a biconvex , lens-shaped hematoma that does not cross suture lines. This condition is often associated with a history of trauma , particularly skull fractures .</li><li>➤ most common cause</li><li>➤ extradural hemorrhage</li><li>➤ epidural hemorrhage</li><li>➤ biconvex</li><li>➤ lens-shaped hematoma</li><li>➤ history of trauma</li><li>➤ skull fractures</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 173.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 173.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with difficulty in processing and interpreting sounds, despite having normal hearing tests. A lesion in which of the following brain region is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Broca's Area", "correct": false}, {"label": "B", "text": "Heschl's Gyrus", "correct": true}, {"label": "C", "text": "Wernicke's Area", "correct": false}, {"label": "D", "text": "Angular Gyrus", "correct": false}], "correct_answer": "B. Heschl's Gyrus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture49.jpg"], "explanation": "<p><strong>Ans. B) Heschl's Gyrus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Broca's area , located in the frontal lobe , is involved in the production of speech . A lesion here typically causes expressive aphasia , where patients have difficulty with speech production , but their understanding of language is intact .</li><li>• Option A</li><li>• Broca's area</li><li>• frontal lobe</li><li>• production of speech</li><li>• causes expressive aphasia</li><li>• difficulty with speech production</li><li>• understanding of language</li><li>• intact</li><li>• Option C . Wernicke's area , located in the posterior part of the superior temporal gyrus , is involved in language comprehension . A lesion here would typically result in receptive aphasia , where patients can speak fluently but have difficulty understanding language .</li><li>• Option C</li><li>• Wernicke's area</li><li>• posterior part</li><li>• superior temporal gyrus</li><li>• language comprehension</li><li>• typically result</li><li>• receptive aphasia</li><li>• speak fluently</li><li>• difficulty understanding language</li><li>• Option D . The Angular gyrus , located in the parietal lobe , is involved in processing language , numbers , and spatial cognition . While a lesion here can affect language function , it is not typically associated with difficulties in processing sounds.</li><li>• Option D</li><li>• Angular gyrus</li><li>• parietal lobe</li><li>• processing language</li><li>• numbers</li><li>• spatial cognition</li><li>• affect language function</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that a lesion in Heschl's gyrus, part of the primary auditory cortex , can lead to difficulties in processing and interpreting sounds without affecting the actual hearing ability, distinguishing it from lesions in language areas such as Broca's and Wernicke's areas or the angular gyrus.</li><li>➤ Recognize that a lesion in Heschl's gyrus, part of the primary auditory cortex , can lead to difficulties in processing and interpreting sounds without affecting the actual hearing ability, distinguishing it from lesions in language areas such as Broca's and Wernicke's areas or the angular gyrus.</li><li>➤ primary auditory cortex</li><li>➤ lead</li><li>➤ difficulties</li><li>➤ processing</li><li>➤ interpreting sounds</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 144.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 144.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is studying the relationship between cranial nerves and the ventricles of the brain. Which ventricle is most closely associated with the exit points of the sixth, eighth, tenth, and twelfth cranial nerves?", "options": [{"label": "A", "text": "Lateral Ventricle", "correct": false}, {"label": "B", "text": "Third Ventricle", "correct": false}, {"label": "C", "text": "Fourth Ventricle", "correct": true}, {"label": "D", "text": "Cerebral Aqueduct", "correct": false}], "correct_answer": "C. Fourth Ventricle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture52.jpg"], "explanation": "<p><strong>Ans. C) Fourth ventricle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The lateral ventricles are located in the cerebral hemispheres and are not directly associated with the exit points of the cranial nerves mentioned.</li><li>• Option A.</li><li>• cerebral hemispheres</li><li>• Option B. The third ventricle is located within the diencephalon , primarily between the two thalami , and does not have a direct relationship with the exit points of these cranial nerves.</li><li>• Option B.</li><li>• diencephalon</li><li>• between</li><li>• two thalami</li><li>• Option D . The cerebral aqueduct ( aqueduct of Sylvius ) connects the third and fourth ventricles but is a narrow channel that doesn't directly relate to the exit points of these cranial nerves.</li><li>• Option D</li><li>• aqueduct of Sylvius</li><li>• third</li><li>• fourth ventricles</li><li>• narrow channel</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that the fourth ventricle , located in the brainstem , is closely associated with the exit points of the sixth (Abducens ), eighth (Vestibulocochlear ), tenth (Vagus ), and twelfth (Hypoglossal ) cranial nerves, reflecting its importance in brainstem neuroanatomy .</li><li>➤ Understand that the fourth ventricle , located in the brainstem , is closely associated with the exit points of the sixth (Abducens ), eighth (Vestibulocochlear ), tenth (Vagus ), and twelfth (Hypoglossal ) cranial nerves, reflecting its importance in brainstem neuroanatomy .</li><li>➤ fourth ventricle</li><li>➤ brainstem</li><li>➤ closely associated</li><li>➤ exit points</li><li>➤ sixth (Abducens</li><li>➤ eighth (Vestibulocochlear</li><li>➤ tenth (Vagus</li><li>➤ twelfth (Hypoglossal</li><li>➤ importance</li><li>➤ brainstem neuroanatomy</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 111.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 111.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a lecture on embryology, a medical student learns that the retina develops from a specific part of the embryonic brain. This knowledge is important for understanding congenital disorders of the eye. The retina is considered an outgrowth of which part of the embryonic brain?", "options": [{"label": "A", "text": "Mesencephalon (Midbrain)", "correct": false}, {"label": "B", "text": "Telencephalon", "correct": false}, {"label": "C", "text": "Diencephalon", "correct": true}, {"label": "D", "text": "Metencephalon", "correct": false}], "correct_answer": "C. Diencephalon", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Diencephalon.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The mesencephalon, or midbrain, gives rise to structures such as the cerebral peduncles and the corpora quadrigemina (including the superior and inferior colliculi ), but it does not give rise to the retina.</li><li>• Option A.</li><li>• gives rise to structures</li><li>• cerebral peduncles</li><li>• corpora quadrigemina</li><li>• superior</li><li>• inferior colliculi</li><li>• Option B . The telencephalon gives rise to the cerebral hemispheres, including the cortex and basal ganglia , but not to the retina.</li><li>• Option B</li><li>• cerebral hemispheres,</li><li>• cortex</li><li>• basal ganglia</li><li>• Option D. The metencephalon develops into the pons and the cerebellum , and it is not involved in the development of the retina.</li><li>• Option D.</li><li>• pons</li><li>• cerebellum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that the retina is an embryological outgrowth of the diencephalon , originating from the optic vesicles . This understanding is crucial for comprehending the developmental relationship between the eye and the brain , particularly in the context of congenital eye disorders .</li><li>➤ Recognize that the retina is an embryological outgrowth of the diencephalon , originating from the optic vesicles .</li><li>➤ retina</li><li>➤ embryological outgrowth</li><li>➤ diencephalon</li><li>➤ optic vesicles</li><li>➤ This understanding is crucial for comprehending the developmental relationship between the eye and the brain , particularly in the context of congenital eye disorders .</li><li>➤ developmental relationship</li><li>➤ eye</li><li>➤ brain</li><li>➤ context of congenital eye disorders</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 6-7.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 6-7.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn is diagnosed with meningomyelocele. Which of the following is a common clinical feature associated with this condition?", "options": [{"label": "A", "text": "No neurological deficits and intact skin over the spinal defect", "correct": false}, {"label": "B", "text": "Protrusion of meninges and spinal cord through a spinal defect, with associated neurological deficits", "correct": true}, {"label": "C", "text": "Herniation of cerebellar tonsils into the foramen magnum, leading to hydrocephalus", "correct": false}, {"label": "D", "text": "Bony defect in the spine without protrusion of the spinal cord or meninges", "correct": false}], "correct_answer": "B. Protrusion of meninges and spinal cord through a spinal defect, with associated neurological deficits", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture51.jpg"], "explanation": "<p><strong>Ans. B. Protrusion of meninges and spinal cord through a spinal defect, with associated neurological deficits.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . This description matches spina bifida occulta , a mild form of spina bifida where there is a bony defect without herniation of the spinal cord or meninges, typically not associated with neurological deficits.</li><li>• Option A</li><li>• matches spina bifida occulta</li><li>• mild form</li><li>• spina bifida</li><li>• bony defect</li><li>• Option C. Herniation of cerebellar tonsils into the foramen magnum describes a Chiari malformation , which can lead to hydrocephalus and other neurological symptoms, but it is not related to meningomyelocele.</li><li>• Option C.</li><li>• Chiari malformation</li><li>• hydrocephalus</li><li>• Option D . A bony defect in the spine without protrusion of the spinal cord or meninges describes spina bifida occulta , which is usually asymptomatic.</li><li>• Option D</li><li>• spina bifida occulta</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that meningomyelocele is a severe form of spina bifida where both the meninges and spinal cord protrude through a defect in the spine, often resulting in significant neurological deficits . This is different from other forms of spina bifida , such as spina bifida occulta, which is usually asymptomatic , and Chiari malformation .</li><li>➤ Understand that meningomyelocele is a severe form of spina bifida where both the meninges and spinal cord protrude through a defect in the spine, often resulting in significant neurological deficits . This is different from other forms of spina bifida , such as spina bifida occulta, which is usually asymptomatic , and Chiari malformation .</li><li>➤ severe form of spina bifida</li><li>➤ both the meninges</li><li>➤ spinal cord protrude</li><li>➤ defect</li><li>➤ resulting</li><li>➤ significant neurological deficits</li><li>➤ other forms of spina bifida</li><li>➤ usually asymptomatic</li><li>➤ Chiari malformation</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 67.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 67.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with a sudden onset of ataxia and difficulty coordinating his movements. A magnetic resonance imaging (MRI) scan reveals a lesion in the cerebellum. Which of the following structures, if involved by the lesion, is primarily responsible for conveying efferent signals from the cerebellum to the midbrain and thalamus?", "options": [{"label": "A", "text": "Inferior Cerebellar Peduncle", "correct": false}, {"label": "B", "text": "Middle Cerebellar Peduncle", "correct": false}, {"label": "C", "text": "Superior Cerebellar Peduncle", "correct": true}, {"label": "D", "text": "Medial Longitudinal Fasciculus", "correct": false}], "correct_answer": "C. Superior Cerebellar Peduncle", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Superior Cerebellar Peduncle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The inferior cerebellar peduncle primarily carries afferent fibers to the cerebellum from the spinal cord and medulla , not efferent fibers from the cerebellum.</li><li>• Option A</li><li>• afferent fibers</li><li>• cerebellum</li><li>• spinal cord</li><li>• medulla</li><li>• Option B . The middle cerebellar peduncle is the largest cerebellar peduncle and carries afferent fibers from the contralateral pontine nuclei to the cerebellum . It is involved in the coordination of movement but does not convey efferent signals from the cerebellum.</li><li>• Option B</li><li>• largest cerebellar peduncle</li><li>• afferent fibers</li><li>• contralateral pontine nuclei</li><li>• cerebellum</li><li>• coordination</li><li>• movement</li><li>• Option D. The medial longitudinal fasciculus is a neural tract that runs up and down the brainstem and is involved in coordinating eye movements and head movements , not primarily conveying cerebellar efferents.</li><li>• Option D.</li><li>• neural tract</li><li>• runs up</li><li>• down</li><li>• brainstem</li><li>• coordinating eye movements</li><li>• head movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior cerebellar peduncle is the main pathway for efferent signals from the cerebellum to the midbrain and thalamus , crucial for the regulation and coordination of movement. Damage to this structure can result in ataxia and coordination difficulties .</li><li>➤ The superior cerebellar peduncle is the main pathway for efferent signals from the cerebellum to the midbrain and thalamus , crucial for the regulation and coordination of movement. Damage to this structure can result in ataxia and coordination difficulties .</li><li>➤ main pathway</li><li>➤ efferent signals</li><li>➤ cerebellum</li><li>➤ midbrain</li><li>➤ thalamus</li><li>➤ regulation</li><li>➤ coordination</li><li>➤ Damage</li><li>➤ result</li><li>➤ ataxia</li><li>➤ coordination difficulties</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 83-85.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 83-85.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn is diagnosed with craniorachischisis shortly after birth. This condition is characterized by which of the following features?", "options": [{"label": "A", "text": "Complete closure of the neural tube with minor vertebral anomalies", "correct": false}, {"label": "B", "text": "Partial closure of the neural tube with the spinal cord exposed in the lumbar region", "correct": false}, {"label": "C", "text": "Complete closure of the neural tube with ventricular enlargement", "correct": false}, {"label": "D", "text": "Complete failure of neural tube closure resulting in an exposed spinal cord and brain", "correct": true}], "correct_answer": "D. Complete failure of neural tube closure resulting in an exposed spinal cord and brain", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture50.jpg"], "explanation": "<p><strong>Ans. D) Complete failure of neural tube closure resulting in an exposed spinal cord and brain.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option A . Complete closure of the neural tube with minor vertebral anomalies describes a less severe neural tube defect , such as spina bifida occulta , not craniorachischisis.</li><li>• Option A</li><li>• less severe neural tube defect</li><li>• spina bifida occulta</li><li>• Option B . Partial closure of the neural tube with the spinal cord exposed in the lumbar region describes spina bifida with myelomeningocele, a condition where the spinal cord and its coverings protrude through an opening in the spine .</li><li>• Option B</li><li>• spina bifida with myelomeningocele,</li><li>• spinal cord</li><li>• coverings protrude</li><li>• opening</li><li>• spine</li><li>• Option C . Complete closure of the neural tube with ventricular enlargement could describe a condition like hydrocephalus , but this is not consistent with craniorachischisis.</li><li>• Option C</li><li>• condition like hydrocephalus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that craniorachischisis is a severe and rare neural tube defect characterized by the complete failure of the neural tube to close , resulting in the exposure of both the brain and spinal cord . This is distinct from other neural tube defects like spina bifida occulta , myelomeningocele , or hydrocephalus .</li><li>➤ Understand that craniorachischisis is a severe and rare neural tube defect characterized by the complete failure of the neural tube to close , resulting in the exposure of both the brain and spinal cord .</li><li>➤ severe</li><li>➤ rare neural tube defect</li><li>➤ complete failure</li><li>➤ neural tube to close</li><li>➤ exposure</li><li>➤ both the brain</li><li>➤ spinal cord</li><li>➤ This is distinct from other neural tube defects like spina bifida occulta , myelomeningocele , or hydrocephalus .</li><li>➤ spina bifida occulta</li><li>➤ myelomeningocele</li><li>➤ hydrocephalus</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 2.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 2.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old male with a history of hypertension presents with acute onset of right-sided weakness. Examination reveals ptosis and mydriasis on the right side, as well as a right-sided loss of proprioception. His left side shows a loss of pain and temperature sensation. MRI shows an infarct in the midbrain. This constellation of findings is most consistent with which of the following syndromes?", "options": [{"label": "A", "text": "Weber's Syndrome", "correct": true}, {"label": "B", "text": "Claude's Syndrome", "correct": false}, {"label": "C", "text": "Benedikt's Syndrome", "correct": false}, {"label": "D", "text": "Wallenberg's Syndrome", "correct": false}], "correct_answer": "A. Weber's Syndrome", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture5.jpg"], "explanation": "<p><strong>Ans. A) Weber's syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Claude's syndrome combines features of both oculomotor nerve palsy (like in Weber’s syndrome ) and cerebellar ataxia (not described in the patient's presentation) due to a lesion that affects the red nucleus and the superior cerebellar peduncle .</li><li>• Option B</li><li>• combines features</li><li>• both oculomotor nerve palsy</li><li>• Weber’s syndrome</li><li>• cerebellar ataxia</li><li>• affects the red nucleus</li><li>• superior cerebellar peduncle</li><li>• Option C . Benedikt's syndrome is characterized by ipsilateral oculomotor nerve palsy and contralateral involuntary movements ( tremor ), reflecting damage to the red nucleus and substantia nigra , which is not consistent with the presented case.</li><li>• Option C</li><li>• Benedikt's syndrome</li><li>• ipsilateral oculomotor nerve palsy</li><li>• contralateral involuntary movements</li><li>• tremor</li><li>• red nucleus</li><li>• substantia nigra</li><li>• Option D. Wallenberg's syndrome, or lateral medullary syndrome , occurs due to a lesion in the lateral part of the medulla oblongata , not the midbrain, and presents with symptoms such as dysphagia, hoarseness, ipsilateral Horner’s syndrome , and contralateral loss of pain and temperature sensation in the body.</li><li>• Option D.</li><li>• lateral medullary syndrome</li><li>• lesion</li><li>• lateral part of the medulla oblongata</li><li>• dysphagia, hoarseness, ipsilateral Horner’s syndrome</li><li>• contralateral loss of pain</li><li>• temperature sensation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Weber's syndrome is indicative of a midbrain lesion that affects both the oculomotor nerve , leading to ipsilateral ocular symptoms , and the corticospinal tract , causing contralateral motor deficits .</li><li>➤ Weber's syndrome is indicative of a midbrain lesion that affects both the oculomotor nerve , leading to ipsilateral ocular symptoms , and the corticospinal tract , causing contralateral motor deficits .</li><li>➤ midbrain lesion</li><li>➤ both</li><li>➤ oculomotor nerve</li><li>➤ ipsilateral ocular symptoms</li><li>➤ corticospinal tract</li><li>➤ contralateral motor deficits</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 87.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 87.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of smoking and hypertension presents to the clinic with difficulty swallowing and hoarseness. On examination, he has a decreased gag reflex and asymmetry of the soft palate with uvula deviating to the left upon phonation. These findings suggest a lesion in which of the following structures?", "options": [{"label": "A", "text": "Hypoglossal Nucleus", "correct": false}, {"label": "B", "text": "Nucleus Solitarius", "correct": false}, {"label": "C", "text": "Nucleus Ambiguus", "correct": true}, {"label": "D", "text": "Dorsal Motor Nucleus of Vagus", "correct": false}], "correct_answer": "C. Nucleus Ambiguus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture47.jpg"], "explanation": "<p><strong>Ans. C) Nucleus Ambiguus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The hypoglossal nucleus is responsible for motor innervation to the muscles of the tongue. A lesion here would primarily present with tongue weakness or atrophy , and deviation of the tongue to the side of the lesion upon protrusion , not with swallowing difficulty or hoarseness.</li><li>• Option A.</li><li>• motor innervation</li><li>• muscles</li><li>• present</li><li>• tongue weakness</li><li>• atrophy</li><li>• deviation</li><li>• tongue</li><li>• side</li><li>• lesion upon protrusion</li><li>• Option B . The nucleus solitarius is associated with taste and visceral sensory information . While it is involved in the gag reflex , a lesion here would not typically cause hoarseness or palatal asymmetry.</li><li>• Option B</li><li>• taste</li><li>• visceral sensory information</li><li>• gag reflex</li><li>• Option D . The dorsal motor nucleus of the vagus provides parasympathetic innervation to the heart, lungs , and digestive tract. While a lesion might affect visceral function , it does not cause the motor deficits seen in this patient.</li><li>• Option D</li><li>• provides parasympathetic innervation</li><li>• heart, lungs</li><li>• digestive tract.</li><li>• affect visceral function</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that a lesion in the nucleus ambiguus can present with difficulty swallowing, hoarseness, decreased gag reflex, and palatal asymmetry due to its role in providing motor innervation to the muscles of the pharynx , larynx , and upper esophagus .</li><li>➤ Understand that a lesion in the nucleus ambiguus can present with difficulty swallowing, hoarseness, decreased gag reflex, and palatal asymmetry due to its role in providing motor innervation to the muscles of the pharynx , larynx , and upper esophagus .</li><li>➤ nucleus ambiguus</li><li>➤ present</li><li>➤ difficulty swallowing, hoarseness, decreased gag reflex,</li><li>➤ palatal asymmetry</li><li>➤ providing motor innervation</li><li>➤ muscles of the pharynx</li><li>➤ larynx</li><li>➤ upper esophagus</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 94.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 94.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male with a history of poorly controlled hypertension presents with acute onset right-sided weakness and difficulty speaking. Imaging studies reveal a hemorrhagic stroke within the left basal ganglia. Which of the following arteries is most likely involved in supplying the area of the patient's stroke in the putamen?", "options": [{"label": "A", "text": "Middle Cerebral Artery", "correct": true}, {"label": "B", "text": "Anterior Cerebral Artery", "correct": false}, {"label": "C", "text": "Posterior Cerebral Artery", "correct": false}, {"label": "D", "text": "Anterior Choroidal Artery", "correct": false}], "correct_answer": "A. Middle Cerebral Artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Middle Cerebral Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The anterior cerebral artery (ACA) primarily supplies the medial surfaces of the frontal lobes and superior medial parietal lobes . It does not typically supply the basal ganglia.</li><li>• Option B.</li><li>• medial surfaces</li><li>• frontal lobes</li><li>• superior medial parietal lobes</li><li>• Option C . The posterior cerebral artery (PCA) mainly supplies the occipital lobe and the bottom portion of the temporal lobe . It does not provide the primary blood supply to the basal ganglia.</li><li>• Option C</li><li>• occipital lobe</li><li>• bottom portion</li><li>• temporal lobe</li><li>• Option D . The anterior choroidal artery can contribute to the blood supply of the posterior limb of the internal capsule and part of the basal ganglia, but it is less commonly involved in hypertensive hemorrhages affecting the putamen compared to the lenticulostriate branches of the MCA.</li><li>• Option D</li><li>• blood supply</li><li>• posterior limb</li><li>• internal capsule</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle cerebral artery, through its lenticulostriate branches, is the primary supplier of blood to the putamen , and hemorrhagic strokes in this area are often related to hypertension-induced damage to these small penetrating vessels .</li><li>➤ primary supplier</li><li>➤ blood</li><li>➤ putamen</li><li>➤ hemorrhagic strokes</li><li>➤ hypertension-induced damage</li><li>➤ small penetrating vessels</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 172.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 172.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old woman awakens in the morning and has difficulty in talking. She is obese, known diabetic and hypertensive. The result of examination suggests probability of a small stroke. MRI shows a lesion localised to the area indicated by the arrow in the image below. Which of the following deficits would most likely be seen in this patient based on the location &amp; extent of damage?", "options": [{"label": "A", "text": "Deviation of the Tongue to the Left on Attempted Protrusion", "correct": false}, {"label": "B", "text": "Deviation of Uvula to the Right on Phonation", "correct": false}, {"label": "C", "text": "Difficulty Elevating the Right Shoulder Against Resistance", "correct": false}, {"label": "D", "text": "Weakness of Facial Muscles on the Lower Right Side of Face", "correct": true}], "correct_answer": "D. Weakness of Facial Muscles on the Lower Right Side of Face", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture21.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture23_zV4edmi.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deviation of the Tongue to the Left on Attempted Protrusion: The hypoglossal nerve , which controls tongue movements , can cause the tongue to deviate towards the side of a lesion if damaged. However, a lesion in the genu of the internal capsule is unlikely to directly affect the hypoglossal nerve , as the nerve's primary motor cortex is not located near the genu.</li><li>• Option A. Deviation of the Tongue to the Left on Attempted Protrusion:</li><li>• The hypoglossal nerve</li><li>• tongue movements</li><li>• tongue</li><li>• deviate</li><li>• side of a lesion</li><li>• damaged.</li><li>• genu</li><li>• internal capsule</li><li>• directly affect</li><li>• hypoglossal nerve</li><li>• Option B. Deviation of Uvula to the Right on Phonation: This sign is typically associated with lesions affecting the vagus nerve or its nucleus in the medulla . A lesion in the genu of the internal capsule would not typically affect the vagus nerve.</li><li>• Option B. Deviation of Uvula to the Right on Phonation:</li><li>• lesions affecting</li><li>• vagus nerve</li><li>• nucleus</li><li>• medulla</li><li>• Option C. Difficulty Elevating the Right Shoulder Against Resistance: This could indicate damage to the accessory nerve , which innervates the sternocleidomastoid and trapezius muscles . Like the hypoglossal nerve, its control areas are not located near the genu of the internal capsule.</li><li>• Option C. Difficulty Elevating the Right Shoulder Against Resistance:</li><li>• damage</li><li>• accessory nerve</li><li>• innervates</li><li>• sternocleidomastoid</li><li>• trapezius muscles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Weakness of Facial Muscles on the Lower Right Side of Face : The genu of the internal capsule contains fibers that carry motor signals from the brain's primary motor cortex to various parts of the body. The upper motor neurons for facial muscles are located here. In the case of a lesion in the left genu, there would be an interruption of the motor signals to the lower facial muscles on the opposite side of the body (right side) , leading to weakness . It's important to note that in upper motor neuron lesions , the lower part of the face is typically affected , whereas the upper part remains intact due to bilateral upper motor neuron innervation . Understand that a lesion in the genu of the internal capsule typically results in contralateral weakness of the lower facial muscles , without affecting the tongue or shoulder movements, due to the interruption of corticobulbar tracts that innervate the lower facial muscles .</li><li>➤ Weakness of Facial Muscles on the Lower Right Side of Face : The genu of the internal capsule contains fibers that carry motor signals from the brain's primary motor cortex to various parts of the body. The upper motor neurons for facial muscles are located here.</li><li>➤ Weakness of Facial Muscles on the Lower Right Side of Face</li><li>➤ carry motor signals</li><li>➤ brain's primary motor cortex</li><li>➤ upper motor neurons</li><li>➤ facial muscles</li><li>➤ In the case of a lesion in the left genu, there would be an interruption of the motor signals to the lower facial muscles on the opposite side of the body (right side) , leading to weakness . It's important to note that in upper motor neuron lesions , the lower part of the face is typically affected , whereas the upper part remains intact due to bilateral upper motor neuron innervation .</li><li>➤ interruption</li><li>➤ motor signals</li><li>➤ lower facial muscles</li><li>➤ opposite side</li><li>➤ body (right side)</li><li>➤ leading to weakness</li><li>➤ upper motor neuron lesions</li><li>➤ lower part</li><li>➤ typically affected</li><li>➤ upper part</li><li>➤ intact</li><li>➤ bilateral upper motor neuron innervation</li><li>➤ Understand that a lesion in the genu of the internal capsule typically results in contralateral weakness of the lower facial muscles , without affecting the tongue or shoulder movements, due to the interruption of corticobulbar tracts that innervate the lower facial muscles .</li><li>➤ genu</li><li>➤ internal capsule</li><li>➤ results</li><li>➤ contralateral weakness</li><li>➤ lower facial muscles</li><li>➤ interruption</li><li>➤ corticobulbar tracts</li><li>➤ innervate</li><li>➤ lower facial muscles</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 167-168</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 167-168</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male presents with a 6-month history of tremor, rigidity, and bradykinesia. On examination, the tremor is more pronounced at rest and improves with voluntary movement. His medical history is unremarkable, and he is currently not taking any medications. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Essential Tremor", "correct": false}, {"label": "B", "text": "Parkinson's Disease", "correct": true}, {"label": "C", "text": "Huntington's Disease", "correct": false}, {"label": "D", "text": "Multiple Sclerosis", "correct": false}], "correct_answer": "B. Parkinson's Disease", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Parkinson's Disease</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Essential tremor is characterized by action tremors (tremors that worsen during voluntary movement ) and usually does not involve rigidity or bradykinesia. It is often familial and can improve with alcohol consumption .</li><li>• Option A.</li><li>• action tremors</li><li>• worsen</li><li>• voluntary movement</li><li>• familial</li><li>• alcohol consumption</li><li>• Option C. Huntington's disease is a genetic disorder marked by chorea ( involuntary, jerky movements ), psychiatric disturbances , and dementia . The presentation is different from the resting tremor and bradykinesia seen in Parkinson's disease.</li><li>• Option C.</li><li>• genetic disorder</li><li>• chorea</li><li>• involuntary, jerky movements</li><li>• psychiatric disturbances</li><li>• dementia</li><li>• Option D . Multiple sclerosis is a demyelinating disease of the central nervous system , presenting with varied neurological symptoms such as vision loss, pain, fatigue, and impaired coordination . It typically does not present with the classic triad of Parkinson's disease.</li><li>• Option D</li><li>• demyelinating disease</li><li>• central nervous system</li><li>• varied neurological symptoms</li><li>• vision loss, pain, fatigue,</li><li>• impaired coordination</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Parkinson's disease should be suspected in patients presenting with a triad of resting tremor , rigidity , and bradykinesia , distinguishing it from other movement disorders like essential tremor , Huntington's disease , and multiple sclerosis .</li><li>➤ triad</li><li>➤ resting tremor</li><li>➤ rigidity</li><li>➤ bradykinesia</li><li>➤ essential tremor</li><li>➤ Huntington's disease</li><li>➤ multiple sclerosis</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 156.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 156.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 68-year-old man presents with a sudden loss of vision in the left halves of both visual fields. He has a history of hypertension and hypercholesterolemia. Examination reveals that his visual acuity is intact, and he is able to read small print with both eyes, indicating macular sparing. This visual field defect most likely indicates a lesion in which of the following locations?", "options": [{"label": "A", "text": "Left Optic Nerve", "correct": false}, {"label": "B", "text": "Optic Chiasm", "correct": false}, {"label": "C", "text": "Right Optic Tract", "correct": false}, {"label": "D", "text": "Right Occipital Cortex", "correct": true}], "correct_answer": "D. Right Occipital Cortex", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Right Occipital Cortex</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . A lesion in the left optic nerve would cause complete blindness (anopsia) in the left eye , not a homonymous hemianopia.</li><li>• Option A</li><li>• complete blindness (anopsia)</li><li>• left eye</li><li>• Option B . A lesion at the optic chiasm typically leads to bitemporal hemianopia , which is the loss of the outer (temporal) visual fields in both eyes .</li><li>• Option B</li><li>• bitemporal hemianopia</li><li>• loss</li><li>• outer (temporal) visual fields</li><li>• both eyes</li><li>• Option C . A lesion in the right optic tract would cause a left homonymous hemianopia , but this would typically not spare the macula, as the macular fibers would be affected.</li><li>• Option C</li><li>• left homonymous hemianopia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that a homonymous hemianopia with macular sparing typically results from a lesion in the occipital cortex , due to the dual blood supply to the macular region , allowing central vision to be preserved even when the rest of the visual field is lost.</li><li>➤ Recognize that a homonymous hemianopia with macular sparing typically results from a lesion in the occipital cortex , due to the dual blood supply to the macular region , allowing central vision to be preserved even when the rest of the visual field is lost.</li><li>➤ Recognize</li><li>➤ homonymous hemianopia</li><li>➤ lesion</li><li>➤ occipital cortex</li><li>➤ dual blood supply</li><li>➤ macular region</li><li>➤ central vision</li><li>➤ preserved</li><li>➤ rest of the visual field is lost.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 152.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 152.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-month-old infant is brought to the emergency department after a fall. Imaging studies are ordered to assess for spinal injury. Compared to an adult, at which vertebral level does the spinal cord typically end in infants?", "options": [{"label": "A", "text": "L1-L2 Inter-Vertebral Disc", "correct": false}, {"label": "B", "text": "L2-L3 Inter-Vertebral Disc", "correct": true}, {"label": "C", "text": "L3-L4 Inter-Vertebral Disc", "correct": false}, {"label": "D", "text": "T12-L1 Inter-Vertebral Disc", "correct": false}], "correct_answer": "B. L2-L3 Inter-Vertebral Disc", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) L2-L3 Inter-Vertebral Disc</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . In adults, the spinal cord usually ends at the level of the L1-L2 intervertebral disc . This is the typical location for the conus medullaris in an adult patient .</li><li>• Option A</li><li>• ends</li><li>• level</li><li>• L1-L2 intervertebral disc</li><li>• location</li><li>• conus medullaris</li><li>• adult patient</li><li>• Option C . The L3-L4 intervertebral disc is a common site for lumbar puncture in adults due to the lower end of the spinal cord ; however, in infants , the spinal cord may extend to this level , making this an incorrect choice for a lumbar puncture site in infants.</li><li>• Option C</li><li>• lumbar puncture</li><li>• adults</li><li>• lower end</li><li>• spinal cord</li><li>• infants</li><li>• spinal cord may extend to this level</li><li>• Option D . The T12-L1 intervertebral disc level is above the terminal end of the spinal cord even in infants.</li><li>• Option D</li><li>• above</li><li>• terminal end</li><li>• spinal cord</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Recognize that the spinal cord in infants typically ends around the L2-L3 intervertebral disc , which is lower than in adults , where it ends at the L1-L2 intervertebral disc level. This knowledge is crucial when performing procedures like lumbar punctures in infants to avoid iatrogenic injury to the spinal cord.</li><li>➤ Recognize that the spinal cord in infants typically ends around the L2-L3 intervertebral disc , which is lower than in adults , where it ends at the L1-L2 intervertebral disc level. This knowledge is crucial when performing procedures like lumbar punctures in infants to avoid iatrogenic injury to the spinal cord.</li><li>➤ spinal cord in infants</li><li>➤ L2-L3 intervertebral disc</li><li>➤ lower than in adults</li><li>➤ lumbar punctures in infants</li><li>➤ avoid iatrogenic injury</li><li>➤ spinal cord.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 51-52.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 51-52.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pointed structure in the image below?", "options": [{"label": "A", "text": "The CSF from this can enter the subarachnoid space through foramen of magendie", "correct": false}, {"label": "B", "text": "Its superior angle is continuous above with the cerebello-medullary cistern", "correct": true}, {"label": "C", "text": "Its median dorsal recess extends into the white core of cerebellum", "correct": false}, {"label": "D", "text": "Its choroid plexus is derived from posterior inferior cerebellar arteries", "correct": false}], "correct_answer": "B. Its superior angle is continuous above with the cerebello-medullary cistern", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture41.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The CSF from the fourth ventricle can indeed enter the subarachnoid space through the foramen of Magendie , which is the median aperture of the fourth ventricle . Additionally, CSF also passes through the lateral apertures ( foramina of Luschka ).</li><li>• Option A.</li><li>• fourth ventricle</li><li>• subarachnoid space</li><li>• foramen of Magendie</li><li>• median aperture</li><li>• fourth ventricle</li><li>• CSF</li><li>• passes</li><li>• lateral apertures</li><li>• foramina of Luschka</li><li>• Option C. The median dorsal recess of the fourth ventricle , also known as the obex , extends into the white core of the cerebellum and lies superior to the nodule . The right and left lateral dorsal recesses project in the white matter lateral to the nodule but above the inferior medullary velum .</li><li>• Option C.</li><li>• median dorsal recess</li><li>• fourth ventricle</li><li>• obex</li><li>• extends</li><li>• white core</li><li>• lies superior</li><li>• nodule</li><li>• right</li><li>• left lateral dorsal recesses</li><li>• white matter lateral</li><li>• nodule</li><li>• above</li><li>• inferior medullary velum</li><li>• Option D. The choroid plexus of the fourth ventricle, which produces CSF , is indeed vascularized by branches of the posterior inferior cerebellar arteries (PICA) and other arteries like the anterior inferior cerebellar artery (AICA).</li><li>• Option D.</li><li>• choroid plexus</li><li>• produces CSF</li><li>• vascularized</li><li>• branches</li><li>• posterior inferior cerebellar arteries (PICA)</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The superior angle of the fourth ventricle is continuous with the cerebral aqueduct that runs from the third ventricle .</li><li>• The superior angle of the fourth ventricle is continuous with the cerebral aqueduct that runs from the third ventricle .</li><li>• runs from the third ventricle</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 120-122</li><li>• Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 120-122</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old male with a history of diabetes mellitus presents with numbness and a loss of vibratory sense and proprioception in both lower extremities. Physical examination reveals decreased sensation to light touch in a stocking distribution, absent Achilles tendon reflex, and a positive Romberg sign. These findings suggest a lesion affecting which of the following neural pathways?", "options": [{"label": "A", "text": "Lateral Corticospinal Tract", "correct": false}, {"label": "B", "text": "Anterolateral (Spinothalamic) Tract", "correct": false}, {"label": "C", "text": "Dorsal Columns (Posterior Columns)", "correct": true}, {"label": "D", "text": "Lateral Spinothalamic Tract", "correct": false}], "correct_answer": "C. Dorsal Columns (Posterior Columns)", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dorsal Columns (Posterior Columns)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The lateral corticospinal tract is responsible for voluntary motor control . A lesion here would likely result in spastic paralysis and hyperreflexia , not sensory deficits.</li><li>• Option A.</li><li>• voluntary motor control</li><li>• spastic paralysis</li><li>• hyperreflexia</li><li>• Option B. The anterolateral (spinothalamic) tract carries pain and temperature sensations . While damage to this tract can cause loss of pain and temperature sensation , it does not affect vibratory sense or proprioception.</li><li>• Option B.</li><li>• carries pain</li><li>• temperature sensations</li><li>• loss of</li><li>• pain</li><li>• temperature sensation</li><li>• Option D. The lateral spinothalamic tract specifically carries pain and temperature sensations from the body to the brain . As with the anterolateral tract, a lesion here would not affect vibratory sense or proprioception.</li><li>• Option D.</li><li>• carries pain</li><li>• temperature sensations</li><li>• body</li><li>• brain</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Loss of proprioception and vibratory sense , along with a positive Romberg sign , is indicative of a lesion in the dorsal columns of the spinal cord , which are responsible for carrying proprioceptive and fine touch information from the periphery to the brain.</li><li>➤ Loss of proprioception</li><li>➤ vibratory sense</li><li>➤ positive Romberg sign</li><li>➤ lesion</li><li>➤ dorsal columns</li><li>➤ spinal cord</li><li>➤ carrying proprioceptive</li><li>➤ fine touch information</li><li>➤ periphery</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-65.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 60-65.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the incorrect statement about the marked structure?", "options": [{"label": "A", "text": "Receives Afferents from Neocerebellum", "correct": false}, {"label": "B", "text": "Efferent pass mainly via Inferior Cerebellar Peduncle", "correct": true}, {"label": "C", "text": "It is the largest of Intracerebellar Nuclei", "correct": false}, {"label": "D", "text": "Efferent terminate in Red Nucleus and Ventral Lateral Nucleus of Thalamus", "correct": false}], "correct_answer": "B. Efferent pass mainly via Inferior Cerebellar Peduncle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture37.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/29/picture4.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Receives Afferents from Neocerebellum</li><li>• Option A</li><li>• The dentate nucleus receives input from the neocerebellum , which is the phylogenetically newest part of the cerebellum and is involved in the planning and initiation of voluntary movements . The neocerebellum projects to the dentate nucleus as part of the cerebro-cerebellar feedback loop .</li><li>• The dentate nucleus receives input from the neocerebellum , which is the phylogenetically newest part of the cerebellum and is involved in the planning and initiation of voluntary movements .</li><li>• receives input</li><li>• neocerebellum</li><li>• phylogenetically</li><li>• cerebellum</li><li>• planning</li><li>• initiation</li><li>• voluntary movements</li><li>• The neocerebellum projects to the dentate nucleus as part of the cerebro-cerebellar feedback loop .</li><li>• neocerebellum projects</li><li>• dentate nucleus</li><li>• cerebro-cerebellar feedback loop</li><li>• Option C . It is the Largest of Intracerebellar Nuclei</li><li>• Option C</li><li>• The dentate nucleus is the largest of the deep cerebellar nuclei . The dentate nucleus is characterized by its large size and convoluted , or dentate , appearance .</li><li>• The dentate nucleus is the largest of the deep cerebellar nuclei .</li><li>• largest</li><li>• deep cerebellar nuclei</li><li>• The dentate nucleus is characterized by its large size and convoluted , or dentate , appearance .</li><li>• large size</li><li>• convoluted</li><li>• dentate</li><li>• appearance</li><li>• Option D . Efferent Terminate in Red Nucleus and Ventral Lateral Nucleus of Thalamus</li><li>• Option D</li><li>• The red nucleus and the ventral lateral nucleus of the thalamus are important relay stations in the motor pathway . The efferent pathways from the dentate nucleus project to these structures, which are involved in the coordination and planning of movements .</li><li>• The red nucleus and the ventral lateral nucleus of the thalamus are important relay stations in the motor pathway .</li><li>• red nucleus</li><li>• ventral lateral nucleus</li><li>• relay stations</li><li>• motor pathway</li><li>• The efferent pathways from the dentate nucleus project to these structures, which are involved in the coordination and planning of movements .</li><li>• coordination</li><li>• planning of movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Efferent Pass Mainly via Inferior Cerebellar Peduncle</li><li>➤ Efferent Pass Mainly via Inferior Cerebellar Peduncle</li><li>➤ The cerebellar peduncles are three paired structures ( superior, middle, and inferior ) that connect the cerebellum to the brainstem . The efferents from the dentate nucleus primarily pass through the superior cerebellar peduncle , not the inferior cerebellar peduncle. The superior cerebellar peduncle is the main output pathway from the cerebellum . The key to understanding the function of the dentate nucleus of the cerebellum lies in recognizing that its efferents, via the superior cerebellar peduncle, not the inferior cerebellar peduncle, and project to important motor areas in the brain such as the red nucleus and the ventral lateral nucleus of the thalamus.</li><li>➤ The cerebellar peduncles are three paired structures ( superior, middle, and inferior ) that connect the cerebellum to the brainstem .</li><li>➤ three paired structures</li><li>➤ superior, middle,</li><li>➤ inferior</li><li>➤ connect</li><li>➤ cerebellum</li><li>➤ brainstem</li><li>➤ The efferents from the dentate nucleus primarily pass through the superior cerebellar peduncle , not the inferior cerebellar peduncle. The superior cerebellar peduncle is the main output pathway from the cerebellum .</li><li>➤ superior cerebellar peduncle</li><li>➤ main output pathway</li><li>➤ cerebellum</li><li>➤ The key to understanding the function of the dentate nucleus of the cerebellum lies in recognizing that its efferents, via the superior cerebellar peduncle, not the inferior cerebellar peduncle, and project to important motor areas in the brain such as the red nucleus and the ventral lateral nucleus of the thalamus.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 115-119</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition, pg 115-119</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the image below?", "options": [{"label": "A", "text": "It is a transverse section of upper medulla", "correct": false}, {"label": "B", "text": "The pointed structure is inferior olivary nucleus", "correct": false}, {"label": "C", "text": "Efferents from inferior olivary nucleus form the parolivocerebellar fibres", "correct": true}, {"label": "D", "text": "The efferents from inferior olivary nucleus reach the cerebellum through inferior cerebellar peduncle", "correct": false}], "correct_answer": "C. Efferents from inferior olivary nucleus form the parolivocerebellar fibres", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture39.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Transverse section of Upper Medulla is commonly studied in neuroanatomy to understand the arrangement of various nuclei and fiber tracts at this level of the brainstem.</li><li>• Option A.</li><li>• neuroanatomy</li><li>• arrangement of various nuclei</li><li>• fiber tracts</li><li>• Option B . If the image shows a prominent , convoluted structure on either side of the midline , it is likely the inferior olivary nucleus . This nucleus is a distinctive feature in the medulla's cross section .</li><li>• Option B</li><li>• prominent</li><li>• convoluted structure</li><li>• either side</li><li>• midline</li><li>• inferior olivary nucleus</li><li>• distinctive feature</li><li>• medulla's cross section</li><li>• Option D. The olivocerebellar fibers, originating from the inferior olivary nucleus, indeed cross over and ascend to the cerebellum via the inferior cerebellar peduncle .</li><li>• Option D.</li><li>• cross over</li><li>• ascend</li><li>• cerebellum</li><li>• inferior cerebellar peduncle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The critical aspect to remember regarding the upper medulla is that the efferents from the inferior olivary nucleus , known as olivocerebellar fibers , project to the cerebellum through the inferior cerebellar peduncle and are vital for motor coordination and learning , not \"parolivocerebellar fibers\".</li><li>➤ upper medulla</li><li>➤ efferents</li><li>➤ inferior olivary nucleus</li><li>➤ olivocerebellar fibers</li><li>➤ cerebellum</li><li>➤ inferior cerebellar peduncle</li><li>➤ vital</li><li>➤ motor coordination</li><li>➤ learning</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 76-77</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 76-77</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true about the pointed structure in the image below:", "options": [{"label": "A", "text": "It lies in the lower part of Frontal Lobe", "correct": false}, {"label": "B", "text": "It lies submerged from surface due to overgrowth of the surrounding cortical area, during development", "correct": true}, {"label": "C", "text": "The Anterior Cerebral Artery lies on its surface", "correct": false}, {"label": "D", "text": "It is separated from Claustrum by Internal Capsule", "correct": false}], "correct_answer": "B. It lies submerged from surface due to overgrowth of the surrounding cortical area, during development", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/28/picture40.jpg"], "explanation_images": [], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The insula is not located in the lower part of the frontal lobe. Instead, it is situated deep within the lateral sulcus ( Sylvian fissure ) and is surrounded by parts of the frontal, parietal , and temporal lobes .</li><li>• Option A</li><li>• situated deep</li><li>• lateral sulcus</li><li>• Sylvian fissure</li><li>• parts</li><li>• frontal, parietal</li><li>• temporal lobes</li><li>• Option C. The insula is largely related to the middle cerebral artery , not the anterior cerebral artery. The branches of the middle cerebral artery, known as the lenticulostriate arteries , supply blood to the insula and the surrounding regions .</li><li>• Option C.</li><li>• middle cerebral artery</li><li>• lenticulostriate arteries</li><li>• blood</li><li>• insula</li><li>• surrounding regions</li><li>• Option D. The insula is indeed separated from the claustrum by the extreme capsule . The claustrum is a thin sheet of grey matter located just lateral to the insula , and the extreme capsule is the thin white matter tract that lies between them.</li><li>• Option D.</li><li>• extreme capsule</li><li>• thin sheet</li><li>• grey matter</li><li>• lateral</li><li>• insula</li><li>• extreme capsule</li><li>• thin white matter</li><li>• tract</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During fetal development , the surrounding cortical areas overgrow and cover the insula , making it not visible on the surface of the brain. This overgrowth leads to the formation of the opercula which cover the insula . Recognize that the insula, a part of the cerebral cortex, becomes covered and hidden from the surface by the overgrowth of the surrounding frontal , parietal, and temporal lobes during brain development . This anatomical characteristic distinguishes it from and is critical for understanding its role and location in the brain.</li><li>➤ During fetal development , the surrounding cortical areas overgrow and cover the insula , making it not visible on the surface of the brain. This overgrowth leads to the formation of the opercula which cover the insula .</li><li>➤ During fetal development</li><li>➤ surrounding cortical areas overgrow</li><li>➤ cover the insula</li><li>➤ not visible</li><li>➤ formation of the opercula</li><li>➤ cover the insula</li><li>➤ Recognize that the insula, a part of the cerebral cortex, becomes covered and hidden from the surface by the overgrowth of the surrounding frontal , parietal, and temporal lobes during brain development . This anatomical characteristic distinguishes it from and is critical for understanding its role and location in the brain.</li><li>➤ part of the cerebral cortex,</li><li>➤ covered</li><li>➤ hidden</li><li>➤ surface</li><li>➤ overgrowth</li><li>➤ surrounding frontal</li><li>➤ parietal,</li><li>➤ temporal lobes</li><li>➤ brain development</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 143.</li><li>➤ Ref</li><li>➤ : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 143.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male with a history of hypertension presents to the emergency room with sudden onset of facial weakness and difficulty coordinating eye movements. Neurological examination reveals left-sided facial paralysis and an inability to abduct his right eye. MRI shows a lesion in the brainstem. Which of the following locations is most likely affected by the lesion?", "options": [{"label": "A", "text": "Left Facial Nerve Nucleus", "correct": false}, {"label": "B", "text": "Right Abducens Nucleus", "correct": false}, {"label": "C", "text": "Left Facial Colliculus", "correct": true}, {"label": "D", "text": "Right Medial Longitudinal Fasciculus", "correct": false}], "correct_answer": "C. Left Facial Colliculus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Left Facial Colliculus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The left facial nerve nucleus, if affected, would result in ipsilateral facial paralysis , but would not typically affect eye movement, specifically abduction of the right eye .</li><li>• Option A</li><li>• ipsilateral facial paralysis</li><li>• specifically abduction</li><li>• right eye</li><li>• Option B. The right abducens nucleus controls the right lateral rectus muscle , which is involved in abduction of the right eye . A lesion here could result in an inability to abduct the right eye , but would not typically cause facial paralysis.</li><li>• Option B.</li><li>• right lateral rectus muscle</li><li>• involved</li><li>• abduction of the right eye</li><li>• result</li><li>• inability to abduct</li><li>• right eye</li><li>• Option D . The medial longitudinal fasciculus is involved in coordinating eye movements , particularly horizontal gaze . A lesion here could affect eye movements , but it would not cause facial paralysis.</li><li>• Option D</li><li>• coordinating eye movements</li><li>• horizontal gaze</li><li>• affect eye movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that a lesion in the facial colliculus , which contains both the facial nerve fibers and the abducens nucleus , can lead to ipsilateral facial paralysis and contralateral abducens nerve palsy , resulting in an inability to abduct the eye on the opposite side .</li><li>➤ Understand that a lesion in the facial colliculus , which contains both the facial nerve fibers and the abducens nucleus , can lead to ipsilateral facial paralysis and contralateral abducens nerve palsy , resulting in an inability to abduct the eye on the opposite side .</li><li>➤ facial colliculus</li><li>➤ both</li><li>➤ facial nerve fibers</li><li>➤ abducens nucleus</li><li>➤ lead</li><li>➤ ipsilateral facial paralysis</li><li>➤ contralateral abducens nerve palsy</li><li>➤ inability</li><li>➤ abduct the eye</li><li>➤ opposite side</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 82.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 82.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with tremor and involuntary movements predominantly in his right arm. Neurological examination reveals that these movements are coarse and jerky in nature. An MRI of the brain shows a lesion in the midbrain. Which of the following structures is most likely involved, given the patient's symptoms?", "options": [{"label": "A", "text": "Subthalamic Nucleus", "correct": false}, {"label": "B", "text": "Caudate Nucleus", "correct": false}, {"label": "C", "text": "Red Nucleus", "correct": true}, {"label": "D", "text": "Globus Pallidus", "correct": false}], "correct_answer": "C. Red Nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Red Nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The subthalamic nucleus, when affected, often results in hemiballismus , characterized by violent, flinging movements of the limbs , rather than coarse and jerky tremors.</li><li>• Option A</li><li>• results in hemiballismus</li><li>• violent, flinging movements of the limbs</li><li>• Option B . Lesions of the caudate nucleus are more commonly associated with Huntington's disease , which presents with chorea – rapid , jerky , and unpredictable movements , but these are usually more widespread and not limited to one limb.</li><li>• Option B</li><li>• Huntington's disease</li><li>• chorea – rapid</li><li>• jerky</li><li>• unpredictable movements</li><li>• more widespread</li><li>• Option D. The globus pallidus is part of the basal ganglia and is involved in the regulation of voluntary movement . Lesions here might lead to movement disorders , but these are typically characterized by dystonia or parkinsonian features , not the coarse tremors described.</li><li>• Option D.</li><li>• basal ganglia</li><li>• regulation of voluntary movement</li><li>• might lead</li><li>• movement disorders</li><li>• typically characterized</li><li>• dystonia or parkinsonian features</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Understand that a lesion in the red nucleus can lead to contralateral involuntary movements , such as coarse tremors and ataxia , as part of Benedikt's syndrome . This is distinct from movement disorders associated with lesions in other structures like the subthalamic nucleus , caudate nucleus , and globus pallidus .</li><li>➤ Understand that a lesion in the red nucleus can lead to contralateral involuntary movements , such as coarse tremors and ataxia , as part of Benedikt's syndrome . This is distinct from movement disorders associated with lesions in other structures like the subthalamic nucleus , caudate nucleus , and globus pallidus .</li><li>➤ red nucleus</li><li>➤ contralateral involuntary movements</li><li>➤ coarse tremors</li><li>➤ ataxia</li><li>➤ part of Benedikt's syndrome</li><li>➤ movement disorders</li><li>➤ associated</li><li>➤ lesions</li><li>➤ subthalamic nucleus</li><li>➤ caudate nucleus</li><li>➤ globus pallidus</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 86.</li><li>➤ Ref : Vishram Singh Textbook of Clinical Neuroanatomy, 2 nd edition pg 86.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 75 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Submandibular Gland", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-171559.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-171716.jpg"], "explanation": "<p><strong>Ans. D) Submandibular Gland</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The mammary gland is derived from modified sweat glands and is a derivative of surface ectoderm . It develops in response to hormonal changes during puberty and pregnancy .</li><li>• Option A:</li><li>• modified sweat glands</li><li>• surface ectoderm</li><li>• hormonal changes</li><li>• puberty</li><li>• pregnancy</li><li>• Option B: The lacrimal gland , responsible for producing tears , is also a derivative of surface ectoderm .</li><li>• Option B:</li><li>• lacrimal gland</li><li>• producing tears</li><li>• derivative</li><li>• surface ectoderm</li><li>• Option C: The enamel of teeth is derived from ectoderm , specifically from the oral epithelium .</li><li>• Option C:</li><li>• ectoderm</li><li>• oral epithelium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Unlike the mammary and lacrimal glands , the submandibular gland is not derived from surface ectoderm. It is a salivary gland and originates from the endoderm .</li><li>➤ Unlike the mammary and lacrimal glands , the submandibular gland is not derived from surface ectoderm. It is a salivary gland and originates from the endoderm .</li><li>➤ mammary</li><li>➤ lacrimal glands</li><li>➤ salivary gland</li><li>➤ originates</li><li>➤ endoderm</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 62</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 62</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following contribute to Development of Diaphragm Except:", "options": [{"label": "A", "text": "Septum Transversum", "correct": false}, {"label": "B", "text": "Pleuropericardial Membrane", "correct": true}, {"label": "C", "text": "Mesoderm of Lateral Body Wall", "correct": false}, {"label": "D", "text": "Dorsal Mesentery of Oesophagus", "correct": false}], "correct_answer": "B. Pleuropericardial Membrane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175659.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175738.jpg"], "explanation": "<p><strong>Ans. B) Pleuropericardial Membrane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The septum transversum forms the central tendon of the diaphragm . It is a thick mass of cranial mesenchyme that gives rise to the central part of the diaphragm . During embryonic development, it migrates caudally and contributes significantly to the formation of the diaphragm .</li><li>• Option A:</li><li>• central tendon</li><li>• diaphragm</li><li>• thick</li><li>• mass</li><li>• cranial mesenchyme</li><li>• central part</li><li>• diaphragm</li><li>• migrates caudally</li><li>• formation</li><li>• diaphragm</li><li>• Option C: The mesoderm of the lateral body wall contributes muscle to the diaphragm . This muscle tissue grows towards the septum transversum and eventually fuses with it, forming the muscular parts of the diaphragm . This process is crucial for the development of the diaphragm as a functional muscle .</li><li>• Option C:</li><li>• muscle</li><li>• diaphragm</li><li>• muscle tissue</li><li>• towards</li><li>• septum transversum</li><li>• eventually fuses</li><li>• muscular parts</li><li>• diaphragm</li><li>• development</li><li>• diaphragm</li><li>• functional muscle</li><li>• Option D: The dorsal mesentery of the esophagus contributes to the formation of the crura of the diaphragm. The crura are tendon-like structures that anchor the diaphragm to structures like the vertebral column , and they play a role in the opening through which the esophagus passes .</li><li>• Option D:</li><li>• formation</li><li>• crura</li><li>• diaphragm.</li><li>• tendon-like structures</li><li>• anchor</li><li>• diaphragm</li><li>• structures</li><li>• vertebral column</li><li>• play</li><li>• role</li><li>• opening</li><li>• esophagus passes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pleuropericardial membranes form the fibrous pericardium of the heart , not the diaphragm. They are responsible for separating the pericardial cavity from the pleural cavities and play no direct role in the formation of the diaphragm.</li><li>➤ The pleuropericardial membranes form the fibrous pericardium of the heart , not the diaphragm.</li><li>➤ fibrous pericardium</li><li>➤ heart</li><li>➤ They are responsible for separating the pericardial cavity from the pleural cavities and play no direct role in the formation of the diaphragm.</li><li>➤ separating</li><li>➤ pericardial cavity</li><li>➤ pleural cavities</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 161</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 161</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the dermatology clinic with multiple dark lesions on her back. She mentions that these lesions have increased in number and size over the past year. On examination, the lesions are found to be macular, hyperpigmented, and vary in size. Biopsy of one of the lesions reveals an increased number of pigment-producing cells in the basal layer of the epidermis. These cells are most likely derived from which of the following embryological structures?", "options": [{"label": "A", "text": "Odontoblasts", "correct": false}, {"label": "B", "text": "Melanocytes", "correct": true}, {"label": "C", "text": "Schwann Cells", "correct": false}, {"label": "D", "text": "Ameloblasts", "correct": false}], "correct_answer": "B. Melanocytes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture3_IUuvoBc.jpg"], "explanation": "<p><strong>Ans. B) Melanocytes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Odontoblasts cells are responsible for the formation of dentin in teeth. They are indeed derived from neural crest cells . The neural crest contributes significantly to the development of the craniofacial structures, including the dentition .</li><li>• Option A</li><li>• formation</li><li>• dentin</li><li>• neural crest cells</li><li>• dentition</li><li>• Option C . Schwann cells are glial cells in the peripheral nervous system that myelinate neuronal axons , facilitating the rapid transmission of nerve impulses . Schwann cells are derived from neural crest cells , which play a crucial role in the development of the peripheral nervous system .</li><li>• Option C</li><li>• glial cells</li><li>• peripheral nervous system</li><li>• myelinate neuronal axons</li><li>• rapid transmission</li><li>• nerve impulses</li><li>• neural crest cells</li><li>• crucial role</li><li>• development</li><li>• peripheral nervous system</li><li>• Option D . Ameloblasts are the cells responsible for the formation of enamel in teeth . Unlike odontoblasts, ameloblasts are not derived from neural crest cells; they originate from the oral epithelium , which is derived from the ectoderm .</li><li>• Option D</li><li>• formation</li><li>• enamel</li><li>• teeth</li><li>• oral epithelium</li><li>• ectoderm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Melanocytes cells produce melanin , the pigment responsible for skin color . They are a classic example of a cell type derived from neural crest cells . Melanocytes migrate to various parts of the body, including the skin , hair follicles , and eyes .</li><li>➤ melanin</li><li>➤ skin color</li><li>➤ cell type</li><li>➤ neural crest cells</li><li>➤ Melanocytes migrate</li><li>➤ skin</li><li>➤ hair follicles</li><li>➤ eyes</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 5-year-old boy is brought to the pediatrician by his parents who are concerned about his frequent episodes of sore throat and difficulty swallowing. His medical history reveals recurrent streptococcal throat infections. Examination reveals enlarged tonsils, which nearly obstruct the oropharyngeal passage. The tonsils are erythematous with white exudates. The development of these enlarged tonsils is primarily associated with which of the following embryonic structures?", "options": [{"label": "A", "text": "First Pharyngeal Pouch", "correct": false}, {"label": "B", "text": "Second Pharyngeal Pouch", "correct": true}, {"label": "C", "text": "Third Pharyngeal Pouch", "correct": false}, {"label": "D", "text": "Neural Crest", "correct": false}], "correct_answer": "B. Second Pharyngeal Pouch", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/01/image_NCyfxjI.png", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture5_nvB6eNH.jpg"], "explanation": "<p><strong>Ans. B) Second Pharyngeal Pouch</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The first pharyngeal pouch does not give rise to the tonsils. Instead, it is involved in the development of the middle ear cavity and the Eustachian tube . The first pouch forms structures that are primarily associated with the ear , not the oropharynx.</li><li>• Option A:</li><li>• development</li><li>• middle ear cavity</li><li>• Eustachian tube</li><li>• ear</li><li>• Option C: The third pharyngeal pouch is responsible for the development of the thymus and the inferior parathyroid glands . It is not involved in the formation of the tonsils.</li><li>• Option C:</li><li>• development</li><li>• thymus</li><li>• inferior parathyroid glands</li><li>• Option D: The neural crest is a group of cells that emerge from the border of the neural tube and contribute to the development of various structures, including certain types of neurons , craniofacial cartilage and bone , and melanocytes . However, the neural crest does not contribute to the formation of the tonsils.</li><li>• Option D:</li><li>• emerge</li><li>• border</li><li>• neural tube</li><li>• neurons</li><li>• craniofacial cartilage</li><li>• bone</li><li>• melanocytes</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The palatine tonsils develop from the second pharyngeal pouch . During embryonic development, the epithelium of this pouch proliferates and invaginates , forming the crypts of the tonsils . Lymphoid tissue then infiltrates these crypts during later development.</li><li>• The palatine tonsils develop from the second pharyngeal pouch .</li><li>• second pharyngeal pouch</li><li>• During embryonic development, the epithelium of this pouch proliferates and invaginates , forming the crypts of the tonsils . Lymphoid tissue then infiltrates these crypts during later development.</li><li>• proliferates</li><li>• invaginates</li><li>• crypts</li><li>• tonsils</li><li>• Lymphoid tissue</li><li>• infiltrates</li><li>• Ref : Textbook of Human embryology, First Edition. Yogesh Sontakke Pg 105</li><li>• Ref :</li><li>• Textbook of Human embryology, First Edition. Yogesh Sontakke Pg 105</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 7-year-old boy is brought to the emergency department with acute onset of abdominal pain localized to the right lower quadrant. The pain is described as cramping and has been present for the last 6 hours. On examination, the boy appears in distress, with a temperature of 38.5°C (101.3°F) and tenderness in the right lower quadrant of the abdomen. Laboratory tests reveal leukocytosis. An abdominal ultrasound is suggestive of a small outpouching in the ileum. This finding is most likely a remnant of which embryonic structure?", "options": [{"label": "A", "text": "Umbilical Fistula", "correct": false}, {"label": "B", "text": "Vitelline Cyst", "correct": false}, {"label": "C", "text": "Median Umbilical Ligament", "correct": false}, {"label": "D", "text": "Meckel's Diverticulum", "correct": true}], "correct_answer": "D. Meckel's Diverticulum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture6_4THoLpE.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture7_UtYVvkQ.jpg"], "explanation": "<p><strong>Ans. D) Meckel's Diverticulum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: An umbilical fistula can occur if the omphalomesenteric duct fails to close completely . This results in an abnormal connection from the intestine to the umbilicus , allowing intestinal contents to drain through the umbilicus . However, an umbilical fistula itself is not a remnant; rather, it's a pathological condition resulting from the failure of the duct to obliterate.</li><li>• Option A:</li><li>• omphalomesenteric duct fails</li><li>• close completely</li><li>• abnormal connection</li><li>• intestine</li><li>• umbilicus</li><li>• intestinal contents</li><li>• drain</li><li>• umbilicus</li><li>• Option B: A vitelline cyst is another potential consequence of the partial obliteration of the omphalomesenteric duct. This cyst forms when a segment of the duct persists and creates a cystic structure , typically located along its course. This is a direct remnant of the duct .</li><li>• Option B:</li><li>• another potential consequence</li><li>• partial obliteration</li><li>• persists</li><li>• creates</li><li>• cystic structure</li><li>• direct remnant</li><li>• duct</li><li>• Option C: The median umbilical ligament is not a remnant of the omphalomesenteric duct. Instead, it is a remnant of the urachus , a structure that connects the fetal bladder to the umbilicus . The urachus typically obliterates to form the median umbilical ligament .</li><li>• Option C:</li><li>• remnant</li><li>• urachus</li><li>• connects</li><li>• fetal bladder</li><li>• umbilicus</li><li>• median umbilical ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meckel's diverticulum is a true congenital diverticulum and is the most common remnant of the omphalomesenteric duct . It is a pouch-like structure that protrudes from the ileum , usually located about 2 feet from the ileocecal valve . Meckel's diverticulum can sometimes lead to complications such as bleeding , inflammation , and obstruction .</li><li>➤ Meckel's diverticulum is a true congenital diverticulum and is the most common remnant of the omphalomesenteric duct .</li><li>➤ true congenital diverticulum</li><li>➤ most common remnant</li><li>➤ omphalomesenteric duct</li><li>➤ It is a pouch-like structure that protrudes from the ileum , usually located about 2 feet from the ileocecal valve .</li><li>➤ pouch-like structure</li><li>➤ protrudes</li><li>➤ ileum</li><li>➤ about 2 feet</li><li>➤ ileocecal valve</li><li>➤ Meckel's diverticulum can sometimes lead to complications such as bleeding , inflammation , and obstruction .</li><li>➤ bleeding</li><li>➤ inflammation</li><li>➤ obstruction</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 105</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 105</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man with a History of Hypertension and Diabetes presents to the Emergency Department with sudden onset of Shortness of Breath and Swelling in his Lower Extremities. His Blood Pressure is 160/90 mmHg, and his Heart Rate is 110 beats per minute. Physical examination reveals Jugular Venous distension, a Positive Hepatojugular Reflux, and pitting Edema in both legs. A Doppler Ultrasound of the Lower Extremities shows no evidence of Deep Vein Thrombosis. An Echocardiogram demonstrates Right Ventricular Enlargement and Increased Pressure in the Right Atrium. These findings suggest increased pressure in the Inferior Vena Cava. The terminal portion of the Inferior Vena Cava is embryologically derived from which of the following?", "options": [{"label": "A", "text": "Right Venous Valve", "correct": false}, {"label": "B", "text": "Right Common Cardinal Vein", "correct": false}, {"label": "C", "text": "Right Vitelline Vein", "correct": true}, {"label": "D", "text": "Left Horn of Sinus Venosus", "correct": false}], "correct_answer": "C. Right Vitelline Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture8_GqNisjW.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-123946.jpg"], "explanation": "<p><strong>Ans. C) Right Vitelline Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: The right venous valve is not directly involved in the formation of the IVC. It is a structure within the right atrium of the heart that directs blood flow during fetal development, especially related to the foramen ovale , but does not contribute to the formation of the IVC.</li><li>• Option A:</li><li>• right atrium</li><li>• heart</li><li>• directs blood</li><li>• flow</li><li>• foramen ovale</li><li>• Option B: The right common cardinal vein contributes to the formation of the systemic venous system , including parts of the IVC. It forms the superior part of the IVC and the right atrial appendage . However, it is not the primary contributor to the terminal portion of the IVC.</li><li>• Option B:</li><li>• systemic venous system</li><li>• superior part</li><li>• IVC</li><li>• right atrial appendage</li><li>• Option D: The left horn of the sinus venosus contributes to the formation of the coronary sinus in the heart , not the IVC. The sinus venosus is an important structure in the developing heart that eventually forms part of the right atrium and its associated structures.</li><li>• Option D:</li><li>• coronary sinus</li><li>• heart</li><li>• developing heart</li><li>• part</li><li>• right atrium</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The terminal portion of the IVC is derived from the right vitelline vein . The vitelline veins , during embryonic development, drain blood from the yolk sac to the heart . The right vitelline vein contributes to the formation of the hepatic segment of the IVC , and its distal part forms the terminal portion of the IVC .</li><li>• The terminal portion of the IVC is derived from the right vitelline vein .</li><li>• right vitelline vein</li><li>• The vitelline veins , during embryonic development, drain blood from the yolk sac to the heart .</li><li>• vitelline veins</li><li>• drain blood</li><li>• yolk sac</li><li>• heart</li><li>• The right vitelline vein contributes to the formation of the hepatic segment of the IVC , and its distal part forms the terminal portion of the IVC .</li><li>• right vitelline vein</li><li>• formation</li><li>• hepatic segment</li><li>• IVC</li><li>• distal part</li><li>• terminal portion</li><li>• IVC</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 196</li><li>• Ref :</li><li>• Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 196</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Midline cleft upper lip due to failure of fusion between:", "options": [{"label": "A", "text": "Maxillary Process", "correct": false}, {"label": "B", "text": "Medial Nasal Process", "correct": true}, {"label": "C", "text": "Medial and Lateral Nasal Process", "correct": false}, {"label": "D", "text": "Mandibular and Maxillary Process", "correct": false}], "correct_answer": "B. Medial Nasal Process", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture23.jpg"], "explanation": "<p><strong>Ans. B) Medial Nasal Process</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The maxillary process contributes to the formation of the upper lip , but it is specifically involved in the lateral parts of the upper lip . The fusion of the maxillary process with the medial nasal process forms the majority of the upper lip , but a midline cleft upper lip typically involves the structures more medially than where the maxillary process is involved .</li><li>• Option A:</li><li>• formation</li><li>• upper lip</li><li>• lateral parts</li><li>• upper lip</li><li>• fusion</li><li>• maxillary process</li><li>• medial nasal process</li><li>• majority</li><li>• upper lip</li><li>• midline cleft upper lip</li><li>• medially</li><li>• maxillary process</li><li>• involved</li><li>• Option C: The medial and lateral nasal processes are involved in the formation of the nose . The medial nasal process forms the crest and tip of the nose , while the lateral nasal process forms the sides of the nose . These processes do not directly contribute to the formation of the upper lip in the context of a midline cleft.</li><li>• Option C:</li><li>• formation</li><li>• nose</li><li>• crest</li><li>• tip</li><li>• nose</li><li>• lateral nasal process</li><li>• sides</li><li>• nose</li><li>• Option D: The mandibular process forms the lower jaw , and its fusion with the maxillary process contributes to the formation of the cheeks and lateral portions of the upper lip . However, this is not related to the formation of the midline portion of the upper lip where a midline cleft would occur.</li><li>• Option D:</li><li>• lower jaw</li><li>• fusion</li><li>• maxillary process</li><li>• formation</li><li>• cheeks</li><li>• lateral portions</li><li>• upper lip</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The midline cleft upper lip is due to the failure of fusion between the two medial nasal processes . During normal development, these processes fuse in the midline to form the central portion of the upper lip , the philtrum , and the primary palate . Failure in this fusion process can result in a midline cleft .</li><li>• The midline cleft upper lip is due to the failure of fusion between the two medial nasal processes .</li><li>• midline cleft upper lip</li><li>• failure</li><li>• fusion</li><li>• two medial nasal processes</li><li>• During normal development, these processes fuse in the midline to form the central portion of the upper lip , the philtrum , and the primary palate . Failure in this fusion process can result in a midline cleft .</li><li>• fuse</li><li>• midline</li><li>• central portion</li><li>• upper lip</li><li>• philtrum</li><li>• primary palate</li><li>• midline cleft</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 110</li><li>• Ref :</li><li>• Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 110</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a history of chronic liver disease presents to the clinic for a routine check-up. During the examination, you discuss various structures associated with the liver. You explain to the patient that one of the following structures, which he might have heard of in the context of liver disease, is not a derivative of the septum transversum. Which structure is this?", "options": [{"label": "A", "text": "Falciform Ligament", "correct": false}, {"label": "B", "text": "Ligamentum Teres", "correct": true}, {"label": "C", "text": "Coronary Ligament", "correct": false}, {"label": "D", "text": "Lesser Omentum", "correct": false}], "correct_answer": "B. Ligamentum Teres", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture13.jpg"], "explanation": "<p><strong>Ans. B) Ligamentum Teres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The falciform ligament is a derivative of the septum transversum . It is a ligament that attaches the liver to the anterior abdominal wall and diaphragm . The falciform ligament is a remnant of the ventral mesentery and is associated with the development of the liver , which is intimately related to the septum transversum.</li><li>• Option A:</li><li>• septum transversum</li><li>• attaches</li><li>• liver</li><li>• anterior abdominal wall</li><li>• diaphragm</li><li>• remnant</li><li>• ventral mesentery</li><li>• liver</li><li>• Option C: The coronary ligament of the liver is a derivative of the septum transversum . It helps to attach the liver to the diaphragm and is an important structure in the peritoneal reflections around the liver .</li><li>• Option C:</li><li>• septum transversum</li><li>• attach</li><li>• liver</li><li>• diaphragm</li><li>• peritoneal reflections</li><li>• liver</li><li>• Option D: The lesser omentum, which extends from the liver to the lesser curvature of the stomach and the first part of the duodenum , is partially derived from the septum transversum . It is a remnant of the ventral mesentery and plays a role in forming the anterior boundary of the omental bursa .</li><li>• Option D:</li><li>• liver</li><li>• lesser curvature</li><li>• stomach</li><li>• first part</li><li>• duodenum</li><li>• partially derived</li><li>• septum transversum</li><li>• remnant</li><li>• ventral mesentery</li><li>• anterior boundary</li><li>• omental bursa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ligamentum teres, also known as the round ligament of the liver , is not a direct derivative of the septum transversum. It is actually a remnant of the umbilical vein , which carried oxygenated blood from the placenta to the fetus during embryonic development. After birth , the umbilical vein obliterates and becomes the ligamentum teres .</li><li>➤ The ligamentum teres, also known as the round ligament of the liver , is not a direct derivative of the septum transversum.</li><li>➤ round ligament</li><li>➤ liver</li><li>➤ It is actually a remnant of the umbilical vein , which carried oxygenated blood from the placenta to the fetus during embryonic development.</li><li>➤ remnant</li><li>➤ umbilical vein</li><li>➤ carried oxygenated blood</li><li>➤ placenta</li><li>➤ fetus</li><li>➤ After birth , the umbilical vein obliterates and becomes the ligamentum teres .</li><li>➤ birth</li><li>➤ umbilical vein</li><li>➤ obliterates</li><li>➤ becomes</li><li>➤ ligamentum teres</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 82, 130</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 82, 130</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old pregnant woman comes to your clinic for her first prenatal visit. She is concerned about the development of her baby and asks about neural tube defects. You explain that these defects can occur due to improper closure of the neural tube. Based on your knowledge, where does the closure of the neural tube begin?", "options": [{"label": "A", "text": "Cephalic End", "correct": false}, {"label": "B", "text": "Cervical Region", "correct": true}, {"label": "C", "text": "Podalic End", "correct": false}, {"label": "D", "text": "Lumbar Region", "correct": false}], "correct_answer": "B. Cervical Region", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture14.jpg"], "explanation": "<p><strong>Ans. B) Cervical Region</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: While closure of the neural tube does occur at the cephalic end, it is not the initial site where the closure begins. The cephalic end of the neural tube will eventually form the brain .</li><li>• Option A:</li><li>• cephalic end</li><li>• eventually</li><li>• brain</li><li>• Option C: The podalic end refers to the foot end or lower end of the embryo . Closure of the neural tube at the podalic end is one of the final steps in the process , not the beginning.</li><li>• Option C:</li><li>• foot end</li><li>• lower end</li><li>• embryo</li><li>• Closure</li><li>• neural tube</li><li>• podalic end</li><li>• final steps</li><li>• process</li><li>• Option D: Although the neural tube also closes in this region, it is not where the closure process begins. The closure here occurs after the initiation in the cervical region and is part of the progression of the closure process along the length of the neural tube .</li><li>• Option D:</li><li>• after</li><li>• initiation</li><li>• cervical region</li><li>• progression</li><li>• closure process</li><li>• length</li><li>• neural tube</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Neural tube closure begins in the cervical region , which is around the future neck area of the embryo . From this point, the closure process proceeds both rostrally and caudally . The initiation of neural tube closure in the cervical region is crucial for proper development of the brain and spinal cord .</li><li>➤ Neural tube closure begins in the cervical region , which is around the future neck area of the embryo .</li><li>➤ Neural tube</li><li>➤ begins</li><li>➤ cervical region</li><li>➤ future neck area</li><li>➤ embryo</li><li>➤ From this point, the closure process proceeds both rostrally and caudally .</li><li>➤ proceeds</li><li>➤ both rostrally</li><li>➤ caudally</li><li>➤ The initiation of neural tube closure in the cervical region is crucial for proper development of the brain and spinal cord .</li><li>➤ initiation</li><li>➤ neural tube closure</li><li>➤ cervical region</li><li>➤ crucial</li><li>➤ proper development</li><li>➤ brain</li><li>➤ spinal cord</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 57</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 29-year-old woman comes to your office for a prenatal consultation. She is at her 8 th week of pregnancy and is concerned about the risk of neural tube defects in her baby. You discuss the development of the neural tube and inform her about the critical period for its closure. By which day after conception does the caudal end of the neural tube typically close?", "options": [{"label": "A", "text": "24 th day", "correct": false}, {"label": "B", "text": "28 th day", "correct": true}, {"label": "C", "text": "32 nd day", "correct": false}, {"label": "D", "text": "40 th day", "correct": false}], "correct_answer": "B. 28 th day", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-130907.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture15.jpg"], "explanation": "<p><strong>Ans. B) 28thday</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: 24th Day is too early for the closure of the caudal neuropore . Typically, around the 24th day of embryonic development , the process of neural tube closure is still ongoing , starting in the middle and progressing towards both ends .</li><li>• Option A:</li><li>• too early</li><li>• closure</li><li>• caudal neuropore</li><li>• 24th day</li><li>• embryonic development</li><li>• neural tube closure</li><li>• ongoing</li><li>• starting</li><li>• middle</li><li>• both ends</li><li>• Option C: 32nd Day is too late for the closure of the caudal neuropore . By the 32nd day, the neural tube should have already closed completely . Delayed closure or failure to close can lead to serious congenital anomalies .</li><li>• Option C:</li><li>• too late</li><li>• closure</li><li>• caudal neuropore</li><li>• already closed completely</li><li>• Delayed closure</li><li>• failure</li><li>• close</li><li>• serious congenital anomalies</li><li>• Option D: Closure of the caudal neuropore certainly does not occur this late i.e. 40th Day . As mentioned earlier, the neural tube, including both the rostral and caudal neuropores , should have closed by around the 28th day .</li><li>• Option D:</li><li>• 40th Day</li><li>• both</li><li>• rostral</li><li>• caudal neuropores</li><li>• around</li><li>• 28th day</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The caudal neuropore typically closes around the 28th day of embryonic development. The closure of the neural tube is a crucial step in the proper development of the spinal cord and the prevention of neural tube defects such as spina bifida .</li><li>➤ The caudal neuropore typically closes around the 28th day of embryonic development.</li><li>➤ around</li><li>➤ 28th day</li><li>➤ embryonic development.</li><li>➤ The closure of the neural tube is a crucial step in the proper development of the spinal cord and the prevention of neural tube defects such as spina bifida .</li><li>➤ closure</li><li>➤ neural tube</li><li>➤ spinal cord</li><li>➤ prevention</li><li>➤ neural tube defects</li><li>➤ spina bifida</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 57</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where is the Highest Oxygen Concentration in Fetal Circulation?", "options": [{"label": "A", "text": "SVC", "correct": false}, {"label": "B", "text": "IVC", "correct": true}, {"label": "C", "text": "Right ventricle", "correct": false}, {"label": "D", "text": "Aorta", "correct": false}], "correct_answer": "B. IVC", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) IVC</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: Superior Vena Cava (SVC) blood has a lower oxygen concentration because it has circulated through the body and oxygen has been used by the tissues . It receives deoxygenated blood and has two parts . Extrapericardial part -part of right anterior cardinal vein and intrapericardial part - from right common cardinal vein .</li><li>• Option A: Superior Vena Cava (SVC)</li><li>• lower oxygen concentration</li><li>• circulated</li><li>• body</li><li>• oxygen</li><li>• tissues</li><li>• receives deoxygenated</li><li>• blood</li><li>• two parts</li><li>• Extrapericardial part</li><li>• right anterior cardinal vein</li><li>• intrapericardial part</li><li>• right common cardinal vein</li><li>• Option C: The right ventricle receives mixed blood from the right atrium and pumps it into the pulmonary artery . However, due to the presence of the ductus arteriosus , most of this blood bypasses the lungs and enters systemic circulation . The oxygen concentration in the right ventricle is not the highest in fetal circulation.</li><li>• Option C:</li><li>• mixed blood</li><li>• right atrium</li><li>• pulmonary artery</li><li>• presence</li><li>• ductus arteriosus</li><li>• bypasses</li><li>• lungs</li><li>• enters systemic circulation</li><li>• Option D: While Aorta does transport blood to the body , the highest concentration of oxygenated blood is present before it reaches the heart , particularly in the blood coming from the placenta via the IVC . Blood shunts three times in the fetus at following places- Ductus arteriosus , foramen ovale and ductus venosus to bypass lungs and liver .</li><li>• Option D:</li><li>• Aorta</li><li>• transport blood</li><li>• body</li><li>• highest concentration</li><li>• oxygenated blood</li><li>• before</li><li>• reaches</li><li>• heart</li><li>• blood coming</li><li>• placenta</li><li>• IVC</li><li>• three times</li><li>• fetus</li><li>• Ductus arteriosus</li><li>• foramen ovale</li><li>• ductus venosus</li><li>• bypass lungs</li><li>• liver</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In fetal circulation , the IVC carries oxygen-rich blood from the placenta , where gas exchange occurs. This blood enters the IVC through the ductus venosus , bypassing the liver . The IVC then transports this highly oxygenated blood to the right atrium . Due to the fetal shunts ( foramen ovale and ductus arteriosus ), this oxygen-rich blood is preferentially directed towards the left side of the heart and subsequently to the brain and upper body , which are high-priority areas for oxygenation in the fetus .</li><li>➤ In fetal circulation , the IVC carries oxygen-rich blood from the placenta , where gas exchange occurs. This blood enters the IVC through the ductus venosus , bypassing the liver .</li><li>➤ fetal circulation</li><li>➤ IVC</li><li>➤ oxygen-rich blood</li><li>➤ placenta</li><li>➤ gas exchange</li><li>➤ enters</li><li>➤ IVC</li><li>➤ ductus venosus</li><li>➤ bypassing</li><li>➤ liver</li><li>➤ The IVC then transports this highly oxygenated blood to the right atrium . Due to the fetal shunts ( foramen ovale and ductus arteriosus ), this oxygen-rich blood is preferentially directed towards the left side of the heart and subsequently to the brain and upper body , which are high-priority areas for oxygenation in the fetus .</li><li>➤ transports</li><li>➤ highly oxygenated blood</li><li>➤ right atrium</li><li>➤ fetal shunts</li><li>➤ foramen ovale</li><li>➤ ductus arteriosus</li><li>➤ oxygen-rich blood</li><li>➤ left side</li><li>➤ heart</li><li>➤ brain</li><li>➤ upper body</li><li>➤ high-priority areas</li><li>➤ oxygenation</li><li>➤ fetus</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 199</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 199</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-year-old boy is brought to the pediatrician due to chronic constipation and failure to thrive. A barium enema shows a markedly dilated colon proximal to a segment of narrowed colon. A biopsy of the narrowed segment shows an absence of ganglion cells. The pediatrician explains to the parents that this condition is related to abnormal development of certain neural structures. Auerbach's plexus and Meissner's ganglion cells, which are missing in this child's condition, are derived from which of the following?", "options": [{"label": "A", "text": "Yolk Sac", "correct": false}, {"label": "B", "text": "Primordial Germ Cell", "correct": false}, {"label": "C", "text": "Neural Crest", "correct": true}, {"label": "D", "text": "Fetal GIT", "correct": false}], "correct_answer": "C. Neural Crest", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture49.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-164455.jpg"], "explanation": "<p><strong>Ans. C) Neural Crest</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The yolk sac is an early embryonic structure that provides nutrients to the developing embryo and also contributes to the formation of the primordial germ cells . However, it is not involved in the development of the enteric nervous system, including Auerbach's plexus and Meissner's ganglion cells .</li><li>• Option A:</li><li>• early embryonic structure</li><li>• nutrients</li><li>• developing embryo</li><li>• contributes</li><li>• formation</li><li>• primordial germ cells</li><li>• Auerbach's plexus</li><li>• Meissner's ganglion cells</li><li>• Option B: Primordial germ cells are the precursors to gametes ( sperm and eggs ) and are involved in the reproductive system . They do not contribute to the development of the nervous system, including the enteric nervous system .</li><li>• Option B:</li><li>• precursors</li><li>• gametes</li><li>• sperm</li><li>• eggs</li><li>• reproductive system</li><li>• enteric nervous system</li><li>• Option D: While Auerbach's plexus and Meissner's ganglion cells are located within the Gastro-Intestinal Tract (GIT) , they are not derived from the fetal GIT tissue itself. Instead, as noted, their origin is from the neural crest cells which migrate to the GIT during development .</li><li>• Option D:</li><li>• Auerbach's plexus</li><li>• Meissner's ganglion cells</li><li>• Gastro-Intestinal Tract (GIT)</li><li>• origin</li><li>• neural crest cells</li><li>• migrate</li><li>• GIT</li><li>• development</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Auerbach's Plexus ( Myenteric Plexus ) and Meissner's Plexus ( Submucosal Plexus ) are derived from Neural Crest Cells .</li><li>➤ Auerbach's Plexus ( Myenteric Plexus ) and Meissner's Plexus ( Submucosal Plexus ) are derived from Neural Crest Cells .</li><li>➤ Auerbach's Plexus</li><li>➤ Myenteric Plexus</li><li>➤ Meissner's Plexus</li><li>➤ Submucosal Plexus</li><li>➤ Neural Crest Cells</li><li>➤ These cells migrate from the neural crest to the gut during embryonic development and differentiate into the neurons and glial cells of the enteric nervous system .</li><li>➤ migrate</li><li>➤ neural crest</li><li>➤ gut</li><li>➤ embryonic development</li><li>➤ differentiate</li><li>➤ neurons</li><li>➤ glial cells</li><li>➤ enteric nervous system</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 236</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 236</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Crystalline Lens is derived from:", "options": [{"label": "A", "text": "Surface Ectoderm", "correct": true}, {"label": "B", "text": "Neuroectoderm", "correct": false}, {"label": "C", "text": "Mesoderm", "correct": false}, {"label": "D", "text": "Endoderm", "correct": false}], "correct_answer": "A. Surface Ectoderm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture17.jpg"], "explanation": "<p><strong>Ans. A) Surface Ectoderm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The neuroectoderm contributes to the formation of the retina and the optic nerve in the eye, but not the crystalline lens. The optic vesicle, which originates from the neuroectoderm , induces the overlying surface ectoderm to form the lens placode .</li><li>• Option B:</li><li>• formation</li><li>• retina</li><li>• optic nerve</li><li>• originates</li><li>• neuroectoderm</li><li>• overlying surface ectoderm</li><li>• form</li><li>• lens placode</li><li>• Option C: While the mesoderm contributes to many structures in the eye, including the vascular components (like the choroid and sclera ), it does not give rise to the crystalline lens. The mesoderm primarily forms the supportive and connective tissue elements of the eye .</li><li>• Option C:</li><li>• vascular components</li><li>• choroid</li><li>• sclera</li><li>• supportive</li><li>• connective tissue</li><li>• elements</li><li>• eye</li><li>• Option D: The endoderm is not involved in the development of the eye. It forms the lining of the gastrointestinal tract , respiratory system , and several associated organs , but it does not contribute to the development of ocular structures.</li><li>• Option D:</li><li>• lining</li><li>• gastrointestinal tract</li><li>• respiratory system</li><li>• several associated organs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The crystalline lens is derived from the surface ectoderm. During embryonic development, the surface ectoderm thickens to form the lens placode in response to signals from the optic vesicle (which is derived from the neuroectoderm ). The lens placode then invaginates to form the lens vesicle , which eventually detaches from the surface ectoderm and differentiates into the lens of the eye .</li><li>➤ The crystalline lens is derived from the surface ectoderm. During embryonic development, the surface ectoderm thickens to form the lens placode in response to signals from the optic vesicle (which is derived from the neuroectoderm ).</li><li>➤ thickens</li><li>➤ lens placode</li><li>➤ signals</li><li>➤ optic vesicle</li><li>➤ neuroectoderm</li><li>➤ The lens placode then invaginates to form the lens vesicle , which eventually detaches from the surface ectoderm and differentiates into the lens of the eye .</li><li>➤ lens placode</li><li>➤ invaginates</li><li>➤ form</li><li>➤ lens vesicle</li><li>➤ detaches</li><li>➤ surface ectoderm</li><li>➤ differentiates</li><li>➤ lens</li><li>➤ eye</li><li>➤ Ref : Textbook of Human Embryology, Embryology, First Edition. Yogesh Sontakke Pg 263</li><li>➤ Ref</li><li>➤ : Textbook of Human Embryology, Embryology, First Edition. Yogesh Sontakke Pg 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "First Commissure to develop:", "options": [{"label": "A", "text": "Corpus Callosum", "correct": false}, {"label": "B", "text": "Anterior Commissure", "correct": true}, {"label": "C", "text": "Hippocampus", "correct": false}, {"label": "D", "text": "Posterior Commissure", "correct": false}], "correct_answer": "B. Anterior Commissure", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture18.jpg"], "explanation": "<p><strong>Ans. B) Anterior Commissure</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: The corpus callosum is the largest commissure in the brain , connecting the left and right cerebral hemispheres . However, it is not the first commissure to develop. The corpus callosum typically begins to form around the 12th to 16th week of gestation and continues to develop and mature after birth .</li><li>• Option A:</li><li>• largest commissure</li><li>• brain</li><li>• connecting</li><li>• left</li><li>• right cerebral hemispheres</li><li>• begins</li><li>• form</li><li>• 12th</li><li>• 16th week</li><li>• gestation</li><li>• continues</li><li>• develop</li><li>• mature</li><li>• after birth</li><li>• Option C: The hippocampus is not a commissure but rather a part of the limbic system within the brain , playing key roles in memory and spatial navigation . It is involved in the formation of new memories and is connected to other parts of the brain , but it does not serve as a commissure itself.</li><li>• Option C:</li><li>• part</li><li>• limbic system</li><li>• brain</li><li>• memory</li><li>• spatial navigation</li><li>• new memories</li><li>• connected</li><li>• other parts</li><li>• brain</li><li>• Option D: The posterior commissure is a small bundle of fibers located at the upper end of the cerebral aqueduct in the midbrain . It is involved in the bilateral coordination of eye movements and other functions. While it is an important structure, it is not the first commissure to develop.</li><li>• Option D:</li><li>• small bundle</li><li>• fibers</li><li>• upper end</li><li>• cerebral aqueduct</li><li>• midbrain</li><li>• bilateral coordination</li><li>• eye movements</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The anterior commissure is a bundle of nerve fibers that connects the two temporal lobes of the cerebral hemispheres across the midline , passing through the basal forebrain . It develops earlier than the corpus callosum , typically forming during the early stages of fetal development , and is the first significant cerebral commissure to develop .</li><li>• The anterior commissure is a bundle of nerve fibers that connects the two temporal lobes of the cerebral hemispheres across the midline , passing through the basal forebrain .</li><li>• bundle</li><li>• nerve fibers</li><li>• connects</li><li>• two temporal lobes</li><li>• cerebral hemispheres</li><li>• midline</li><li>• basal forebrain</li><li>• It develops earlier than the corpus callosum , typically forming during the early stages of fetal development , and is the first significant cerebral commissure to develop .</li><li>• corpus callosum</li><li>• early stages</li><li>• fetal development</li><li>• first significant cerebral commissure</li><li>• develop</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 253</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 253</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man presents with a 6-month history of progressive memory loss, difficulty in planning and organizing, and personality changes. His family also reports episodes of confusion and agitation. MRI of the brain shows widespread cortical atrophy. Neuropathological examination would most likely show a significant increase in which of the following types of cells that are not derived from neuroepithelial cells?", "options": [{"label": "A", "text": "Neuron", "correct": false}, {"label": "B", "text": "Oligodendrocyte", "correct": false}, {"label": "C", "text": "Microglial Cells", "correct": true}, {"label": "D", "text": "Ependymal Cells", "correct": false}], "correct_answer": "C. Microglial Cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture19.jpg"], "explanation": "<p><strong>Ans. C) Microglial Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Neurons are the primary functional cells of the nervous system , responsible for transmitting and processing information . They indeed arise from neuroepithelial cells . During development, neuroepithelial cells in the neural tube differentiate into neural progenitor cells , which then give rise to neurons .</li><li>• Option A:</li><li>• primary functional cells</li><li>• nervous system</li><li>• transmitting</li><li>• processing information</li><li>• arise</li><li>• neuroepithelial cells</li><li>• differentiate</li><li>• neural progenitor cells</li><li>• rise</li><li>• neurons</li><li>• Option B: Oligodendrocytes are a type of glial cell in the central nervous system that produce myelin , a substance that insulates nerve fibers and increases the speed of electrical transmission between neurons . Oligodendrocytes also originate from neuroepithelial cells . As the neural tube develops, neuroepithelial cells give rise to neural stem cells that can differentiate into oligodendrocytes .</li><li>• Option B:</li><li>• type</li><li>• glial cell</li><li>• central nervous system</li><li>• myelin</li><li>• insulates nerve fibers</li><li>• increases</li><li>• speed</li><li>• electrical transmission</li><li>• between neurons</li><li>• originate</li><li>• neuroepithelial cells</li><li>• rise</li><li>• neural stem cells</li><li>• differentiate</li><li>• oligodendrocytes</li><li>• Option D: Ependymal cells line the ventricles in the brain and the central canal of the spinal cord . They are involved in the production and circulation of cerebrospinal fluid . Ependymal cells are derived from neuroepithelial cells . During development, neuroepithelial cells in the ventricular zone of the neural tube differentiate into ependymal cells .</li><li>• Option D:</li><li>• line</li><li>• ventricles</li><li>• brain</li><li>• central canal</li><li>• spinal cord</li><li>• production</li><li>• circulation</li><li>• cerebrospinal fluid</li><li>• Ependymal cells</li><li>• neuroepithelial cells</li><li>• ventricular zone</li><li>• neural tube differentiate</li><li>• ependymal cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Microglial cells are the resident immune cells of the central nervous system . However, they do not arise from neuroepithelial cells. Instead, microglia are derived from mesodermal progenitor cells , specifically from the yolk sac during early embryogenesis . They migrate into the developing nervous system .</li><li>➤ Microglial cells are the resident immune cells of the central nervous system . However, they do not arise from neuroepithelial cells.</li><li>➤ resident immune cells</li><li>➤ central nervous system</li><li>➤ Instead, microglia are derived from mesodermal progenitor cells , specifically from the yolk sac during early embryogenesis . They migrate into the developing nervous system .</li><li>➤ mesodermal progenitor cells</li><li>➤ yolk sac</li><li>➤ early embryogenesis</li><li>➤ migrate</li><li>➤ developing nervous system</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 238</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-month-old male infant is brought to the pediatric clinic for a routine check-up. On examination, the pediatrician notes that the right testicle is not palpable in the scrotum. The left testicle is normally located. The pediatrician explains to the parents about the normal process of testicular descent. During which month of gestation does the testis typically descend into the inguinal canal?", "options": [{"label": "A", "text": "4 th month", "correct": false}, {"label": "B", "text": "6 th month", "correct": false}, {"label": "C", "text": "7 th month", "correct": true}, {"label": "D", "text": "9 th month", "correct": false}], "correct_answer": "C. 7 th month", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-153841.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture32.jpg"], "explanation": "<p><strong>Ans. C) 7thmonth</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: During the 4th month of gestation, the testes are still in the process of developing and are located in the abdominal cavity , near the kidneys . They have not yet begun their descent through the inguinal canal. This timing is too early for the descent of the testes.</li><li>• Option A:</li><li>• abdominal cavity</li><li>• kidneys</li><li>• timing</li><li>• too early</li><li>• descent</li><li>• Option B: By the 6th month, the testes may begin their descent , but this is generally not the primary period when they descend through the inguinal canal. The process of testicular descent is typically not complete at this stage.</li><li>• Option B:</li><li>• may begin</li><li>• descent</li><li>• Option D: By the 9th month, the process of testicular descent is usually complete . The testes should already be in the scrotum by this time. If the testes have not descended by birth (a condition known as cryptorchidism ), it may require medical evaluation and intervention .</li><li>• Option D:</li><li>• testicular descent</li><li>• usually complete</li><li>• already be</li><li>• scrotum</li><li>• cryptorchidism</li><li>• medical evaluation</li><li>• intervention</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The descent of the testes through the inguinal canal into the scrotum primarily occurs around the 7th month of gestation . This is a critical developmental milestone in male fetuses , as proper positioning of the testes in the scrotum is important for sperm production and fertility later in life due to the temperature sensitivity of spermatogenesis .Top of Form</li><li>➤ The descent of the testes through the inguinal canal into the scrotum primarily occurs around the 7th month of gestation .</li><li>➤ inguinal canal</li><li>➤ scrotum</li><li>➤ 7th month</li><li>➤ gestation</li><li>➤ This is a critical developmental milestone in male fetuses , as proper positioning of the testes in the scrotum is important for sperm production and fertility later in life due to the temperature sensitivity of spermatogenesis .Top of Form</li><li>➤ critical developmental milestone</li><li>➤ male fetuses</li><li>➤ positioning</li><li>➤ testes</li><li>➤ scrotum</li><li>➤ sperm production</li><li>➤ fertility</li><li>➤ life</li><li>➤ temperature sensitivity</li><li>➤ spermatogenesis</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 219</li><li>➤ Ref</li><li>➤ : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 219</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old man presents to the clinic complaining of a small, painless lump at the upper pole of his left testis. He denies any history of trauma or infection. On examination, the lump is non-tender, mobile, and located at the head of the epididymis. The remainder of the testicular examination is normal. The physician reassures the patient about the benign nature of the lump and discusses its embryological origin. The appendix of the testis, as found in this patient, develops from which of the following structures?", "options": [{"label": "A", "text": "Allantois", "correct": false}, {"label": "B", "text": "Paramesonephric Duct", "correct": true}, {"label": "C", "text": "Mesonephric Duct", "correct": false}, {"label": "D", "text": "Cloaca", "correct": false}], "correct_answer": "B. Paramesonephric Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture34.jpg"], "explanation": "<p><strong>Ans. B) Paramesonephric Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The allantois is an early embryonic structure involved in nutrient and waste exchange for the developing embryo . It contributes to the formation of the urinary bladder and the umbilical cord but does not contribute to the development of the appendix of the testis.</li><li>• Option</li><li>• A:</li><li>• early embryonic structure</li><li>• nutrient</li><li>• waste exchange</li><li>• developing embryo</li><li>• formation</li><li>• urinary bladder</li><li>• umbilical cord</li><li>• Option C: The mesonephric duct (or Wolffian duct ) is important in the development of male internal genital structures , such as the epididymis , vas deferens , and seminal vesicles . However, it does not give rise to the appendix of the testis.</li><li>• Option C:</li><li>• Wolffian duct</li><li>• development</li><li>• male internal genital structures</li><li>• epididymis</li><li>• vas deferens</li><li>• seminal vesicles</li><li>• Option D: The cloaca is an embryonic structure that serves as a common cavity into which the intestinal , urinary , and genital tracts initially open . It later divides into separate components, forming structures of the urinary and digestive systems . The cloaca does not directly contribute to the formation of the appendix of the testis.</li><li>• Option D:</li><li>• embryonic structure</li><li>• common cavity</li><li>• intestinal</li><li>• urinary</li><li>• genital tracts</li><li>• open</li><li>• urinary</li><li>• digestive systems</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The appendix of the testis (or hydatid of Morgagni ) is thought to be a remnant of the paramesonephric duct (also known as the Müllerian duct ). In males , the paramesonephric ducts typically regress due to the influence of anti-Müllerian hormone ( AMH ) secreted by the Sertoli cells of the developing testes . However, small remnants can persist, one of which may become the appendix of the testis .</li><li>➤ The appendix of the testis (or hydatid of Morgagni ) is thought to be a remnant of the paramesonephric duct (also known as the Müllerian duct ).</li><li>➤ appendix</li><li>➤ testis</li><li>➤ hydatid of Morgagni</li><li>➤ remnant</li><li>➤ paramesonephric duct</li><li>➤ Müllerian duct</li><li>➤ In males , the paramesonephric ducts typically regress due to the influence of anti-Müllerian hormone ( AMH ) secreted by the Sertoli cells of the developing testes . However, small remnants can persist, one of which may become the appendix of the testis .</li><li>➤ males</li><li>➤ regress</li><li>➤ influence</li><li>➤ anti-Müllerian hormone</li><li>➤ AMH</li><li>➤ Sertoli cells</li><li>➤ developing testes</li><li>➤ small remnants</li><li>➤ become</li><li>➤ appendix</li><li>➤ testis</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Derivative of basal plate of neuroectoderm are all, except:", "options": [{"label": "A", "text": "Hypoglossal Nucleus", "correct": false}, {"label": "B", "text": "Nucleus Ambiguus", "correct": false}, {"label": "C", "text": "Nucleus Tractus Solitarius", "correct": true}, {"label": "D", "text": "Edinger Westphal Nucleus", "correct": false}], "correct_answer": "C. Nucleus Tractus Solitarius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture42.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture43.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture44.jpg"], "explanation": "<p><strong>Ans. C) Nucleus Tractus Solitarius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: The hypoglossal nucleus is a motor nucleus in the brainstem and is indeed derived from the basal plate of the neuroectoderm . It provides motor innervation to the muscles of the tongue and is located in the medulla oblongata .</li><li>• Option A:</li><li>• motor nucleus</li><li>• brainstem</li><li>• basal</li><li>• plate</li><li>• neuroectoderm</li><li>• motor innervation</li><li>• muscles</li><li>• tongue</li><li>• medulla oblongata</li><li>• Option B: The nucleus ambiguus, also derived from the basal plate of the neuroectoderm , is a motor nucleus in the medulla . It provides motor innervation to the muscles of the pharynx , larynx , and upper esophagus , playing a role in swallowing and vocalization .</li><li>• Option B:</li><li>• basal plate</li><li>• neuroectoderm</li><li>• motor nucleus</li><li>• medulla</li><li>• motor innervation</li><li>• muscles</li><li>• pharynx</li><li>• larynx</li><li>• upper esophagus</li><li>• role</li><li>• swallowing</li><li>• vocalization</li><li>• Option D: The Edinger-Westphal nucleus is derived from the basal plate and is part of the oculomotor complex . It provides parasympathetic innervation to the eye , controlling functions such as pupil constriction and lens accommodation .</li><li>• Option D:</li><li>• basal plate</li><li>• oculomotor complex</li><li>• parasympathetic innervation</li><li>• eye</li><li>• controlling functions</li><li>• pupil constriction</li><li>• lens accommodation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Nucleus Tractus Solitarius (NTS) is not derived from the basal plate; it is derived from the alar plate of the neuroectoderm . The alar plate is responsible for giving rise to sensory nuclei . The NTS is a sensory nucleus that receives afferent taste information and primary visceral sensory information .</li><li>➤ The Nucleus Tractus Solitarius (NTS) is not derived from the basal plate; it is derived from the alar plate of the neuroectoderm . The alar plate is responsible for giving rise to sensory nuclei . The NTS is a sensory nucleus that receives afferent taste information and primary visceral sensory information .</li><li>➤ alar plate</li><li>➤ neuroectoderm</li><li>➤ rise</li><li>➤ sensory nuclei</li><li>➤ sensory nucleus</li><li>➤ receives</li><li>➤ afferent taste information</li><li>➤ primary visceral sensory information</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 244</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 244</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Closure of umbilical vessel occur by:", "options": [{"label": "A", "text": "3-5 day", "correct": true}, {"label": "B", "text": "7-10 th day", "correct": false}, {"label": "C", "text": "2-3 months", "correct": false}, {"label": "D", "text": "2-3 weeks", "correct": false}], "correct_answer": "A. 3-5 day", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture45.jpg"], "explanation": "<p><strong>Ans. A) 3-5 day</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A:</li><li>• Option A:</li><li>• Muscle contraction in umbilical arteries occludes their lumen . Umbilical vein contracts a few minutes after the arteries .</li><li>• Muscle contraction in umbilical arteries occludes their lumen . Umbilical vein contracts a few minutes after the arteries .</li><li>• Muscle contraction</li><li>• umbilical arteries</li><li>• lumen</li><li>• few minutes</li><li>• arteries</li><li>• Physiological closure occurs soon after birth . Umbilical vein and ductus venosus close within two to five days after birth .</li><li>• Physiological closure occurs soon after birth . Umbilical vein and ductus venosus close within two to five days after birth .</li><li>• after birth</li><li>• Umbilical vein</li><li>• ductus venosus</li><li>• within two</li><li>• five days</li><li>• after birth</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The umbilical vessels , which include two arteries and one vein , begin to close soon after birth . The functional closure of the umbilical arteries typically occurs within the first few hours to days of life , often within 3-5 days . The mechanism involves muscular contraction of the vessel walls and the presence of Wharton's jelly , a gelatinous substance within the umbilical cord that also contributes to the occlusion process .</li><li>➤ The umbilical vessels , which include two arteries and one vein , begin to close soon after birth .</li><li>➤ umbilical vessels</li><li>➤ two arteries</li><li>➤ one vein</li><li>➤ close soon</li><li>➤ after birth</li><li>➤ The functional closure of the umbilical arteries typically occurs within the first few hours to days of life , often within 3-5 days .</li><li>➤ umbilical arteries</li><li>➤ within</li><li>➤ first few hours</li><li>➤ days of life</li><li>➤ within 3-5 days</li><li>➤ The mechanism involves muscular contraction of the vessel walls and the presence of Wharton's jelly , a gelatinous substance within the umbilical cord that also contributes to the occlusion process .</li><li>➤ muscular contraction</li><li>➤ vessel walls</li><li>➤ presence</li><li>➤ Wharton's jelly</li><li>➤ gelatinous substance</li><li>➤ umbilical cord</li><li>➤ contributes</li><li>➤ occlusion process</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 199</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 199</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents for a prenatal visit. She is currently at 12 weeks of gestation based on her last menstrual period. During the ultrasound, the physician discusses various developmental milestones of the fetus. The physician explains the importance of certain developmental processes in the early weeks of gestation. At what gestational age does the cloacal membrane typically rupture to form separate openings for the gastrointestinal and genitourinary tracts?", "options": [{"label": "A", "text": "7 weeks", "correct": true}, {"label": "B", "text": "8 weeks", "correct": false}, {"label": "C", "text": "10 weeks", "correct": false}, {"label": "D", "text": "12 weeks", "correct": false}], "correct_answer": "A. 7 weeks", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture46.jpg"], "explanation": "<p><strong>Ans. A) 7 weeks</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Rupture of the cloacal membrane typically occurs earlier than 8 weeks of gestation . By the 8th week, the separation of the anal and urogenital regions is usually already established due to the rupture that generally happens around the 7th week .</li><li>• Option B:</li><li>• Rupture</li><li>• cloacal membrane</li><li>• earlier than 8 weeks</li><li>• gestation</li><li>• separation</li><li>• anal</li><li>• urogenital regions</li><li>• already established</li><li>• rupture</li><li>• generally happens</li><li>• 7th week</li><li>• Option C: The rupture of the cloacal membrane happens earlier than 10 weeks of gestation . By this time in fetal development, the distinct anal and urogenital openings have been formed and further differentiation of the systems is underway .</li><li>• Option C:</li><li>• earlier</li><li>• 10 weeks</li><li>• gestation</li><li>• distinct anal</li><li>• urogenital openings</li><li>• formed</li><li>• differentiation</li><li>• systems</li><li>• underway</li><li>• Option D: The rupture of the cloacal membrane occurs earlier than 12 weeks of gestation . By the 12th week, significant development and differentiation of the urinary , reproductive , and digestive systems occurred, well after the cloacal membrane ruptured .</li><li>• Option D:</li><li>• earlier than 12 weeks of gestation</li><li>• significant development</li><li>• differentiation</li><li>• urinary</li><li>• reproductive</li><li>• digestive systems</li><li>• after</li><li>• cloacal membrane</li><li>• ruptured</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cloacal membrane usually ruptures around the 7th week of gestation . The rupture of the cloacal membrane allows for the establishment of separate anal and urogenital openings . This is an important step in the development of the urinary , reproductive, and digestive systems .</li><li>➤ The cloacal membrane usually ruptures around the 7th week of gestation . The rupture of the cloacal membrane allows for the establishment of separate anal and urogenital openings . This is an important step in the development of the urinary , reproductive, and digestive systems .</li><li>➤ ruptures</li><li>➤ 7th week</li><li>➤ gestation</li><li>➤ allows</li><li>➤ establishment</li><li>➤ separate anal</li><li>➤ urogenital openings</li><li>➤ development</li><li>➤ urinary</li><li>➤ reproductive,</li><li>➤ digestive systems</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man with a history of colorectal cancer is undergoing follow-up evaluation after surgical resection. The oncologist discusses the biology of cancer and its implications for treatment and prognosis. He explains the process of cell division and its importance in both normal cellular function and cancer growth. Based on this discussion, which of the following processes is not observed during mitosis?", "options": [{"label": "A", "text": "Cytokinesis", "correct": false}, {"label": "B", "text": "Separation of Chromatids", "correct": false}, {"label": "C", "text": "DNA Replication", "correct": true}, {"label": "D", "text": "Kinetochore Formation", "correct": false}], "correct_answer": "C. DNA Replication", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture47_AP2hSOo.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-163724_yQrKuGd.jpg"], "explanation": "<p><strong>Ans. C) DNA Replication</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Cytokinesis is seen in mitosis . It is the process that follows the completion of mitosis , where the cell cytoplasm divides and separates into two daughter cells . Cytokinesis is the final step in the process of cell division.</li><li>• Option A:</li><li>• mitosis</li><li>• completion</li><li>• mitosis</li><li>• cell cytoplasm</li><li>• divides</li><li>• separates</li><li>• two daughter cells</li><li>• final step</li><li>• Option B: The separation of sister chromatids is a key feature of mitosis . During anaphase , the sister chromatids (previously joined together ) are pulled apart by the spindle fibers towards opposite poles of the cell . This separation ensures that each new daughter cell will receive an identical set of chromosomes .</li><li>• Option B:</li><li>• mitosis</li><li>• During anaphase</li><li>• sister chromatids</li><li>• joined together</li><li>• pulled apart</li><li>• spindle fibers</li><li>• opposite poles</li><li>• cell</li><li>• each new daughter</li><li>• cell</li><li>• receive</li><li>• identical set</li><li>• chromosomes</li><li>• Option D: Kinetochore formation occurs in mitosis . Kinetochores are protein structures on the chromosomes where spindle fibers attach during cell division . The attachment of spindle fibers to kinetochores is crucial for the proper segregation of chromosomes into the daughter cells during mitosis .</li><li>• Option D:</li><li>• mitosis</li><li>• protein structures</li><li>• chromosomes</li><li>• spindle fibers</li><li>• cell division</li><li>• spindle fibers</li><li>• kinetochores</li><li>• proper segregation</li><li>• chromosomes</li><li>• daughter cells</li><li>• mitosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ DNA replication occurs during the S phase of the cell cycle , which precedes mitosis . It is not a part of mitosis itself. Before a cell enters mitosis , its DNA has already been replicated in the previous interphase stage of the cell cycle . Therefore, DNA replication is not seen during mitosis itself.</li><li>➤ DNA replication occurs during the S phase of the cell cycle , which precedes mitosis .</li><li>➤ S phase</li><li>➤ cell cycle</li><li>➤ precedes mitosis</li><li>➤ It is not a part of mitosis itself. Before a cell enters mitosis , its DNA has already been replicated in the previous interphase stage of the cell cycle . Therefore, DNA replication is not seen during mitosis itself.</li><li>➤ cell enters mitosis</li><li>➤ DNA</li><li>➤ replicated</li><li>➤ interphase stage</li><li>➤ cell cycle</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 3-4</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 3-4</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a Routine Prenatal visit, a 28-Week Pregnant Woman undergoes an Ultrasound. The obstetrician observes the Umbilical Cord and explains its structure and function to the Mother. The Umbilical Cord plays a crucial role in Fetal Development by transporting Blood between the Fetus and the Placenta. Typically, the umbilical cord contains how many Arteries and Veins?", "options": [{"label": "A", "text": "2 Artery and 1 Vein", "correct": true}, {"label": "B", "text": "1 Artery and 2 Vein", "correct": false}, {"label": "C", "text": "2 Artery and 2 Vein", "correct": false}, {"label": "D", "text": "Only One Artery", "correct": false}], "correct_answer": "A. 2 Artery and 1 Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture56.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture57.jpg"], "explanation": "<p><strong>Ans. A) 2 Artery and 1 Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: While the umbilical cord does have two vessels in addition to the artery, these are not both veins. Instead, there are two arteries and one vein , as stated in option A.</li><li>• Option B:</li><li>• two vessels</li><li>• two arteries</li><li>• one vein</li><li>• Option C: The umbilical cord does not have two veins . It only has one vein and two arteries .</li><li>• Option C:</li><li>• does not</li><li>• two veins</li><li>• one vein</li><li>• two arteries</li><li>• Option D: While there are rare cases where the umbilical cord may have only one artery (known as a single umbilical artery ), the typical anatomical arrangement includes two arteries . A single umbilical artery can be associated with certain fetal anomalies and is closely monitored when detected .</li><li>• Option D:</li><li>• may</li><li>• only one artery</li><li>• single umbilical artery</li><li>• two arteries</li><li>• single umbilical artery</li><li>• fetal anomalies</li><li>• closely monitored</li><li>• detected</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The umbilical cord typically contains two umbilical arteries and one umbilical vein . The umbilical arteries carry deoxygenated blood and waste products from the fetus to the placenta , while the umbilical vein carries oxygenated blood and nutrients from the placenta back to the fetus . This arrangement is critical for the proper exchange of blood and nutrients between the fetus and the mother .</li><li>➤ The umbilical cord typically contains two umbilical arteries and one umbilical vein .</li><li>➤ two umbilical arteries</li><li>➤ one umbilical vein</li><li>➤ The umbilical arteries carry deoxygenated blood and waste products from the fetus to the placenta , while the umbilical vein carries oxygenated blood and nutrients from the placenta back to the fetus .</li><li>➤ deoxygenated blood</li><li>➤ waste products</li><li>➤ fetus</li><li>➤ placenta</li><li>➤ oxygenated blood</li><li>➤ nutrients</li><li>➤ placenta back</li><li>➤ fetus</li><li>➤ This arrangement is critical for the proper exchange of blood and nutrients between the fetus and the mother .</li><li>➤ proper exchange</li><li>➤ blood</li><li>➤ nutrients</li><li>➤ fetus</li><li>➤ mother</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 82</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 82</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fertilization is complete when:", "options": [{"label": "A", "text": "First Polar Body is formed", "correct": false}, {"label": "B", "text": "2 nd Polar Body is formed", "correct": true}, {"label": "C", "text": "Primary Oocyte is formed", "correct": false}, {"label": "D", "text": "Secondary Oocyte is formed", "correct": false}], "correct_answer": "B. 2 nd Polar Body is formed", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture58_6m5YNuw.jpg"], "explanation": "<p><strong>Ans. B) 2ndPolar Body is formed</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The formation of the first polar body occurs as a part of oogenesis , specifically during the first meiotic division . Primary oocyte completes first meiotic division and forms secondary oocyte and first polar body in the ovary during follicular phase .</li><li>• Option A:</li><li>• part</li><li>• oogenesis</li><li>• first meiotic division</li><li>• Primary oocyte</li><li>• first meiotic division</li><li>• secondary oocyte</li><li>• first polar</li><li>• body</li><li>• ovary</li><li>• follicular phase</li><li>• Option C: The formation of the primary oocyte is an early stage in oogenesis and occurs before the oocyte is released from the ovary . The primary oocyte is arrested in prophase I of meiosis until ovulation. The formation of the primary oocyte is not related to the completion of fertilization.</li><li>• Option C:</li><li>• early stage</li><li>• oogenesis</li><li>• before</li><li>• oocyte</li><li>• released</li><li>• ovary</li><li>• arrested</li><li>• prophase I</li><li>• meiosis</li><li>• Option D: The secondary oocyte is formed after the first meiotic division and is the cell that is ovulated and available for fertilization . However, the formation of the secondary oocyte is not the final step in fertilization. The secondary oocyte remains arrested in metaphase II of meiosis until fertilization occurs.</li><li>• Option D:</li><li>• after</li><li>• first meiotic division</li><li>• cell</li><li>• ovulated</li><li>• available</li><li>• fertilization</li><li>• secondary oocyte</li><li>• arrested</li><li>• metaphase II</li><li>• meiosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Fertilization is complete when the second polar body is formed. This event occurs after the sperm has penetrated the oocyte, and the oocyte completes its second meiotic division . The formation of the second polar body ensures that the resulting zygote has the correct haploid number of chromosomes from the female gamete .</li><li>➤ Fertilization is complete when the second polar body is formed.</li><li>➤ second polar body</li><li>➤ This event occurs after the sperm has penetrated the oocyte, and the oocyte completes its second meiotic division .</li><li>➤ after</li><li>➤ sperm</li><li>➤ penetrated</li><li>➤ oocyte,</li><li>➤ second meiotic division</li><li>➤ The formation of the second polar body ensures that the resulting zygote has the correct haploid number of chromosomes from the female gamete .</li><li>➤ second polar body</li><li>➤ resulting zygote</li><li>➤ correct haploid number</li><li>➤ chromosomes</li><li>➤ female gamete</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 12</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 12</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old female presents to the clinic with Primary Amenorrhea. She has normal Secondary Sexual characteristics and Normal External Genitalia. Pelvic Ultrasound reveals a Normal Uterus but a Very Short Vaginal Canal. The physician discusses with her the Embryological Development of the Female Reproductive Tract. The Vaginal Epithelium is derived from which of the following Embryonic Structures?", "options": [{"label": "A", "text": "Mesoderm of Urogenital Sinus", "correct": false}, {"label": "B", "text": "Mesoderm of Urogenital Ridge", "correct": false}, {"label": "C", "text": "Endoderm of Urogenital Sinus", "correct": true}, {"label": "D", "text": "Endoderm of Genital Ridge", "correct": false}], "correct_answer": "C. Endoderm of Urogenital Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture59.jpg"], "explanation": "<p><strong>Ans. C) Endoderm of Urogenital Ridge</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: While the mesoderm contributes significantly to the reproductive system's development , the vaginal epithelium does not directly arise from the mesoderm of the urogenital sinus. The mesoderm primarily forms the connective tissue and muscular layers of the urogenital tract , not the epithelial lining.</li><li>• Option A:</li><li>• reproductive system's development</li><li>• connective tissue</li><li>• muscular layers</li><li>• urogenital tract</li><li>• Option B: The urogenital ridge primarily gives rise to the gonads ( ovaries in females ) and the mesonephric and paramesonephric ducts . The mesoderm of the urogenital ridge does not directly form the vaginal epithelium.</li><li>• Option B:</li><li>• gonads</li><li>• ovaries</li><li>• females</li><li>• mesonephric</li><li>• paramesonephric ducts</li><li>• Option D: The genital ridge is involved in the formation of the gonads ( ovaries in females ), and its endodermal component does not contribute to the development of the vaginal epithelium.</li><li>• Option D:</li><li>• formation</li><li>• gonads</li><li>• ovaries in females</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The urogenital sinus is involved in the development of the gonads and adjacent structures , and its endoderm does contribute to the vaginal epithelium .</li><li>• The urogenital sinus is involved in the development of the gonads and adjacent structures , and its endoderm does contribute to the vaginal epithelium .</li><li>• development</li><li>• gonads</li><li>• adjacent structures</li><li>• endoderm</li><li>• contribute</li><li>• vaginal epithelium</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 224</li><li>• Ref :</li><li>• Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 224</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with epigastric pain radiating to the back, nausea, and vomiting. He has a history of chronic alcohol use. On examination, he has epigastric tenderness. Laboratory tests show elevated serum amylase and lipase levels. A CT scan of the abdomen is ordered to evaluate his pancreatic anatomy and possible complications. Uncinate process of pancreas, often involved in pancreatitis, arises from the which embryological part?", "options": [{"label": "A", "text": "Ventral Bud", "correct": true}, {"label": "B", "text": "Dorsal Bud", "correct": false}, {"label": "C", "text": "Pars Cystica", "correct": false}, {"label": "D", "text": "Pars Hepatica", "correct": false}], "correct_answer": "A. Ventral Bud", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture67.jpg"], "explanation": "<p><strong>Ans. A) Ventral Bud</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The dorsal pancreatic bud contributes to most of the pancreas, including the majority of the head , the body , and the tail of the pancreas . However, it does not give rise to the uncinate process. The dorsal bud is the larger of the two and forms the initial structure of the gland .</li><li>• Option B:</li><li>• majority</li><li>• head</li><li>• body</li><li>• tail</li><li>• pancreas</li><li>• dorsal bud</li><li>• larger</li><li>• two</li><li>• forms</li><li>• gland</li><li>• Option C: Pars cystica refers to a part of the gallbladder , not the pancreas. It is involved in the storage and concentration of bile , produced by the liver . This option is not relevant to the development of the pancreas.</li><li>• Option C:</li><li>• gallbladder</li><li>• storage</li><li>• concentration</li><li>• bile</li><li>• liver</li><li>• Option D: Pars Hepatica refers to parts of the liver , specifically the functional tissue of the liver. Like pars cystica, this term is unrelated to the development of the pancreas and therefore is not involved in the formation of the uncinate process.</li><li>• Option D:</li><li>• liver</li><li>• development</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The uncinate process of the pancreas is a part that arises from the ventral pancreatic bud . During embryonic development, the ventral bud rotates and fuses with the dorsal bud . The ventral bud forms the lower part of the head of the pancreas and the uncinate process , which extends posteriorly .</li><li>➤ The uncinate process of the pancreas is a part that arises from the ventral pancreatic bud .</li><li>➤ uncinate process</li><li>➤ pancreas</li><li>➤ arises</li><li>➤ ventral pancreatic bud</li><li>➤ During embryonic development, the ventral bud rotates and fuses with the dorsal bud . The ventral bud forms the lower part of the head of the pancreas and the uncinate process , which extends posteriorly .</li><li>➤ rotates</li><li>➤ fuses</li><li>➤ dorsal bud</li><li>➤ lower part</li><li>➤ head</li><li>➤ pancreas</li><li>➤ uncinate process</li><li>➤ extends posteriorly</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 147.</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 147.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sertoli cells are derived from:", "options": [{"label": "A", "text": "Primordial Germ Cells", "correct": false}, {"label": "B", "text": "Surface Epithelium of Gonadal Ridge", "correct": true}, {"label": "C", "text": "Mesenchyme", "correct": false}, {"label": "D", "text": "Ectoderm", "correct": false}], "correct_answer": "B. Surface Epithelium of Gonadal Ridge", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture68.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture69.jpg"], "explanation": "<p><strong>Ans. B) Surface Epithelium of Gonadal Ridge</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Primordial Germ Cells are the precursors to spermatozoa in males . They migrate to the developing gonads during embryogenesis , where they eventually give rise to sperm . However, they do not differentiate into Sertoli cells. Sertoli cells functionally support the development of germ cells but have a different origin.</li><li>• Option</li><li>• A:</li><li>• spermatozoa</li><li>• males</li><li>• migrate</li><li>• gonads</li><li>• embryogenesis</li><li>• rise</li><li>• sperm</li><li>• Sertoli cells</li><li>• development</li><li>• germ cells</li><li>• Option C: The mesenchyme contributes to various structures in the gonads , including the Leydig cells in males , which produce testosterone . However, it is not the source of Sertoli cells. The mesenchyme is more involved in the structural and connective tissue components of the gonads .</li><li>• Option C:</li><li>• gonads</li><li>• Leydig cells</li><li>• males</li><li>• produce testosterone</li><li>• structural</li><li>• connective tissue</li><li>• gonads</li><li>• Option D: Ectoderm does not contribute to the development of Sertoli cells, as these are specific to the reproductive system originating from the surface epithelium of the gonadal ridge .</li><li>• Option D:</li><li>• reproductive system</li><li>• surface epithelium</li><li>• gonadal ridge</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 216</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 216</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old man presents to the clinic with symptoms of Urinary Frequency, Urgency, and a Weak Urinary System. His Prostate-Specific Antigen (PSA) Level is slightly elevated. Digital Rectal Examination reveals an Enlarged, but Smooth Prostate. He is being evaluated for Benign Prostatic Hyperplasia. Understanding the Embryological Development of the Prostate can help in managing conditions affecting this organ. Which of the following statements about Prostate Development is Correct?", "options": [{"label": "A", "text": "Parenchyma arise from Mesoderm", "correct": false}, {"label": "B", "text": "Prostatic Utricle from Wolffian Duct", "correct": false}, {"label": "C", "text": "Ejaculatory Duct from Mullerian Duct", "correct": false}, {"label": "D", "text": "Prostatic Urethra from Primitive Urethra", "correct": true}], "correct_answer": "D. Prostatic Urethra from Primitive Urethra", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Prostatic Urethra from Primitive Urethra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The parenchyma of the prostate gland arises from the endodermal urogenital sinus , not the mesoderm. The mesoderm contributes to the connective tissue and the smooth muscle of the prostate .</li><li>• Option</li><li>• A:</li><li>• prostate gland</li><li>• endodermal urogenital sinus</li><li>• connective tissue</li><li>• smooth muscle</li><li>• prostate</li><li>• Option B: The prostatic utricle is a small , midline cystic structure in the prostate , which is actually a remnant of the Müllerian ducts , not the Wolffian ducts. The Wolffian ducts give rise to male reproductive structures like the epididymis , vas deferens , and seminal vesicles .</li><li>• Option B:</li><li>• small</li><li>• midline cystic structure</li><li>• prostate</li><li>• remnant</li><li>• Müllerian ducts</li><li>• male reproductive structures</li><li>• epididymis</li><li>• vas deferens</li><li>• seminal vesicles</li><li>• Option C: The ejaculatory ducts are formed from the distal part of the Wolffian ducts and the seminal vesicle ducts . The Müllerian ducts regress in males and do not contribute to the formation of the ejaculatory ducts.</li><li>• Option C:</li><li>• distal part</li><li>• Wolffian ducts</li><li>• seminal vesicle</li><li>• ducts</li><li>• regress</li><li>• males</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The prostatic urethra, which passes through the prostate gland , is derived from a portion of the primitive urethra . The primitive urethra is part of the early developmental structure of the urethra , which eventually differentiates into various segments, including the prostatic urethra .</li><li>➤ The prostatic urethra, which passes through the prostate gland , is derived from a portion of the primitive urethra . The primitive urethra is part of the early developmental structure of the urethra , which eventually differentiates into various segments, including the prostatic urethra .</li><li>➤ prostate gland</li><li>➤ portion</li><li>➤ primitive urethra</li><li>➤ early developmental structure</li><li>➤ urethra</li><li>➤ differentiates</li><li>➤ prostatic urethra</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 225</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 225</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 27-year-old woman presents to the clinic with a complaint of lower abdominal pain. She mentions the pain becomes more pronounced during her menstrual periods. Physical examination reveals tenderness in the lower abdominal quadrants bilaterally. Her medical history is unremarkable. While considering the differential diagnosis, you recall the embryological remnants in the female reproductive system. Which of the following structures in the female reproductive system is a remnant of the gubernaculum?", "options": [{"label": "A", "text": "Broad Ligament", "correct": false}, {"label": "B", "text": "Ligamentum Teres", "correct": false}, {"label": "C", "text": "Cardinal Ligament", "correct": false}, {"label": "D", "text": "Round Ligament", "correct": true}], "correct_answer": "D. Round Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-160904.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-161021.jpg"], "explanation": "<p><strong>Ans. D) Round Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The broad ligament is a wide fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis . It is not a remnant of the gubernaculum. Instead, it serves as a major support structure for the uterus and other reproductive organs in females .</li><li>• Option A:</li><li>• wide fold</li><li>• peritoneum</li><li>• connects</li><li>• sides</li><li>• uterus</li><li>• walls</li><li>• floor</li><li>• pelvis</li><li>• serves</li><li>• major</li><li>• uterus</li><li>• females</li><li>• Option B: The ligamentum teres is a remnant of the umbilical vein from fetal life . It is not related to the gubernaculum. It extends from the umbilicus to the liver's inferior surface .</li><li>• Option B:</li><li>• remnant</li><li>• umbilical vein</li><li>• fetal life</li><li>• extends</li><li>• umbilicus</li><li>• liver's inferior surface</li><li>• Option C: The cardinal ligament, also known as the transverse cervical ligament , is a major support structure of the uterus. It is not a remnant of the gubernaculum. The cardinal ligament helps in holding the uterus in its position within the pelvis .</li><li>• Option C:</li><li>• transverse cervical ligament</li><li>• structure</li><li>• cardinal ligament</li><li>• holding</li><li>• uterus</li><li>• within</li><li>• pelvis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The round ligament of the uterus in females is indeed the remnant of the gubernaculum . During embryonic development, the gubernaculum guides the descent of the ovaries . In females , it forms the round ligament of the uterus , which extends from the uterus to the labia majora .</li><li>➤ The round ligament of the uterus in females is indeed the remnant of the gubernaculum .</li><li>➤ uterus</li><li>➤ females</li><li>➤ remnant</li><li>➤ gubernaculum</li><li>➤ During embryonic development, the gubernaculum guides the descent of the ovaries . In females , it forms the round ligament of the uterus , which extends from the uterus to the labia majora .</li><li>➤ gubernaculum</li><li>➤ descent</li><li>➤ ovaries</li><li>➤ females</li><li>➤ round ligament</li><li>➤ uterus</li><li>➤ extends</li><li>➤ uterus</li><li>➤ labia majora</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 221</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Parenchyma of all the following glands are derived from endoderm except?", "options": [{"label": "A", "text": "Thyroid Gland", "correct": false}, {"label": "B", "text": "Parathyroid Gland", "correct": false}, {"label": "C", "text": "Pancreas", "correct": false}, {"label": "D", "text": "Pituitary Gland", "correct": true}], "correct_answer": "D. Pituitary Gland", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-171014.jpg"], "explanation": "<p><strong>Ans. D) Pituitary Gland</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The thyroid glands parenchyma is derived from endoderm . Specifically, it originates from the floor of the pharynx at the level of the foramen cecum . The cells that form the thyroid gland migrate downwards to their final location in the neck .</li><li>• Option A:</li><li>• endoderm</li><li>• floor</li><li>• pharynx</li><li>• level</li><li>• foramen cecum</li><li>• thyroid gland migrate</li><li>• final location</li><li>• neck</li><li>• Option B: The parathyroid glands are also derived from the endoderm . They develop from the third and fourth pharyngeal pouches . The parathyroids are responsible for the production of parathyroid hormone , which regulates calcium levels in the body .</li><li>• Option B:</li><li>• endoderm</li><li>• third</li><li>• fourth pharyngeal pouches</li><li>• parathyroids</li><li>• production</li><li>• parathyroid hormone</li><li>• regulates</li><li>• calcium levels</li><li>• body</li><li>• Option C: The pancreas is derived from the endoderm as well. It develops from the dorsal and ventral pancreatic buds , which arise from the duodenal region of the gut tube . These buds eventually fuse to form the pancreas .</li><li>• Option C:</li><li>• endoderm</li><li>• dorsal</li><li>• ventral pancreatic buds</li><li>• arise</li><li>• duodenal region</li><li>• gut tube</li><li>• fuse</li><li>• form</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pituitary gland, also known as the hypophysis , has a dual origin . The anterior pituitary originates from an ectodermal outgrowth of the oral cavity known as Rathke's pouch , while the posterior pituitary is an extension of the brain , derived from the neuroectoderm .</li><li>➤ The pituitary gland, also known as the hypophysis , has a dual origin .</li><li>➤ hypophysis</li><li>➤ dual origin</li><li>➤ The anterior pituitary originates from an ectodermal outgrowth of the oral cavity known as Rathke's pouch , while the posterior pituitary is an extension of the brain , derived from the neuroectoderm .</li><li>➤ anterior pituitary</li><li>➤ ectodermal outgrowth</li><li>➤ oral cavity</li><li>➤ Rathke's pouch</li><li>➤ posterior pituitary</li><li>➤ extension</li><li>➤ brain</li><li>➤ neuroectoderm</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 69</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 69</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the clinic complaining of progressive difficulty in hearing, especially in noisy environments. She has no history of ear infections or trauma. On examination, her external auditory canals and tympanic membranes appear normal. A Rinne test shows bone conduction to be better than air conduction in the affected ear, and a Weber test lateralizes to the affected ear. Audiometry confirms conductive hearing loss. Which of the following structures, if affected, is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Malleus", "correct": false}, {"label": "B", "text": "Stapes", "correct": true}, {"label": "C", "text": "Maxilla", "correct": false}, {"label": "D", "text": "Mandible", "correct": false}], "correct_answer": "B. Stapes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-132456.jpg"], "explanation": "<p><strong>Ans. B) Stapes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The malleus is one of the ossicles in the middle ear, but it is not derived from the second pharyngeal arch. It is actually derived from the first pharyngeal arch , along with the incus . These two bones are involved in the transmission of sound vibrations to the inner ear .</li><li>• Option</li><li>• A:</li><li>• first pharyngeal arch</li><li>• incus</li><li>• transmission</li><li>• sound vibrations</li><li>• inner ear</li><li>• Option C: Maxilla , Upper jawbone, is not derived from the second pharyngeal arch. It is primarily a derivative of the first pharyngeal arch . The maxilla forms the upper part of the oral cavity and houses the upper teeth .</li><li>• Option C:</li><li>• ,</li><li>• first pharyngeal arch</li><li>• upper part</li><li>• oral cavity</li><li>• houses</li><li>• upper teeth</li><li>• Option D: Mandible, Lower jawbone, is also a derivative of the first pharyngeal arch , not the second. It forms the lower part of the jaw and houses the lower teeth .</li><li>• Option D:</li><li>• first pharyngeal arch</li><li>• lower part</li><li>• jaw</li><li>• houses</li><li>• lower teeth</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The stapes, another ossicle in the middle ear, is derived from the second pharyngeal arch . The stapes plays a crucial role in hearing , transmitting sound vibrations from the incus to the oval window of the inner ear .</li><li>➤ The stapes, another ossicle in the middle ear, is derived from the second pharyngeal arch .</li><li>➤ second pharyngeal arch</li><li>➤ The stapes plays a crucial role in hearing , transmitting sound vibrations from the incus to the oval window of the inner ear .</li><li>➤ hearing</li><li>➤ transmitting sound vibrations</li><li>➤ incus</li><li>➤ oval window</li><li>➤ inner ear</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 99</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 99</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with difficulty in speaking and swallowing. He reports that these symptoms have been progressively worsening over the past six months. Physical examination reveals atrophy and weakness of the tongue muscles. There is no sensory loss, and other cranial nerve functions are intact. His past medical history is significant for a long-standing diagnosis of a neurodegenerative disorder. Which of the following is the embryological origin of the affected muscle?", "options": [{"label": "A", "text": "Ectoderm", "correct": false}, {"label": "B", "text": "Branchial Arch", "correct": false}, {"label": "C", "text": "Occipital Myotomes", "correct": true}, {"label": "D", "text": "Septum Transversum", "correct": false}], "correct_answer": "C. Occipital Myotomes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture1_H9YdyKU.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture30.jpg"], "explanation": "<p><strong>Ans. C) Occipital Myotomes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The ectoderm gives rise to the skin , nervous system , and certain parts of the orofacial region . However, it does not contribute to the development of tongue muscles. The ectoderm forms more superficial structures rather than the musculature.</li><li>• Option A:</li><li>• skin</li><li>• nervous system</li><li>• orofacial region</li><li>• Option B: While the branchial arches contribute significantly to the structures in the head and neck , including parts of the tongue , they are not the primary source of the tongue muscles. The arches primarily contribute to the formation of the bones, cartilage , and connective tissues in the face and neck .</li><li>• Option B:</li><li>• head</li><li>• neck</li><li>• parts</li><li>• tongue</li><li>• bones, cartilage</li><li>• connective tissues</li><li>• face</li><li>• neck</li><li>• Option D: Septum Transversum is an embryonic structure that primarily contributes to the formation of the central tendon of the diaphragm . It is not involved in the development of tongue muscles. The septum transversum is more closely related to the development of structures in the thoracic region .</li><li>• Option D:</li><li>• embryonic</li><li>• structure</li><li>• central tendon</li><li>• diaphragm</li><li>• development</li><li>• structures</li><li>• thoracic region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The intrinsic muscles of the tongue develop from the occipital myotomes , which are segments of paraxial mesoderm located in the occipital region of the embryo . These myotomes give rise to the muscle precursors that migrate into the developing tongue , forming its musculature .</li><li>➤ The intrinsic muscles of the tongue develop from the occipital myotomes , which are segments of paraxial mesoderm located in the occipital region of the embryo .</li><li>➤ intrinsic muscles</li><li>➤ tongue</li><li>➤ occipital myotomes</li><li>➤ paraxial mesoderm</li><li>➤ occipital region</li><li>➤ embryo</li><li>➤ These myotomes give rise to the muscle precursors that migrate into the developing tongue , forming its musculature .</li><li>➤ muscle precursors</li><li>➤ migrate</li><li>➤ developing tongue</li><li>➤ musculature</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the emergency department with neck pain and limited range of motion following a minor car accident. Radiologic examination reveals an abnormality in the apical ligament of the dens. This ligament is embryologically derived from which of the following structures?", "options": [{"label": "A", "text": "Neural Tube", "correct": false}, {"label": "B", "text": "Neural Crest", "correct": false}, {"label": "C", "text": "Notochord", "correct": true}, {"label": "D", "text": "Neuropore", "correct": false}], "correct_answer": "C. Notochord", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture9_ocUwy9z.jpg"], "explanation": "<p><strong>Ans. C) Notochord</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: The neural tube is the precursor to the central nervous system , forming structures like the brain and spinal cord . While it is essential for the development of the nervous system, it does not give rise to the apical ligament of the dens.</li><li>• Option A:</li><li>• precursor</li><li>• central nervous system</li><li>• brain</li><li>• spinal cord</li><li>• Option B. Neural crest cells are a group of cells that arise from the border of the neural tube and migrate to various parts of the embryo . They contribute to the development of diverse structures , including peripheral nerves , melanocytes , and facial cartilage , but they do not form the apical ligament of the dens.</li><li>• Option B.</li><li>• arise</li><li>• border</li><li>• neural tube</li><li>• migrate</li><li>• embryo</li><li>• contribute</li><li>• development</li><li>• diverse structures</li><li>• peripheral nerves</li><li>• melanocytes</li><li>• facial cartilage</li><li>• Option D. The neuropores are the openings at the ends of the neural tube during early embryonic development . The closure of the neuropores is critical in the formation of the central nervous system . The neuropores do not contribute to the development of the apical ligament of the dens.</li><li>• Option D.</li><li>• openings</li><li>• ends</li><li>• neural tube</li><li>• early embryonic development</li><li>• closure</li><li>• neuropores</li><li>• critical</li><li>• formation</li><li>• central nervous system</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The apical ligament of the dens is a derivative of the notochord . The notochord is an embryonic structure that provides signals for the development of the vertebral column and eventually forms the nucleus pulposus of intervertebral discs . The apical ligament of the dens represents a remnant of the notochord .</li><li>➤ The apical ligament of the dens is a derivative of the notochord .</li><li>➤ apical ligament</li><li>➤ dens</li><li>➤ notochord</li><li>➤ The notochord is an embryonic structure that provides signals for the development of the vertebral column and eventually forms the nucleus pulposus of intervertebral discs .</li><li>➤ embryonic structure</li><li>➤ signals</li><li>➤ development</li><li>➤ vertebral column</li><li>➤ nucleus pulposus</li><li>➤ intervertebral discs</li><li>➤ The apical ligament of the dens represents a remnant of the notochord .</li><li>➤ apical ligament</li><li>➤ dens</li><li>➤ remnant</li><li>➤ notochord</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke pg 57</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke pg 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fate of 6 th aortic arch:", "options": [{"label": "A", "text": "Arch of Aorta", "correct": false}, {"label": "B", "text": "Ductus Arteriosus", "correct": true}, {"label": "C", "text": "Brachiocephalic Artery", "correct": false}, {"label": "D", "text": "Left Subclavian Artery", "correct": false}], "correct_answer": "B. Ductus Arteriosus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture10_QA7XZz3.jpg"], "explanation": "<p><strong>Ans. B) Ductus Arteriosus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: The arch of the aorta is not derived from the 6th aortic arch. It mainly arises from the left fourth aortic arch . These arch forms the part of the aorta that arches over the heart, giving rise to several major arteries .</li><li>• Option A:</li><li>• left fourth aortic arch</li><li>• several major arteries</li><li>• Option C: The brachiocephalic artery is not derived from the 6th aortic arch. It originates from the aortic sac and is associated with the development of the right fourth aortic arch . This artery branches into the right subclavian and right common carotid arteries .</li><li>• Option C:</li><li>• aortic sac</li><li>• development</li><li>• right fourth aortic arch</li><li>• right subclavian</li><li>• right common carotid arteries</li><li>• Option D: The left subclavian artery is derived from the seventh intersegmental artery , not from the 6th aortic arch. It supplies blood to the left arm and has different origins in embryonic development .</li><li>• Option D:</li><li>• seventh intersegmental artery</li><li>• supplies blood</li><li>• left arm</li><li>• embryonic development</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ductus arteriosus, a key fetal blood vessel that connects the pulmonary artery to the descending aorta , is derived from the left sixth aortic arch . In fetal life, the ductus arteriosus allows blood to bypass the non-functioning lungs . After birth, this vessel normally closes and becomes the ligamentum arteriosum .</li><li>➤ The ductus arteriosus, a key fetal blood vessel that connects the pulmonary artery to the descending aorta , is derived from the left sixth aortic arch .</li><li>➤ connects</li><li>➤ pulmonary artery</li><li>➤ descending aorta</li><li>➤ left sixth aortic arch</li><li>➤ In fetal life, the ductus arteriosus allows blood to bypass the non-functioning lungs . After birth, this vessel normally closes and becomes the ligamentum arteriosum .</li><li>➤ blood</li><li>➤ bypass</li><li>➤ non-functioning lungs</li><li>➤ closes</li><li>➤ ligamentum arteriosum</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 187</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 187</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The reason for the long left recurrent laryngeal is due to the persistence of which arch artery?", "options": [{"label": "A", "text": "3 rd", "correct": false}, {"label": "B", "text": "4 th", "correct": false}, {"label": "C", "text": "6 th", "correct": true}, {"label": "D", "text": "2 nd", "correct": false}], "correct_answer": "C. 6 th", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) 6th</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: The third arch artery contributes to the formation of the common carotid arteries and the proximal part of the internal carotid arteries . It does not play a role in the development of the left recurrent laryngeal nerve's course.</li><li>• Option A:</li><li>• common carotid arteries</li><li>• proximal part</li><li>• internal carotid arteries</li><li>• Option B: The fourth arch artery contributes to the formation of the aortic arch on the left side and the right subclavian artery on the right side . While important in the vascular development of the thoracic region, it is not directly responsible for the long course of the left recurrent laryngeal nerve.</li><li>• Option B:</li><li>• formation</li><li>• aortic arch</li><li>• left side</li><li>• right subclavian artery</li><li>• right side</li><li>• Option D: The second arch artery largely regresses during development and does not contribute significantly to the major arteries of the neck and thorax. It is not involved in the path of the left recurrent laryngeal nerve.</li><li>• Option D:</li><li>• largely regresses during development</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The left recurrent laryngeal nerve's length is due to its relationship with the 6th arch artery . In embryonic development, the left recurrent laryngeal nerve hooks around the ductus arteriosus , which is derived from the left 6th arch artery. As the ductus arteriosus becomes the ligamentum arteriosum after birth , the left recurrent laryngeal nerve maintains its long course beneath it. This is in contrast to the right side , where the right recurrent laryngeal nerve loops around the right subclavian artery and has a shorter course .</li><li>• The left recurrent laryngeal nerve's length is due to its relationship with the 6th arch artery .</li><li>• left recurrent laryngeal nerve's length</li><li>• 6th arch artery</li><li>• In embryonic development, the left recurrent laryngeal nerve hooks around the ductus arteriosus , which is derived from the left 6th arch artery.</li><li>• hooks around</li><li>• ductus arteriosus</li><li>• As the ductus arteriosus becomes the ligamentum arteriosum after birth , the left recurrent laryngeal nerve maintains its long course beneath it.</li><li>• ductus arteriosus</li><li>• ligamentum arteriosum</li><li>• after birth</li><li>• left recurrent laryngeal</li><li>• long course</li><li>• This is in contrast to the right side , where the right recurrent laryngeal nerve loops around the right subclavian artery and has a shorter course .</li><li>• right side</li><li>• right recurrent laryngeal nerve</li><li>• right subclavian artery</li><li>• shorter course</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 187</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 187</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic complaining of persistent abdominal discomfort and bloating. She has a history of chronic gastritis. On examination, you note mild tenderness in the epigastric region. Imaging studies reveal an enlargement in a structure derived from the dorsal mesentery. Which of the following structures is most likely involved in this patient's condition?", "options": [{"label": "A", "text": "Greater Omentum", "correct": true}, {"label": "B", "text": "Lesser Omentum", "correct": false}, {"label": "C", "text": "Liver", "correct": false}, {"label": "D", "text": "Diaphragm", "correct": false}], "correct_answer": "A. Greater Omentum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture11_MhB1mrI.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-125220.jpg"], "explanation": "<p><strong>Ans. A) Greater Omentum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B: The lesser omentum develops from the ventral mesentery , not the dorsal mesentery. It connects the lesser curvature of the stomach and the proximal part of the duodenum to the liver .</li><li>• Option B:</li><li>• ventral mesentery</li><li>• connects</li><li>• lesser curvature</li><li>• stomach</li><li>• proximal part</li><li>• duodenum</li><li>• liver</li><li>• Option C: The liver develops primarily from the endoderm of the foregut and the ventral mesentery . The liver buds from the ventral foregut endoderm and grows into the septum transversum , a part of the ventral mesentery . Hence, the liver does not develop from the dorsal mesentery.</li><li>• Option C:</li><li>• endoderm</li><li>• foregut</li><li>• ventral mesentery</li><li>• liver buds</li><li>• ventral foregut endoderm</li><li>• grows</li><li>• septum transversum</li><li>• ventral mesentery</li><li>• Option D: The diaphragm is a complex structure with multiple embryological origins . It arises from the septum transversum , pleuroperitoneal folds , esophageal mesentery , and body wall musculature . The septum transversum forms the central tendon of the diaphragm , but it is not a part of the dorsal mesentery.</li><li>• Option D:</li><li>• complex structure</li><li>• multiple embryological origins</li><li>• arises</li><li>• septum transversum</li><li>• pleuroperitoneal folds</li><li>• esophageal mesentery</li><li>• body wall musculature</li><li>• central tendon</li><li>• diaphragm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The greater omentum develops from the dorsal mesentery . It is a large apron-like fold of visceral peritoneum that hangs down from the stomach . During embryonic development, the greater omentum is formed from the dorsal mesentery that extends from the greater curvature of the stomach .</li><li>➤ The greater omentum develops from the dorsal mesentery . It is a large apron-like fold of visceral peritoneum that hangs down from the stomach . During embryonic development, the greater omentum is formed from the dorsal mesentery that extends from the greater curvature of the stomach .</li><li>➤ dorsal mesentery</li><li>➤ large apron-like fold</li><li>➤ visceral peritoneum</li><li>➤ hangs down</li><li>➤ stomach</li><li>➤ dorsal mesentery</li><li>➤ extends</li><li>➤ greater curvature</li><li>➤ stomach</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 130</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 130</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of them develop in the mesentery of gut tube except:", "options": [{"label": "A", "text": "Liver", "correct": false}, {"label": "B", "text": "Kidney", "correct": true}, {"label": "C", "text": "Spleen", "correct": false}, {"label": "D", "text": "Pancreas", "correct": false}], "correct_answer": "B. Kidney", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture12_f2zlxKN.jpg"], "explanation": "<p><strong>Ans. B) Kidney</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The liver develops in close association with the mesentery of the gut tube . It arises from the ventral foregut endoderm and is initially connected to the ventral mesentery . Although the liver is not technically within the mesentery, it has developmental and anatomical connections to it, especially through the hepatic portal system .</li><li>• Option</li><li>• A:</li><li>• mesentery</li><li>• gut tube</li><li>• arises</li><li>• ventral foregut endoderm</li><li>• connected</li><li>• ventral mesentery</li><li>• developmental</li><li>• anatomical connections</li><li>• hepatic portal system</li><li>• Option C: The spleen develops within the dorsal mesentery of the stomach , known as the dorsal mesogastrium . It arises from the mesenchymal cells in the dorsal mesogastrium and has a close developmental relationship with the gut tube .</li><li>• Option C:</li><li>• dorsal mesentery</li><li>• stomach</li><li>• dorsal mesogastrium</li><li>• mesenchymal cells</li><li>• dorsal mesogastrium</li><li>• gut tube</li><li>• Option D: The pancreas develops from two separate buds originating from the foregut endoderm , which are located in the dorsal and ventral mesentery of the gut tube . These buds eventually rotate and fuse to form the pancreas . Therefore, the pancreas has a developmental origin closely associated with the gut mesentery .</li><li>• Option D:</li><li>• two separate buds</li><li>• foregut endoderm</li><li>• dorsal</li><li>• ventral mesentery</li><li>• gut tube</li><li>• rotate</li><li>• fuse</li><li>• pancreas</li><li>• developmental origin</li><li>• gut mesentery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The kidneys develop from the intermediate mesoderm , not within the mesentery of the gut tube. They arise from a more dorsal position in the embryo and do not have the same type of developmental relationship with the gut tube and its mesentery as do the liver, spleen, and pancreas.</li><li>➤ The kidneys develop from the intermediate mesoderm , not within the mesentery of the gut tube.</li><li>➤ intermediate mesoderm</li><li>➤ They arise from a more dorsal position in the embryo and do not have the same type of developmental relationship with the gut tube and its mesentery as do the liver, spleen, and pancreas.</li><li>➤ more dorsal position</li><li>➤ embryo</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 145</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 145</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents to your clinic with chronic pelvic pain. During the examination and discussion about her reproductive anatomy, you mention remnants of embryological structures that can sometimes be implicated in such pain. One of these structures is the remnant of the Wolffian duct in females. Where are these remnants typically located?", "options": [{"label": "A", "text": "Pouch of Douglas", "correct": false}, {"label": "B", "text": "Broad Ligament", "correct": true}, {"label": "C", "text": "Uterovesical Pouch", "correct": false}, {"label": "D", "text": "Iliac Fossa", "correct": false}], "correct_answer": "B. Broad Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture16.jpg"], "explanation": "<p><strong>Ans. B) Broad Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Pouch of Douglas , a lso known as the rectouterine pouch , is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus . It is not a site for the remnants of the Wolffian ducts in females. It is the most dependent part of the peritoneal cavity in a female in erect posture .</li><li>• Option A:</li><li>• ,</li><li>• rectouterine pouch</li><li>• extension</li><li>• peritoneal cavity</li><li>• rectum</li><li>• posterior wall</li><li>• uterus</li><li>• most dependent</li><li>• part</li><li>• peritoneal cavity</li><li>• female</li><li>• erect posture</li><li>• Option C: The uterovesical pouch is the part of the peritoneal cavity that is located between the bladder and the uterus . It does not typically contain remnants of the Wolffian ducts.</li><li>• Option C:</li><li>• peritoneal cavity</li><li>• bladder</li><li>• uterus</li><li>• Option D: Iliac Fossa is not a location where remnants of the Wolffian ducts are typically found in females. The iliac fossa primarily contains structures like muscles and the iliacus muscle .</li><li>• Option D: Iliac Fossa</li><li>• muscles</li><li>• iliacus muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In females , remnants of the Wolffian ducts can be found in the broad ligament of the uterus . The broad ligament is a large fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis . The remnants of the Wolffian ducts in the broad ligament are known as the epoophoron and the paroophoron , which are small structures located near the ovaries and fallopian tubes .</li><li>➤ In females , remnants of the Wolffian ducts can be found in the broad ligament of the uterus .</li><li>➤ females</li><li>➤ broad ligament</li><li>➤ uterus</li><li>➤ The broad ligament is a large fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis .</li><li>➤ large fold</li><li>➤ peritoneum</li><li>➤ connects</li><li>➤ sides</li><li>➤ uterus</li><li>➤ walls</li><li>➤ floor</li><li>➤ pelvis</li><li>➤ The remnants of the Wolffian ducts in the broad ligament are known as the epoophoron and the paroophoron , which are small structures located near the ovaries and fallopian tubes .</li><li>➤ broad ligament</li><li>➤ epoophoron</li><li>➤ paroophoron</li><li>➤ small structures</li><li>➤ ovaries</li><li>➤ fallopian tubes</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 223</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 223</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old boy is brought to the emergency department with intermittent cramping abdominal pain and bloody stools for the past two days. He has no significant past medical history. On examination, he is afebrile, and his abdomen is soft with mild tenderness in the right lower quadrant. No masses are palpable, and the rest of the examination is unremarkable. An ultrasound of the abdomen shows a small outpouching in the distal ileum. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Gastroschisis", "correct": false}, {"label": "B", "text": "Omphalocele", "correct": false}, {"label": "C", "text": "Meckel’s Diverticulum", "correct": true}, {"label": "D", "text": "Ectopia Vesicae", "correct": false}], "correct_answer": "C. Meckel’s Diverticulum", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Meckel’s Diverticulum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Gastroschisis is a congenital defect in which there is an opening in the abdominal wall through which the abdominal contents protrude outside the body cavity . It is not associated with the persistence of the omphalomesenteric duct. Gastroschisis typically occurs to the right of the umbilicus and involves no covering sac around the protruding intestines.</li><li>• Option A:</li><li>• congenital defect</li><li>• opening</li><li>• abdominal wall</li><li>• abdominal</li><li>• protrude outside</li><li>• body cavity</li><li>• right</li><li>• umbilicus</li><li>• Option B: Omphalocele is a birth defect where the intestines , liver , and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall . Unlike gastroschisis, the organs are covered by a membrane. This condition is also not due to the persistence of the omphalomesenteric duct but is related to a failure in the normal return of intestines into the abdominal cavity during development.</li><li>• Option B:</li><li>• birth defect</li><li>• intestines</li><li>• liver</li><li>• remain outside</li><li>• abdomen</li><li>• development</li><li>• muscles</li><li>• abdominal wall</li><li>• failure</li><li>• normal return</li><li>• intestines</li><li>• abdominal cavity</li><li>• development.</li><li>• Option D: Ectopia vesicae is a rare congenital anomaly in which the bladder is turned inside out and exposed outside of the body, typically in the lower abdominal wall . It is not related to the persistence of the omphalomesenteric duct but results from abnormal development of the lower abdominal wall and bladder during embryogenesis .</li><li>• Option D:</li><li>• rare congenital anomaly</li><li>• bladder</li><li>• turned inside out</li><li>• exposed outside</li><li>• lower abdominal wall</li><li>• abnormal development</li><li>• lower abdominal</li><li>• wall</li><li>• bladder</li><li>• embryogenesis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meckel’s Diverticulum results from the incomplete obliteration of the omphalomesenteric duct . It is a pouch-like structure that can be found along the small intestine , usually within a few feet of the ileocecal valve . Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract .</li><li>➤ Meckel’s Diverticulum results from the incomplete obliteration of the omphalomesenteric duct .</li><li>➤ incomplete obliteration</li><li>➤ omphalomesenteric duct</li><li>➤ It is a pouch-like structure that can be found along the small intestine , usually within a few feet of the ileocecal valve .</li><li>➤ pouch-like structure</li><li>➤ small intestine</li><li>➤ few feet</li><li>➤ ileocecal valve</li><li>➤ Meckel's diverticulum is the most common congenital malformation of the gastrointestinal tract .</li><li>➤ most common congenital malformation</li><li>➤ gastrointestinal tract</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 213</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 213</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-Month-Old Infant is brought to the Pediatrician due to Recurrent Urinary Tract infections and Poor Urinary Stream. Ultrasound of the Urinary Tract reveals Dilatation of the Renal Pelvis and calyces with a Normal Bladder. The Pediatrician discusses the Embryological Development of the Urinary System with the parents. Which of the following statements is true regarding the Development of the Urinary Tract?", "options": [{"label": "A", "text": "If Cloaca not formed properly it can result in Urorectal Fistula", "correct": false}, {"label": "B", "text": "Apex of Bladder is formed by Mesonephros", "correct": false}, {"label": "C", "text": "Structure formed by Ureteric Bud is Collecting Ducts", "correct": true}, {"label": "D", "text": "Mesonephric Duct disappears completely", "correct": false}], "correct_answer": "C. Structure formed by Ureteric Bud is Collecting Ducts", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture26.jpg"], "explanation": "<p><strong>Ans. C) Structure formed by Ureteric Bud is Collecting Ducts.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The cloaca is the embryonic structure that initially receives drainage from the gastrointestinal and urogenital tracts . During normal development, the cloaca is divided into the urogenital sinus and the rectum by the urorectal septum . If this division does not occur properly, it can result in an abnormal connection between the urinary and rectal systems , known as a urorectal fistula .</li><li>• Option A:</li><li>• embryonic structure</li><li>• initially receives</li><li>• drainage</li><li>• gastrointestinal</li><li>• urogenital tracts</li><li>• cloaca</li><li>• urogenital sinus</li><li>• rectum</li><li>• urorectal septum</li><li>• does not occur</li><li>• abnormal connection</li><li>• urinary</li><li>• rectal systems</li><li>• urorectal fistula</li><li>• Option B: The apex of the bladder is actually formed by the urachus , which is a remnant of the allantois , not by the mesonephros. The mesonephros is a temporary kidney structure in the embryo that contributes to the development of the male reproductive system and the nephrons of the kidney , but it does not form the apex of the bladder.</li><li>• Option B:</li><li>• urachus</li><li>• remnant</li><li>• allantois</li><li>• mesonephros</li><li>• temporary kidney structure</li><li>• embryo</li><li>• development</li><li>• male reproductive system</li><li>• nephrons</li><li>• kidney</li><li>• Option D: The mesonephric duct does not disappear completely. In males, it contributes to the formation of the epididymis , vas deferens , ejaculatory duct , and seminal vesicles . In females, most of it degenerates, but remnants can persist as vestigial structures like the Gartner’s duct .</li><li>• Option D:</li><li>• contributes</li><li>• formation</li><li>• epididymis</li><li>• vas deferens</li><li>• ejaculatory duct</li><li>• seminal vesicles</li><li>• vestigial structures</li><li>• Gartner’s duct</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ureteric bud is an outgrowth from the mesonephric duct and plays a crucial role in the development of the urinary system . It gives rise to the ureter , renal pelvis , major and minor calyces , and collecting ducts of the kidney . The interaction between the ureteric bud and the metanephric mesenchyme is essential for the proper formation of the urinary system .</li><li>➤ The ureteric bud is an outgrowth from the mesonephric duct and plays a crucial role in the development of the urinary system .</li><li>➤ outgrowth</li><li>➤ mesonephric duct</li><li>➤ crucial role</li><li>➤ development</li><li>➤ urinary system</li><li>➤ It gives rise to the ureter , renal pelvis , major and minor calyces , and collecting ducts of the kidney .</li><li>➤ ureter</li><li>➤ renal pelvis</li><li>➤ major</li><li>➤ minor calyces</li><li>➤ collecting ducts</li><li>➤ kidney</li><li>➤ The interaction between the ureteric bud and the metanephric mesenchyme is essential for the proper formation of the urinary system .</li><li>➤ ureteric bud</li><li>➤ metanephric mesenchyme</li><li>➤ proper formation</li><li>➤ urinary system</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 205,211</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 205,211</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A Child complaint of recurrent abdominal pain and bilious vomiting. The condition was diagnosed by barium follow through.Surgical procedures followed-ladd's band division, appendicectomy and mesenteric widening. What will be the probable diagnosis?", "options": [{"label": "A", "text": "Duodenal Web", "correct": false}, {"label": "B", "text": "Acute Appendicitis", "correct": false}, {"label": "C", "text": "Malrotation", "correct": true}, {"label": "D", "text": "Caecal Volvulus", "correct": false}], "correct_answer": "C. Malrotation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture27.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture28.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture29.jpg"], "explanation": "<p><strong>Ans. C) Malrotation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: A duodenal web is a congenital malformation where a membrane partially or completely obstructs the lumen of the duodenum . This can cause symptoms like vomiting (which may be bilious ), feeding difficulties , and failure to thrive . However, the surgical approach for a duodenal web typically involves excision of the web , not the procedures described (Ladd's procedure and appendectomy).</li><li>• Option A:</li><li>• congenital</li><li>• malformation</li><li>• membrane partially</li><li>• completely obstructs</li><li>• lumen</li><li>• duodenum</li><li>• vomiting</li><li>• bilious</li><li>• feeding difficulties</li><li>• failure</li><li>• thrive</li><li>• surgical approach</li><li>• duodenal web</li><li>• excision</li><li>• web</li><li>• Option B: Acute appendicitis is inflammation of the appendix , presenting typically with abdominal pain , fever , and sometimes vomiting . Appendectomy is a treatment for appendicitis , but Ladd's procedure and mesenteric widening are not associated with the management of acute appendicitis.</li><li>• Option B:</li><li>• inflammation</li><li>• appendix</li><li>• abdominal pain</li><li>• fever</li><li>• sometimes vomiting</li><li>• appendicitis</li><li>• Option D: Caecal volvulus is a condition where the cecum twists on itself , leading to obstruction . It presents abdominal pain , distention , and vomiting . While surgical intervention is required, the typical approach does not involve Ladd's procedure or mesenteric widening. Instead, surgery aims to detorse the volvulus and may involve resection or fixation of the cecum .</li><li>• Option D:</li><li>• cecum twists</li><li>• itself</li><li>• obstruction</li><li>• abdominal pain</li><li>• distention</li><li>• vomiting</li><li>• detorse</li><li>• volvulus</li><li>• resection</li><li>• fixation</li><li>• cecum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Malrotation is a congenital anomaly in which the intestines do not rotate properly around the superior mesenteric artery during embryonic development. This can lead to volvulus which causes bilious vomiting and abdominal pain . Ladd's procedure is the surgical intervention for malrotation , which involves the division of Ladd's bands , appendectomy and widening of the mesenteric base to reduce the risk of future volvulus .Top of Form</li><li>➤ Malrotation is a congenital anomaly in which the intestines do not rotate properly around the superior mesenteric artery during embryonic development.</li><li>➤ congenital anomaly</li><li>➤ This can lead to volvulus which causes bilious vomiting and abdominal pain .</li><li>➤ volvulus</li><li>➤ bilious vomiting</li><li>➤ abdominal pain</li><li>➤ Ladd's procedure is the surgical intervention for malrotation , which involves the division of Ladd's bands , appendectomy and widening of the mesenteric base to reduce the risk of future volvulus .Top of Form</li><li>➤ surgical intervention</li><li>➤ malrotation</li><li>➤ division</li><li>➤ Ladd's bands</li><li>➤ appendectomy</li><li>➤ widening</li><li>➤ mesenteric base</li><li>➤ reduce</li><li>➤ risk</li><li>➤ future volvulus</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li><li>➤ Ref :</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with intermittent epigastric pain, nausea, and episodes of non-bloody vomiting over the last six months. An upper endoscopy reveals a 2 cm submucosal lesion with central umbilication in the antrum of the stomach. Biopsy results show ectopic pancreatic tissue. Given this finding, what is the most common site of ectopic pancreatic tissue?", "options": [{"label": "A", "text": "Stomach", "correct": true}, {"label": "B", "text": "Appendix", "correct": false}, {"label": "C", "text": "Jejunum", "correct": false}, {"label": "D", "text": "Hilum of Spleen", "correct": false}], "correct_answer": "A. Stomach", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture35.jpg"], "explanation": "<p><strong>Ans. A) Stomach</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: While ectopic pancreatic tissue can occur in the appendix , it is a rare occurrence . The appendix is not the most common site for ectopic pancreatic tissue.</li><li>• Option B:</li><li>• ectopic pancreatic tissue</li><li>• appendix</li><li>• rare occurrence</li><li>• Option C: The jejunum is another location where ectopic pancreatic tissue can be found, but it is less common compared to the stomach. When it does occur in the small intestine , it is more likely to cause symptoms, such as intestinal obstruction or bleeding .</li><li>• Option C:</li><li>• another location</li><li>• ectopic pancreatic tissue</li><li>• small intestine</li><li>• intestinal obstruction</li><li>• bleeding</li><li>• Option D: Ectopic pancreatic tissue at the hilum of the spleen is extremely rare . The spleen and pancreas develop in close proximity to each other, which can explain the occurrence of ectopic pancreatic tissue in this area, but it is not the most common site.</li><li>• Option D:</li><li>• Ectopic pancreatic tissue</li><li>• hilum</li><li>• spleen</li><li>• extremely rare</li><li>• spleen</li><li>• pancreas</li><li>• close proximity</li><li>• occurrence</li><li>• ectopic pancreatic</li><li>• tissue</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The most common site of ectopic pancreatic tissue is in the stomach, particularly along the greater curvature and near the pylorus . This anomaly often presents as asymptomatic , but it can sometimes lead to clinical problems such as abdominal pain , gastrointestinal bleeding , or obstruction .</li><li>• The most common site of ectopic pancreatic tissue is in the stomach, particularly along the greater curvature and near the pylorus .</li><li>• ectopic pancreatic tissue</li><li>• greater curvature</li><li>• near</li><li>• pylorus</li><li>• This anomaly often presents as asymptomatic , but it can sometimes lead to clinical problems such as abdominal pain , gastrointestinal bleeding , or obstruction .</li><li>• asymptomatic</li><li>• clinical problems</li><li>• abdominal pain</li><li>• gastrointestinal bleeding</li><li>• obstruction</li><li>• Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 148</li><li>• Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 148</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn male infant is brought to the pediatrician for a routine examination. The doctor notes that the infant has well-developed external genitalia. The parents inquire about the normal development of the male genitalia. The physician explains the embryological development of the external genital structures. The genital swellings in a male fetus differentiate into which of the following structures?", "options": [{"label": "A", "text": "Prepuce", "correct": false}, {"label": "B", "text": "Penile Urethra", "correct": false}, {"label": "C", "text": "Ischiocavernosus Penis", "correct": false}, {"label": "D", "text": "Scrotum", "correct": true}], "correct_answer": "D. Scrotum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture36.jpg"], "explanation": "<p><strong>Ans. D) Scrotum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The prepuce, or foreskin , in males is a fold of skin that covers the glans of the penis . It does not develop directly from genital swellings. Instead, it develops from the skin around the tip of the genital tubercle .</li><li>• Option A:</li><li>• foreskin</li><li>• males</li><li>• fold</li><li>• skin</li><li>• covers</li><li>• glans</li><li>• penis</li><li>• skin</li><li>• tip</li><li>• genital tubercle</li><li>• Option B: Penile Urethra is the tube through which urine and semen exit the body , is formed from the urethral plate on the ventral side of the genital tubercle , not directly from the genital swellings.</li><li>• Option B:</li><li>• urine</li><li>• semen</li><li>• exit</li><li>• body</li><li>• urethral plate</li><li>• ventral side</li><li>• genital tubercle</li><li>• Option C: The ischiocavernosus muscle is one of the pelvic floor muscles involved in penile erection . This muscle is not a direct derivative of genital swellings. It forms from the pelvic floor musculature , which has a different embryological origin .</li><li>• Option C:</li><li>• ischiocavernosus muscle</li><li>• pelvic floor muscles</li><li>• penile erection</li><li>• pelvic floor musculature</li><li>• different embryological origin</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In males, the genital swellings develop into the scrotum , the sac that houses the testes . These swellings grow , fuse at the midline , and eventually form the scrotal sac , which plays a crucial role in maintaining the optimal temperature for sperm production .</li><li>➤ In males, the genital swellings develop into the scrotum , the sac that houses the testes . These swellings grow , fuse at the midline , and eventually form the scrotal sac , which plays a crucial role in maintaining the optimal temperature for sperm production .</li><li>➤ genital swellings</li><li>➤ scrotum</li><li>➤ houses</li><li>➤ testes</li><li>➤ swellings grow</li><li>➤ fuse</li><li>➤ midline</li><li>➤ scrotal sac</li><li>➤ crucial role</li><li>➤ maintaining</li><li>➤ optimal temperature</li><li>➤ sperm production</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 226</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 226</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The caecum is found to be placed below the stomach and is midline. Which of the following abnormalities must have taken place while rotation of the gut?", "options": [{"label": "A", "text": "Malrotation", "correct": false}, {"label": "B", "text": "Nonrotation", "correct": false}, {"label": "C", "text": "Reverse Rotation", "correct": false}, {"label": "D", "text": "Mixed Rotation", "correct": true}], "correct_answer": "D. Mixed Rotation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-155333.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture38.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture39.jpg"], "explanation": "<p><strong>Ans. D) Mixed rotation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Malrotation is a broad term that refers to any abnormal rotation of the gut during embryonic development . It can result in various clinical presentations, depending on the degree and type of rotational error . Malrotation often leads to the small intestine being positioned on the right side of the abdomen and the large intestine on the left , but the description of the cecum being below the stomach and midline does not typically fit the classic presentation of malrotation.</li><li>• Option A:</li><li>• any abnormal rotation</li><li>• gut</li><li>• embryonic development</li><li>• depending</li><li>• degree</li><li>• type</li><li>• rotational error</li><li>• small intestine</li><li>• positioned</li><li>• right side</li><li>• abdomen</li><li>• large intestine</li><li>• left</li><li>• Option B: Nonrotation is a specific type of malrotation where the gut does not undergo any rotation . As a result, the small intestine is positioned on the right side of the abdomen, and the colon is on the left , with the cecum near the lower pole of the spleen . However, this does not typically result in the cecum being located below the stomach and in the midline.</li><li>• Option B:</li><li>• does not undergo</li><li>• any rotation</li><li>• small intestine</li><li>• positioned</li><li>• right side</li><li>• abdomen,</li><li>• colon</li><li>• left</li><li>• cecum</li><li>• lower pole</li><li>• spleen</li><li>• Option C: Reverse rotation is a rare form of intestinal malrotation where the transverse colon is located behind the superior mesenteric artery , and the small intestines are positioned anteriorly . While this is an abnormal rotation, it typically does not result in the cecum being positioned below the stomach and in the midline.</li><li>• Option C:</li><li>• rare form</li><li>• intestinal malrotation</li><li>• transverse colon</li><li>• behind</li><li>• superior mesenteric artery</li><li>• small intestines</li><li>• positioned anteriorly</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Mixed rotation refers to an atypical form of gut rotation that does not follow the usual patterns of malrotation, nonrotation, or reverse rotation. In mixed rotation, there can be various combinations of normal and abnormal rotations and fixations , which could lead to the cecum being in an unusual position , such as below the stomach and midline .</li><li>• Mixed rotation refers to an atypical form of gut rotation that does not follow the usual patterns of malrotation, nonrotation, or reverse rotation.</li><li>• atypical form</li><li>• gut rotation</li><li>• In mixed rotation, there can be various combinations of normal and abnormal rotations and fixations , which could lead to the cecum being in an unusual position , such as below the stomach and midline .</li><li>• combinations</li><li>• normal</li><li>• abnormal rotations</li><li>• fixations</li><li>• lead</li><li>• cecum</li><li>• unusual position</li><li>• below</li><li>• stomach</li><li>• midline</li><li>• Ref Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li><li>• Ref</li><li>• Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 135</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is Remnant of Mesonephric Tubules in Males?", "options": [{"label": "A", "text": "Ductus Deferens", "correct": false}, {"label": "B", "text": "Seminal Vesicle", "correct": false}, {"label": "C", "text": "Appendix of Epididymis", "correct": false}, {"label": "D", "text": "Paradidymis", "correct": true}], "correct_answer": "D. Paradidymis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture40.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture41.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-160413.jpg"], "explanation": "<p><strong>Ans. D) Paradidymis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The ductus deferens, also known as the vas deferens , is indeed derived from the mesonephric (Wolffian) duct . However, it is not a remnant; instead, it is a fully developed and functional component of the male reproductive system, responsible for transporting sperm from the epididymis to the ejaculatory ducts .</li><li>• Option A:</li><li>• vas deferens</li><li>• mesonephric (Wolffian) duct</li><li>• fully developed</li><li>• functional component</li><li>• male reproductive system,</li><li>• transporting sperm</li><li>• epididymis</li><li>• ejaculatory ducts</li><li>• Option B: The seminal vesicles develop from the mesonephric ducts , but like the ductus deferens, they are not considered remnants. The seminal vesicles are active glands that produce a significant portion of the seminal fluid .</li><li>• Option B:</li><li>• mesonephric ducts</li><li>• active glands</li><li>• significant portion</li><li>• seminal fluid</li><li>• Option C: The appendix of the epididymis is a small vestigial remnant found on the epididymis . However, it is actually derived from the Müllerian duct ( paramesonephric duct ), not the mesonephric duct, and is therefore not the correct answer.</li><li>• Option C:</li><li>• small vestigial remnant</li><li>• epididymis</li><li>• Müllerian duct</li><li>• paramesonephric duct</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The paradidymis is a small vestigial structure found near the testis . It consists of small tubules that are remnants of the mesonephric tubules . These tubules are non-functional in the adult male and represent a vestigial remnant of embryonic development .</li><li>• The paradidymis is a small vestigial structure found near the testis . It consists of small tubules that are remnants of the mesonephric tubules .</li><li>• small vestigial structure</li><li>• testis</li><li>• small tubules</li><li>• remnants</li><li>• mesonephric tubules</li><li>• These tubules are non-functional in the adult male and represent a vestigial remnant of embryonic development .</li><li>• non-functional</li><li>• adult male</li><li>• vestigial remnant</li><li>• embryonic development</li><li>• Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 222</li><li>• Ref :</li><li>• Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 222</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is seen in the fertility clinic due to difficulty conceiving for the past two years. During her evaluation, the physician discusses various aspects of reproductive biology. She explains the origin of germ cells, which are crucial for fertility. From which of the following embryonic structures are germ cells derived?", "options": [{"label": "A", "text": "Epiblast", "correct": true}, {"label": "B", "text": "Hypoblast", "correct": false}, {"label": "C", "text": "Endoderm", "correct": false}, {"label": "D", "text": "Neural Crest Cells", "correct": false}], "correct_answer": "A. Epiblast", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture50.jpg"], "explanation": "<p><strong>Ans. A) Epiblast</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The hypoblast is a layer of cells in the early embryo that contributes to the formation of the extraembryonic structures like the yolk sac . However, it does not give rise to germ cells. The hypoblast is located beneath the epiblast but is not involved in the formation of the primary germ layers or the germ cells.</li><li>• Option B:</li><li>• layer</li><li>• cells</li><li>• early embryo</li><li>• contributes</li><li>• formation</li><li>• extraembryonic structures</li><li>• yolk sac</li><li>• hypoblast</li><li>• beneath</li><li>• epiblast</li><li>• Option C: The endoderm is one of the three primary germ layers formed during gastrulation . It gives rise to the lining of the digestive and respiratory systems and associated organs. While the endoderm is important for many aspects of organogenesis , it is not the source of germ cells.</li><li>• Option C:</li><li>• three primary germ</li><li>• layers</li><li>• during gastrulation</li><li>• rise</li><li>• lining</li><li>• digestive</li><li>• respiratory systems</li><li>• organs.</li><li>• endoderm</li><li>• organogenesis</li><li>• Option D: Neural crest cells are a group of cells that originate from the ectoderm and contribute to the development of many structures, including certain neurons , glial cells , and components of the peripheral nervous system . However, they are not involved in the formation of germ cells.</li><li>• Option D:</li><li>• group of cells</li><li>• originate</li><li>• ectoderm</li><li>• neurons</li><li>• glial cells</li><li>• components</li><li>• peripheral nervous system</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Germ cells are derived from the epiblast , which is a layer of cells in the early embryo . The epiblast gives rise to all three primary germs during gastrulation and also to the primordial germ cells . These primordial germ cells migrate to the developing gonads where they will eventually give rise to gametes .</li><li>➤ Germ cells are derived from the epiblast , which is a layer of cells in the early embryo .</li><li>➤ Germ cells</li><li>➤ epiblast</li><li>➤ layer</li><li>➤ cells</li><li>➤ early embryo</li><li>➤ The epiblast gives rise to all three primary germs during gastrulation and also to the primordial germ cells . These primordial germ cells migrate to the developing gonads where they will eventually give rise to gametes .</li><li>➤ all three primary germs</li><li>➤ gastrulation</li><li>➤ primordial germ cells</li><li>➤ migrate</li><li>➤ developing gonads</li><li>➤ gametes</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 6</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 6</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Trophoblast gives rise to all of the following except:", "options": [{"label": "A", "text": "Cytotrophoblast", "correct": false}, {"label": "B", "text": "Syncytiotrophoblast", "correct": false}, {"label": "C", "text": "Intraembryonic Mesoderm", "correct": true}, {"label": "D", "text": "Extra Embryonic Mesoderm", "correct": false}], "correct_answer": "C. Intraembryonic Mesoderm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture52.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture53.jpg"], "explanation": "<p><strong>Ans. C) Intraembryonic Mesoderm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Trophoblasts differentiate into cytotrophoblasts and syncytiotrophoblasts . It consists of mononucleated cells that maintain their cell boundaries and continue to proliferate throughout pregnancy . The cytotrophoblast contributes to the formation and maintenance of the placenta .</li><li>• Option A:</li><li>• cytotrophoblasts</li><li>• syncytiotrophoblasts</li><li>• mononucleated cells</li><li>• cell boundaries</li><li>• continue</li><li>• proliferate</li><li>• pregnancy</li><li>• formation</li><li>• maintenance</li><li>• placenta</li><li>• Option B: The syncytiotrophoblast also arises from the trophoblast . It is formed when cells of the cytotrophoblast fuse , creating a multinucleated structure without distinct cell boundaries . The syncytiotrophoblast is involved in the invasion of the uterine lining and facilitates the exchange of nutrients and waste between the mother and the embryo .</li><li>• Option B:</li><li>• trophoblast</li><li>• cytotrophoblast fuse</li><li>• multinucleated structure</li><li>• distinct cell boundaries</li><li>• invasion</li><li>• uterine lining</li><li>• facilitates</li><li>• exchange</li><li>• nutrients</li><li>• waste between</li><li>• mother</li><li>• embryo</li><li>• Option D: The extraembryonic mesoderm arises from the trophoblast and yolk sac . It forms the connective tissue of the placenta and the umbilical cord , as well as the primary structures of the chorion and amnion , which are membranes that surround the embryo .</li><li>• Option D:</li><li>• trophoblast</li><li>• yolk sac</li><li>• connective tissue</li><li>• placenta</li><li>• umbilical cord</li><li>• primary structures</li><li>• chorion</li><li>• amnion</li><li>• surround</li><li>• embryo</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Intraembryonic Mesoderm, as the intraembryonic mesoderm does not arise from the trophoblast. The intraembryonic mesoderm is a germ layer that forms within the embryo and gives rise to many internal structures , including the muscles , skeleton , vascular system , and some organs . It is distinct from the trophoblast and arises from a different part of the early embryo during the process of gastrulation .</li><li>➤ Intraembryonic Mesoderm, as the intraembryonic mesoderm does not arise from the trophoblast.</li><li>➤ The intraembryonic mesoderm is a germ layer that forms within the embryo and gives rise to many internal structures , including the muscles , skeleton , vascular system , and some organs .</li><li>➤ germ layer</li><li>➤ within</li><li>➤ embryo</li><li>➤ many internal structures</li><li>➤ muscles</li><li>➤ skeleton</li><li>➤ vascular system</li><li>➤ some organs</li><li>➤ It is distinct from the trophoblast and arises from a different part of the early embryo during the process of gastrulation .</li><li>➤ trophoblast</li><li>➤ arises</li><li>➤ different part</li><li>➤ early embryo</li><li>➤ process</li><li>➤ gastrulation</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 74</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 74</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A First-Year Medical Student is discussing Embryological development with her professor. She learns about a key structure that forms early in Embryogenesis and is crucial for the establishment of the Body Axis and Germ Layer Formation. The professor asks her to identify this structure. The Primitive Streak, which is essential for this process, develops from which of the following Embryonic Layers?", "options": [{"label": "A", "text": "Mesoderm", "correct": false}, {"label": "B", "text": "Epiblast", "correct": true}, {"label": "C", "text": "Neural Plate", "correct": false}, {"label": "D", "text": "Hypoblast", "correct": false}], "correct_answer": "B. Epiblast", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture54.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture55.jpg"], "explanation": "<p><strong>Ans. B) Epiblast</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Mesoderm is not the source of the primitive streak. Instead, the formation of the mesoderm is actually initiated by the process of gastrulation , which begins with the formation of the primitive streak .</li><li>• Option A:</li><li>• formation</li><li>• mesoderm</li><li>• initiated</li><li>• process</li><li>• gastrulation</li><li>• begins</li><li>• formation</li><li>• primitive streak</li><li>• Option C: The neural plate is the precursor to the central nervous system and is derived from the ectoderm , one of the germ layers formed after the establishment of the primitive streak . Therefore, the neural plate is a result of development processes that occur after the formation of the primitive streak and not its source.</li><li>• Option C:</li><li>• precursor</li><li>• central nervous system</li><li>• ectoderm</li><li>• germ layers</li><li>• after</li><li>• establishment</li><li>• primitive streak</li><li>• neural plate</li><li>• result</li><li>• development processes</li><li>• formation</li><li>• primitive streak</li><li>• Option D: The hypoblast is a layer of cells that contribute to the formation of the extraembryonic structures like the yolk sac but does not give rise to the primitive streak. The hypoblast is located beneath the epiblast in the early embryo .</li><li>• Option D:</li><li>• layer</li><li>• cells</li><li>• contribute</li><li>• formation</li><li>• extraembryonic structures</li><li>• yolk sac</li><li>• hypoblast</li><li>• beneath</li><li>• epiblast</li><li>• early embryo</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The primitive streak arises from the epiblast layer . The epiblast is a layer of cells in the early embryo that gives rise to all three germ layers during gastrulation . The cells of the epiblast migrate inward at the primitive streak, differentiating into the various germ layers .</li><li>➤ The primitive streak arises from the epiblast layer . The epiblast is a layer of cells in the early embryo that gives rise to all three germ layers during gastrulation . The cells of the epiblast migrate inward at the primitive streak, differentiating into the various germ layers .</li><li>➤ arises</li><li>➤ epiblast layer</li><li>➤ rise</li><li>➤ all three germ layers</li><li>➤ gastrulation</li><li>➤ epiblast migrate</li><li>➤ inward</li><li>➤ various germ layers</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 51</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 51</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a derivative of surface ectoderm?", "options": [{"label": "A", "text": "Lacrimal Gland", "correct": false}, {"label": "B", "text": "Conjunctival Epithelium", "correct": false}, {"label": "C", "text": "Epithelium Over Iris", "correct": true}, {"label": "D", "text": "Lens", "correct": false}], "correct_answer": "C. Epithelium Over Iris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-174411.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture60.jpg"], "explanation": "<p><strong>Ans. C) Epithelium Over Iris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The lacrimal gland, which produces tears , is indeed a derivative of the surface ectoderm . During embryonic development, the surface ectoderm gives rise to various glands, including the lacrimal gland .</li><li>• Option A:</li><li>• tears</li><li>• derivative</li><li>• surface ectoderm</li><li>• surface ectoderm</li><li>• lacrimal gland</li><li>• Option B: The conjunctival epithelium, which lines the inside of the eyelids and covers the sclera , is derived from the surface ectoderm . This epithelial layer is crucial for protecting the eye and maintaining a moist environment .</li><li>• Option B:</li><li>• lines</li><li>• inside</li><li>• eyelids</li><li>• covers</li><li>• sclera</li><li>• surface ectoderm</li><li>• protecting</li><li>• eye</li><li>• maintaining</li><li>• moist environment</li><li>• Option D: The lens of the eye is a derivative of the surface ectoderm . It forms from the lens placode , an area of the head ectoderm that thickens and eventually forms the lens vesicle , giving rise to the lens of the eye. This process is critical for proper eye development and function .</li><li>• Option D:</li><li>• derivative</li><li>• surface ectoderm</li><li>• lens placode</li><li>• area</li><li>• head ectoderm</li><li>• thickens</li><li>• lens vesicle</li><li>• rise</li><li>• lens</li><li>• proper eye development</li><li>• function</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The epithelium over the iris is not derived from the surface ectoderm. Instead, it is derived from the neuroectoderm , specifically from the optic cup , which is an outgrowth of the diencephalon (part of the brain). The iris itself, including its epithelium , originates from this neuroectodermal tissue .</li><li>➤ The epithelium over the iris is not derived from the surface ectoderm. Instead, it is derived from the neuroectoderm , specifically from the optic cup , which is an outgrowth of the diencephalon (part of the brain).</li><li>➤ neuroectoderm</li><li>➤ optic cup</li><li>➤ outgrowth</li><li>➤ diencephalon (part of the brain).</li><li>➤ The iris itself, including its epithelium , originates from this neuroectodermal tissue .</li><li>➤ epithelium</li><li>➤ neuroectodermal tissue</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 263</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the true statement about Zona Pellucida:", "options": [{"label": "A", "text": "It is the Cell Membrane of Secondary Oocyte", "correct": false}, {"label": "B", "text": "It Disappears on Day 8", "correct": false}, {"label": "C", "text": "It prevents Implantation", "correct": true}, {"label": "D", "text": "Barrier in Zona Pellucida is provided by Acrosinase", "correct": false}], "correct_answer": "C. It prevents Implantation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture61.jpg"], "explanation": "<p><strong>Ans. C) It prevents Implantation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The zona pellucida is not the cell membrane of the oocyte. It is a non-cellular , gel-like layer that surrounds the oocyte . The actual cell membrane of the oocyte is called the oolemma .</li><li>• Option A:</li><li>• non-cellular</li><li>• gel-like layer</li><li>• oocyte</li><li>• actual cell membrane</li><li>• oocyte</li><li>• oolemma</li><li>• Option B: The zona pellucida does not disappear on Day 8. It remains intact until the blastocyst stage, after which it breaks down to facilitate implantation . This breakdown typically occurs around Day 5-6 post-fertilization , as the embryo needs to hatch out of the zona pellucida to implant in the uterine wall .</li><li>• Option B:</li><li>• remains intact</li><li>• blastocyst stage,</li><li>• breaks down</li><li>• facilitate implantation</li><li>• Day 5-6 post-fertilization</li><li>• hatch out</li><li>• zona pellucida</li><li>• implant</li><li>• uterine wall</li><li>• Option D: Acrosin is an enzyme in the acrosome of the sperm that helps the sperm to penetrate the zona pellucida during fertilization . It does not provide a barrier; instead, it assists in breaking down the barrier to allow the sperm to reach the oocyte .</li><li>• Option D:</li><li>• Acrosin</li><li>• enzyme</li><li>• acrosome</li><li>• sperm</li><li>• sperm</li><li>• penetrate</li><li>• zona pellucida</li><li>• fertilization</li><li>• assists</li><li>• breaking down</li><li>• barrier</li><li>• allow</li><li>• sperm</li><li>• reach</li><li>• oocyte</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The zona pellucida must be shed or hatched through by the developing embryo before implantation can occur . If the embryo does not escape from the zona pellucida, it cannot implant in the uterine lining. This hatching is necessary for the embryo to make direct contact with the endometrial cells of the uterus .</li><li>• The zona pellucida must be shed or hatched through by the developing embryo before implantation can occur .</li><li>• shed</li><li>• hatched</li><li>• developing</li><li>• embryo</li><li>• before implantation</li><li>• occur</li><li>• If the embryo does not escape from the zona pellucida, it cannot implant in the uterine lining.</li><li>• This hatching is necessary for the embryo to make direct contact with the endometrial cells of the uterus .</li><li>• embryo</li><li>• make direct contact</li><li>• endometrial cells</li><li>• uterus</li><li>• Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 15</li><li>• Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 15</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman comes to the clinic concerned about her inability to conceive after one year of trying. She has a regular menstrual cycle and a normal gynecological history. Her husband's semen analysis is normal. Hormonal assays reveal normal levels of FSH, LH, and estradiol. A hysterosalpingogram shows patent fallopian tubes. Which of the following is least likely to be a direct result of successful fertilization in this patient?", "options": [{"label": "A", "text": "Determination of Chromosomal Sex", "correct": false}, {"label": "B", "text": "Initiation of Cleavage", "correct": false}, {"label": "C", "text": "Implantation", "correct": true}, {"label": "D", "text": "Restoration of Diploid Number of Chromosomes", "correct": false}], "correct_answer": "C. Implantation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture62.jpg"], "explanation": "<p><strong>Ans. C) Implantation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The chromosomal sex of the new organism is determined at the moment of fertilization . If the sperm carries an X chromosome and fuses with the ovum (which always carries an X chromosome ), the resulting zygote will be XX (female ). If the sperm carries a Y chromosome , the zygote will be XY ( male ). Thus, the sex of the offspring is determined by the sperm's chromosome .</li><li>• Option</li><li>• A:</li><li>• moment</li><li>• fertilization</li><li>• sperm carries</li><li>• X chromosome</li><li>• fuses</li><li>• ovum</li><li>• always carries</li><li>• X chromosome</li><li>• XX (female</li><li>• sperm</li><li>• Y chromosome</li><li>• XY</li><li>• male</li><li>• sperm's chromosome</li><li>• Option B: Initiation of Cleavage is a direct result of fertilization . Following fertilization, the zygote undergoes a series of rapid mitotic divisions known as cleavage . This process begins soon after fertilization and leads to the formation of a multicellular embryo .</li><li>• Option B:</li><li>• direct result</li><li>• fertilization</li><li>• zygote undergoes</li><li>• rapid mitotic divisions</li><li>• cleavage</li><li>• fertilization</li><li>• leads</li><li>• formation</li><li>• multicellular embryo</li><li>• Option D: Restoration of Diploid Number of Chromosomes is a direct result of fertilization . Each gamete is haploid , meaning it carries half the normal number of chromosomes . When they fuse during fertilization , their chromosomes combine to restore the diploid number , which is the typical number of chromosomes for a species. In humans, this diploid number is 46 .</li><li>• Option D:</li><li>• direct result</li><li>• fertilization</li><li>• haploid</li><li>• carries half</li><li>• normal number</li><li>• chromosomes</li><li>• fuse</li><li>• fertilization</li><li>• combine</li><li>• restore</li><li>• diploid number</li><li>• typical number</li><li>• chromosomes</li><li>• 46</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Implantation is not a direct result of fertilization. Implantation is the process by which the embryo attaches to the wall of the uterus , and it occurs several days after fertilization . While fertilization is a prerequisite for implantation , it is a separate process that occurs later in the development of the embryo .</li><li>➤ Implantation is not a direct result of fertilization. Implantation is the process by which the embryo attaches to the wall of the uterus , and it occurs several days after fertilization .</li><li>➤ embryo</li><li>➤ attaches</li><li>➤ wall</li><li>➤ uterus</li><li>➤ after fertilization</li><li>➤ While fertilization is a prerequisite for implantation , it is a separate process that occurs later in the development of the embryo .</li><li>➤ prerequisite</li><li>➤ implantation</li><li>➤ separate process</li><li>➤ later</li><li>➤ development</li><li>➤ embryo</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 28</li><li>➤ Ref</li><li>➤ : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 28</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following doesn’t contribute to Interatrial Septum formation?", "options": [{"label": "A", "text": "Septum Spurium", "correct": false}, {"label": "B", "text": "Septum Secundum", "correct": false}, {"label": "C", "text": "Right Venous Valve", "correct": true}, {"label": "D", "text": "Left Venous Valve", "correct": false}], "correct_answer": "C. Right Venous Valve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture63.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175600.jpg"], "explanation": "<p><strong>Ans. C) Right Venous Valve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The septum spurium is not a recognized structure in the standard development of the interatrial septum. In embryological development, the interatrial septum primarily forms from the septum primum and septum secundum . The term \"septum spurium\" is not typically used in describing the normal development of the interatrial septum and does not contribute to its formation.</li><li>• Option A:</li><li>• septum primum</li><li>• septum secundum</li><li>• Option B: The septum secundum plays a crucial role in the formation of the interatrial septum . It grows down the right side of the atrium , parallel to the septum primum . The septum secundum contributes to the formation of the upper part of the interatrial septum and also plays a role in the formation of the foramen ovale .</li><li>• Option B:</li><li>• formation</li><li>• interatrial septum</li><li>• grows down</li><li>• right side</li><li>• atrium</li><li>• parallel</li><li>• septum primum</li><li>• septum secundum</li><li>• formation</li><li>• upper part</li><li>• interatrial septum</li><li>• plays</li><li>• role</li><li>• formation</li><li>• foramen ovale</li><li>• Option D: The left venous valve is a structure that contributes to the formation of the septum primum . It assists in directing the flow of blood in the fetal heart and partially degenerates to form a part of the interatrial septum .</li><li>• Option D:</li><li>• contributes</li><li>• formation</li><li>• septum primum</li><li>• directing</li><li>• flow</li><li>• blood</li><li>• fetal heart</li><li>• degenerates</li><li>• form</li><li>• interatrial septum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Right Venous Valve , also known as the Eustachian valve , is associated with the entrance of the inferior vena cava into the right atrium . It does not directly contribute to the formation of the interatrial septum. Its primary function is related to directing oxygenated blood from the inferior vena cava across the foramen ovale during fetal development .</li><li>➤ Right Venous Valve , also known as the Eustachian valve , is associated with the entrance of the inferior vena cava into the right atrium .</li><li>➤ Right Venous Valve</li><li>➤ Eustachian valve</li><li>➤ entrance</li><li>➤ inferior vena cava</li><li>➤ right atrium</li><li>➤ It does not directly contribute to the formation of the interatrial septum.</li><li>➤ Its primary function is related to directing oxygenated blood from the inferior vena cava across the foramen ovale during fetal development .</li><li>➤ directing oxygenated blood</li><li>➤ inferior vena cava</li><li>➤ foramen ovale</li><li>➤ fetal development</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 173</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 173</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old pregnant woman presents for a routine prenatal checkup at 14 weeks of gestation. She is curious about the development of her baby's organs. During the examination, you discuss the development of the liver. Which of the following statements about liver development is incorrect?", "options": [{"label": "A", "text": "Hepatic Diverticulum appears at Distal Part of Foregut at Ventral Border of Primitive Duodenum", "correct": false}, {"label": "B", "text": "Hepatocytes are derived from Septum Transversum", "correct": true}, {"label": "C", "text": "Hematopoiesis begins during 6 th Week", "correct": false}, {"label": "D", "text": "Bile formation begins by 12 th Week", "correct": false}], "correct_answer": "B. Hepatocytes are derived from Septum Transversum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture65.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture66.jpg"], "explanation": "<p><strong>Ans. B) Hepatocytes, Kupffer Cells derived from Septum Transversum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The liver begins to develop as an outgrowth known as the hepatic diverticulum or hepatic bud , which emerges from the distal part of the foregut , specifically at the ventral border of the primitive duodenum . This outgrowth eventually gives rise to the liver , gallbladder , and bile ducts .</li><li>• Option</li><li>• A:</li><li>• outgrowth</li><li>• hepatic diverticulum</li><li>• hepatic bud</li><li>• emerges</li><li>• distal part</li><li>• foregut</li><li>• ventral border</li><li>• primitive duodenum</li><li>• rise</li><li>• liver</li><li>• gallbladder</li><li>• bile ducts</li><li>• Option C: The liver is a major site of hematopoiesis during fetal life . Hematopoiesis in the liver starts around the 6th week of gestation and continues until shortly before birth , when the bone marrow takes over this function.</li><li>• Option C:</li><li>• major site</li><li>• hematopoiesis</li><li>• fetal life</li><li>• liver</li><li>• around</li><li>• 6th week</li><li>• gestation</li><li>• shortly</li><li>• before birth</li><li>• bone marrow</li><li>• Option D: The liver starts to produce bile around the 12th week of gestation . This early bile production is a significant function of the fetal liver , and it continues throughout the life of the individual .</li><li>• Option D:</li><li>• produce bile</li><li>• 12th week</li><li>• gestation</li><li>• bile production</li><li>• function</li><li>• fetal liver</li><li>• throughout</li><li>• life</li><li>• individual</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 141</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 141</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following occur as a result of Conotruncal Septum anomalies except:", "options": [{"label": "A", "text": "VSD", "correct": true}, {"label": "B", "text": "PTA", "correct": false}, {"label": "C", "text": "TGA", "correct": false}, {"label": "D", "text": "TOF", "correct": false}], "correct_answer": "A. VSD", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175008.jpg"], "explanation": "<p><strong>Ans. A) VSD</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Persistent Truncus Arteriosus (PTA) occurs when the conotruncal septum fails to develop properly, resulting in a single arterial trunk emerging from the heart , instead of separate pulmonary and aortic trunks . This is a direct result of a conotruncal septum anomaly .</li><li>• Option B: Persistent Truncus Arteriosus (PTA)</li><li>• fails</li><li>• single arterial trunk</li><li>• emerging</li><li>• heart</li><li>• separate pulmonary</li><li>• aortic trunks</li><li>• direct result</li><li>• conotruncal septum</li><li>• anomaly</li><li>• Option C: Transposition of the Great Arteries (TGA) is a condition where the positions of the pulmonary artery and the aorta are switched . This is due to abnormal development of the conotruncal septum , which fails to align properly with the ventricular septum .</li><li>• Option C: Transposition of the Great Arteries (TGA)</li><li>• pulmonary artery</li><li>• aorta</li><li>• switched</li><li>• abnormal development</li><li>• conotruncal septum</li><li>• align properly</li><li>• ventricular septum</li><li>• Option D: Tetralogy of Fallot (TOF) is a complex heart defect that includes four abnormalities : VSD , pulmonary stenosis , overriding aorta , and right ventricular hypertrophy . The overriding aorta, which is a key feature of TOF , occurs due to an anterior deviation of the conotruncal septum .</li><li>• Option D: Tetralogy of Fallot (TOF)</li><li>• heart defect</li><li>• four abnormalities</li><li>• VSD</li><li>• pulmonary stenosis</li><li>• overriding aorta</li><li>• right ventricular hypertrophy</li><li>• TOF</li><li>• anterior deviation</li><li>• conotruncal septum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ventricular Septal Defect (VSD) is a defect in the ventricular septum , the wall dividing the left and right ventricles of the heart . While it is a common congenital heart defect , it is not typically a direct result of conotruncal septum anomalies. VSDs are usually related to defects in the formation of the interventricular septum rather than the conotruncal septum .</li><li>➤ Ventricular Septal Defect (VSD) is a defect in the ventricular septum , the wall dividing the left and right ventricles of the heart .</li><li>➤ ventricular septum</li><li>➤ left</li><li>➤ right ventricles</li><li>➤ heart</li><li>➤ While it is a common congenital heart defect , it is not typically a direct result of conotruncal septum anomalies.</li><li>➤ common congenital heart defect</li><li>➤ VSDs are usually related to defects in the formation of the interventricular septum rather than the conotruncal septum .</li><li>➤ defects</li><li>➤ formation</li><li>➤ interventricular septum</li><li>➤ conotruncal septum</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 180</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 180</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a Mesoderm Derivative?", "options": [{"label": "A", "text": "Suprarenal Medulla", "correct": true}, {"label": "B", "text": "Renal Cortex", "correct": false}, {"label": "C", "text": "Cardiac Muscle", "correct": false}, {"label": "D", "text": "Skeletal Muscle", "correct": false}], "correct_answer": "A. Suprarenal Medulla", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175155.jpg"], "explanation": "<p><strong>Ans. A) Suprarenal Medulla</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The renal cortex is a mesodermal derivative . The kidneys develop from the intermediate mesoderm during embryogenesis . This includes all the major structures of the kidney, including the renal cortex .</li><li>• Option B:</li><li>• mesodermal derivative</li><li>• kidneys</li><li>• intermediate mesoderm</li><li>• embryogenesis</li><li>• renal cortex</li><li>• Option C: Cardiac muscle is derived from the mesoderm . Specifically, it originates from the splanchnic mesoderm , which contributes to the formation of the heart and its associated structures.</li><li>• Option C:</li><li>• mesoderm</li><li>• originates</li><li>• splanchnic mesoderm</li><li>• formation</li><li>• heart</li><li>• Option D: Skeletal muscle is also derived from the mesoderm . The somites, which are divisions of the paraxial mesoderm , give rise to skeletal muscle , among other structures. This includes the muscles of the limbs , trunk , and face .</li><li>• Option D:</li><li>• mesoderm</li><li>• paraxial mesoderm</li><li>• skeletal muscle</li><li>• muscles</li><li>• limbs</li><li>• trunk</li><li>• face</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Suprarenal Medulla is not a derivative of mesoderm. It actually arises from neural crest cells , which are ectodermal in origin . Neural crest cells give rise to a variety of structures, including the adrenal medulla , which secretes catecholamines like adrenaline and noradrenaline.</li><li>➤ Suprarenal Medulla is not a derivative of mesoderm.</li><li>➤ It actually arises from neural crest cells , which are ectodermal in origin .</li><li>➤ arises</li><li>➤ neural crest cells</li><li>➤ ectodermal</li><li>➤ origin</li><li>➤ Neural crest cells give rise to a variety of structures, including the adrenal medulla , which secretes catecholamines like adrenaline and noradrenaline.</li><li>➤ adrenal medulla</li><li>➤ secretes</li><li>➤ catecholamines</li><li>➤ adrenaline</li><li>➤ noradrenaline.</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 63</li><li>➤ Ref:</li><li>➤ Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 63</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman presents to the clinic with symptoms of urinary incontinence. She reports a sensation of urgency followed by involuntary loss of urine. Her medical history is significant for type 2 diabetes mellitus and hypertension. Upon further evaluation, you consider the role of the detrusor muscle in her condition. In understanding the embryological origins of muscles, which of the following muscles is not derived from the paraxial mesoderm?", "options": [{"label": "A", "text": "Genioglossus", "correct": false}, {"label": "B", "text": "Superior oblique", "correct": false}, {"label": "C", "text": "Biceps", "correct": false}, {"label": "D", "text": "Detrusor", "correct": true}], "correct_answer": "D. Detrusor", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Detrusor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A : Genioglossus muscle is indeed derived from the paraxial mesoderm. It's a muscle of the tongue, responsible for its movement. The paraxial mesoderm gives rise to skeletal muscles in the body, and the muscles of the tongue are classified as skeletal muscles.</li><li>• Option A</li><li>• Option B : Superior Oblique is a muscle in the eye, involved in its movement. Like the genioglossus, it is also derived from the paraxial mesoderm. The muscles controlling eye movement are skeletal muscles, which are products of the paraxial mesoderm.</li><li>• Option B</li><li>• Option C : Biceps is a well-known muscle in the upper arm, involved in the flexion of the elbow and rotation of the forearm. It is a skeletal muscle and consistent with the others, originates from the paraxial mesoderm.</li><li>• Option C</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Detrusor which forms the muscular wall of the bladder, is not derived from the paraxial mesoderm.</li><li>➤ Instead, it originates from the splanchnic layer of the lateral plate mesoderm.</li><li>➤ This layer gives rise to the visceral muscle of the gut and other internal organs, including the bladder.</li><li>➤ Ref : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 65</li><li>➤ Ref</li><li>➤ : Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 65</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle derived from First Pharyngeal Arch:", "options": [{"label": "A", "text": "Buccinator", "correct": false}, {"label": "B", "text": "Stylopharyyngeus", "correct": false}, {"label": "C", "text": "Mylohyoid", "correct": true}, {"label": "D", "text": "Hyoglossus", "correct": false}], "correct_answer": "C. Mylohyoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175434.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/screenshot-2024-02-10-175535.jpg"], "explanation": "<p><strong>Ans. C) Mylohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The buccinator muscle is derived from the second pharyngeal arch . It is innervated by facial nerve .</li><li>• Option A:</li><li>• second pharyngeal arch</li><li>• innervated</li><li>• facial nerve</li><li>• Option B: The stylopharyngeus muscle is derived from the third pharyngeal arch , not the first. This muscle is innervated by the glossopharyngeal nerve ( cranial nerve IX ), which is associated with the third arch .</li><li>• Option B:</li><li>• third pharyngeal arch</li><li>• glossopharyngeal nerve</li><li>• cranial nerve IX</li><li>• third arch</li><li>• Option D: The hyoglossus muscle is not derived from the first pharyngeal arch. Hyoglossus muscle is innervated by Hypoglossal Nerve and is derived from Occipital somites.</li><li>• Option D:</li><li>• Hypoglossal Nerve</li><li>• Occipital somites.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The mylohyoid muscle is indeed derived from the first pharyngeal arch . It forms the floor of the oral cavity and is innervated by the mandibular branch of the trigeminal nerve . The first pharyngeal arch is primarily associated with the trigeminal nerve .</li><li>➤ The mylohyoid muscle is indeed derived from the first pharyngeal arch .</li><li>➤ first pharyngeal arch</li><li>➤ It forms the floor of the oral cavity and is innervated by the mandibular branch of the trigeminal nerve . The first pharyngeal arch is primarily associated with the trigeminal nerve .</li><li>➤ floor</li><li>➤ oral cavity</li><li>➤ mandibular branch</li><li>➤ trigeminal nerve</li><li>➤ trigeminal nerve</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 97.</li><li>➤ Ref: Textbook of Human Embryology, First Edition. Yogesh Sontakke Pg 97.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 6-year-old child is brought to the clinic with a midline neck mass that elevates upon protrusion of the tongue. This clinical presentation is most likely due to a developmental anomaly related to which of the following structures?", "options": [{"label": "A", "text": "Thyroglossal Duct", "correct": true}, {"label": "B", "text": "Second Branchial Arch", "correct": false}, {"label": "C", "text": "Fourth Pharyngeal Pouch", "correct": false}, {"label": "D", "text": "Foramen Cecum", "correct": false}], "correct_answer": "A. Thyroglossal Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture1_Izv8ZkG.jpg"], "explanation": "<p><strong>Ans. A) Thyroglossal Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Second Branchial Arch gives rise to several structures in the face and neck , including the stapes , styloid process , and Lesser Cornu of the Hyoid Bone . A cyst or fistula related to the second branchial arch would typically present laterally in the neck , not midline.</li><li>• Option B:</li><li>• face</li><li>• neck</li><li>• stapes</li><li>• styloid process</li><li>• Lesser Cornu of the Hyoid Bone</li><li>• cyst</li><li>• fistula</li><li>• second branchial arch</li><li>• laterally</li><li>• neck</li><li>• Option C: Fourth Pharyngeal Pouch contributes to the development of parathyroid glands and parts of the thyroid gland . Anomalies related to this pouch do not typically present as a midline neck mass that moves with tongue protrusion.</li><li>• Option C:</li><li>• parathyroid glands</li><li>• thyroid gland</li><li>• Superior Parathyroid Gland &amp; Ultimobranchial Body develops from Fourth Pharyngeal Pouch.</li><li>• Option D: Foramen Cecum is a small pit-like depression at the junction between the anterior two-thirds and posterior one-third of the tongue . It is the site where the thyroglossal duct begins embryological development. Although related to the thyroglossal duct, anomalies of the foramen cecum itself do not form a neck mass.</li><li>• Option D:</li><li>• small pit-like depression</li><li>• junction</li><li>• anterior two-thirds</li><li>• posterior one-third</li><li>• tongue</li><li>• thyroglossal duct</li><li>• embryological development.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thyroglossal duct is an embryological structure that normally involutes as the thyroid descends into its final position in the neck . A thyroglossal duct cyst can occur if the duct fails to close and can present as a midline neck mass , typically moving upwards upon tongue protrusion due to its connection to the base of the tongue .</li><li>➤ The thyroglossal duct is an embryological structure that normally involutes as the thyroid descends into its final position in the neck . A thyroglossal duct cyst can occur if the duct fails to close and can present as a midline neck mass , typically moving upwards upon tongue protrusion due to its connection to the base of the tongue .</li><li>➤ embryological structure</li><li>➤ thyroid descends</li><li>➤ final position</li><li>➤ neck</li><li>➤ duct fails</li><li>➤ close</li><li>➤ midline neck mass</li><li>➤ upwards</li><li>➤ tongue protrusion</li><li>➤ connection</li><li>➤ base</li><li>➤ tongue</li><li>➤ Ref : Langman's Medical, Embryology 13th Edition, Page no- 293, 294</li><li>➤ Ref</li><li>➤ : Langman's Medical, Embryology 13th Edition, Page no- 293, 294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents with a palpable mass in the anterior neck region. Fine-needle aspiration biopsy suggests the presence of thyroid tissue. This finding is most consistent with a developmental anomaly originating from which of the following structures?", "options": [{"label": "A", "text": "First Pharyngeal Arch", "correct": false}, {"label": "B", "text": "Thyroglossal Duct", "correct": true}, {"label": "C", "text": "Fourth Pharyngeal Pouch", "correct": false}, {"label": "D", "text": "Second Pharyngeal Arch", "correct": false}], "correct_answer": "B. Thyroglossal Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture2_HxedPtN.jpg"], "explanation": "<p><strong>Ans. B) Thyroglossal Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: First Pharyngeal Arch contributes to the development of structures in the face and jaw , but not the thyroid gland. Anomalies related to the first pharyngeal arch would not result in ectopic thyroid tissue in the neck.</li><li>• Option A:</li><li>• face</li><li>• jaw</li><li>• Option C: The fourth pharyngeal pouch contributes to the development of the parathyroid glands and parts of the thyroid gland . However, it is not typically associated with ectopic thyroid tissue in the anterior neck region as a result of its developmental pathway.</li><li>• Option C:</li><li>• parathyroid glands</li><li>• parts</li><li>• thyroid gland</li><li>• Option D: Second Pharyngeal Arch gives rise to structures in the neck such as the stapes , styloid process , and part of the hyoid bone. It is not involved in the development of the thyroid gland, and anomalies related to this arch would not present as ectopic thyroid tissue in the neck.</li><li>• Option D:</li><li>• neck</li><li>• stapes</li><li>• styloid process</li><li>• part</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thyroglossal duct is the embryological structure from which the thyroid gland descends into its final position in the neck . If the duct fails to involute completely , ectopic thyroid tissue can be left along its path, often presenting as a midline neck mass .</li><li>➤ The thyroglossal duct is the embryological structure from which the thyroid gland descends into its final position in the neck . If the duct fails to involute completely , ectopic thyroid tissue can be left along its path, often presenting as a midline neck mass .</li><li>➤ embryological structure</li><li>➤ descends</li><li>➤ final position</li><li>➤ neck</li><li>➤ fails</li><li>➤ involute completely</li><li>➤ ectopic thyroid tissue</li><li>➤ left</li><li>➤ midline neck mass</li><li>➤ Ref : Langman's Medical, Embryology 13th Edition, Page no- 293, 294</li><li>➤ Ref</li><li>➤ : Langman's Medical, Embryology 13th Edition, Page no- 293, 294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A newborn is examined and found to have abnormalities in the axial skeleton, musculature, and dermis of the skin. These findings most likely indicate a developmental disruption involving which of the following embryological structures?", "options": [{"label": "A", "text": "Neural Crest Cells", "correct": false}, {"label": "B", "text": "Somites", "correct": true}, {"label": "C", "text": "Notochord", "correct": false}, {"label": "D", "text": "Intermediate Mesoderm", "correct": false}], "correct_answer": "B. Somites", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/whatsapp-image-2024-02-10-at-53332-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture4_3uhCwHK.jpg"], "explanation": "<p><strong>Ans. B) Somites</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Neural crest cells contribute to the development of diverse structures , including the peripheral nervous system , facial cartilage , and melanocytes in the skin . While neural crest cells are involved in skin pigmentation and certain aspects of the nervous system, they do not directly contribute to the development of the axial skeleton or musculature.</li><li>• Option A:</li><li>• development</li><li>• diverse structures</li><li>• peripheral nervous system</li><li>• facial cartilage</li><li>• melanocytes</li><li>• skin</li><li>• skin pigmentation</li><li>• Option C: The notochord is an embryonic structure that serves as a scaffold for the development of the axial skeleton , but it primarily induces the formation of the neural tube and vertebral column . Its role is more indirect compared to somites in the formation of musculature and dermis .</li><li>• Option C:</li><li>• embryonic structure</li><li>• serves</li><li>• scaffold</li><li>• development</li><li>• axial skeleton</li><li>• formation</li><li>• neural tube</li><li>• vertebral column</li><li>• indirect</li><li>• somites</li><li>• formation</li><li>• musculature</li><li>• dermis</li><li>• Option D: The intermediate mesoderm gives rise to the urogenital system , including the kidneys and gonads . It does not play a significant role in the development of the axial skeleton, musculature, or dermis of the skin.</li><li>• Option D:</li><li>• urogenital system</li><li>• kidneys</li><li>• gonads</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Somites are blocks of mesoderm located on either side of the neural tube in the developing embryo . They differentiate into three major components : the dermatome (which forms the dermis of the skin), the myotome (which forms skeletal muscle), and the sclerotome (which contributes to the axial skeleton). Abnormalities in somite development can affect the axial skeleton , musculature , and dermis .</li><li>➤ Somites are blocks of mesoderm located on either side of the neural tube in the developing embryo . They differentiate into three major components : the dermatome (which forms the dermis of the skin), the myotome (which forms skeletal muscle), and the sclerotome (which contributes to the axial skeleton). Abnormalities in somite development can affect the axial skeleton , musculature , and dermis .</li><li>➤ blocks</li><li>➤ mesoderm</li><li>➤ either side</li><li>➤ neural tube</li><li>➤ developing embryo</li><li>➤ three major components</li><li>➤ dermatome</li><li>➤ myotome</li><li>➤ sclerotome</li><li>➤ affect</li><li>➤ axial skeleton</li><li>➤ musculature</li><li>➤ dermis</li><li>➤ Ref : Langman's Medical, Embryolog 13th Edition, Page no- 142-150</li><li>➤ Ref :</li><li>➤ Langman's Medical, Embryolog</li><li>➤ 13th Edition, Page no- 142-150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pregnant woman in her first trimester undergoes an ultrasound, which reveals that the embryo is in the stage of developing major organs. This stage of development falls under which of the following periods?", "options": [{"label": "A", "text": "Pre-Embryonic Period", "correct": false}, {"label": "B", "text": "Embryonic Period", "correct": true}, {"label": "C", "text": "Fetal Period", "correct": false}, {"label": "D", "text": "Germinal Period", "correct": false}], "correct_answer": "B. Embryonic Period", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Embryonic Period</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Pre-Embryonic Period covers the first two weeks of development after fertilization and includes events like fertilization , zygote formation , and the early stages of cell division . Organ development does not occur during this period.</li><li>• Option A:</li><li>• first two weeks</li><li>• after fertilization</li><li>• fertilization</li><li>• zygote formation</li><li>• early stages</li><li>• cell division</li><li>• Option C: The fetal period begins from the ninth week of development until birth . This period is characterized by the growth and maturation of tissues and organs that developed during the embryonic period . Organ formation per se does not occur in this period; rather, it is a time of growth and refinement .</li><li>• Option C:</li><li>• begins</li><li>• ninth week</li><li>• birth</li><li>• growth</li><li>• maturation</li><li>• tissues</li><li>• organs</li><li>• embryonic period</li><li>• growth</li><li>• refinement</li><li>• Option D: The germinal period is essentially another term for the pre-embryonic period . It includes the first two weeks of development post-fertilization and is not the stage where major organ development occurs.</li><li>• Option D:</li><li>• another term</li><li>• pre-embryonic period</li><li>• first two weeks</li><li>• post-fertilization</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The embryonic period spans from the third to the eighth week of development . During this time, the major organs and systems of the body start to develop in a process known as organogenesis . The scenario described in the question is typical for the embryonic period.</li><li>➤ The embryonic period spans from the third to the eighth week of development . During this time, the major organs and systems of the body start to develop in a process known as organogenesis . The scenario described in the question is typical for the embryonic period.</li><li>➤ third</li><li>➤ eighth week</li><li>➤ development</li><li>➤ major organs</li><li>➤ systems</li><li>➤ start</li><li>➤ develop</li><li>➤ organogenesis</li><li>➤ Ref : Langman's Medical, Embryology 13th Edition, Page no- 71-94</li><li>➤ Ref</li><li>➤ : Langman's Medical, Embryology 13th Edition, Page no- 71-94</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old man comes to the clinic for a fertility evaluation. He is found to have a lower-than-average sperm count. In discussing spermatogenesis, which of the following cells is responsible for the final stage of sperm maturation, transforming spermatids into mature spermatozoa?", "options": [{"label": "A", "text": "Spermatogonia", "correct": false}, {"label": "B", "text": "Sertoli Cells", "correct": true}, {"label": "C", "text": "Leydig Cells", "correct": false}, {"label": "D", "text": "Spermatocytes", "correct": false}], "correct_answer": "B. Sertoli Cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture6_xu0PpOO.jpg"], "explanation": "<p><strong>Ans. B) Sertoli Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Spermatogonia are the stem cells in the testes that initiate spermatogenesis . They divide mitotically to produce primary spermatocytes , but they are not directly responsible for the transformation of spermatids into mature spermatozoa.</li><li>• Option A:</li><li>• stem cells</li><li>• initiate spermatogenesis</li><li>• mitotically</li><li>• produce primary spermatocytes</li><li>• Option C: Leydig cells are found in the interstitial space of the testes and are responsible for producing testosterone , which is essential for the development and maintenance of male secondary sexual characteristics and the overall process of spermatogenesis . However, they are not involved in the direct transformation of spermatids into mature sperm.</li><li>• Option C:</li><li>• interstitial space</li><li>• testes</li><li>• responsible</li><li>• producing testosterone</li><li>• development</li><li>• maintenance</li><li>• male secondary sexual characteristics</li><li>• overall process</li><li>• spermatogenesis</li><li>• Option D: Spermatocytes are the intermediate cells in spermatogenesis . Primary spermatocytes undergo the first meiotic division to form secondary spermatocytes , which then undergo the second meiotic division to produce spermatids . While they are a stage in spermatogenesis, spermatocytes themselves do not transform spermatids into mature spermatozoa.</li><li>• Option D:</li><li>• intermediate cells</li><li>• spermatogenesis</li><li>• first meiotic division</li><li>• form secondary spermatocytes</li><li>• undergo</li><li>• second meiotic division</li><li>• spermatids</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sertoli cells, located in the seminiferous tubules of the testes , play a crucial role in the maturation of sperm . They support and nourish developing sperm cells and facilitate the process of spermiogenesis , where spermatids are transformed into mature spermatozoa .</li><li>➤ Sertoli cells, located in the seminiferous tubules of the testes , play a crucial role in the maturation of sperm . They support and nourish developing sperm cells and facilitate the process of spermiogenesis , where spermatids are transformed into mature spermatozoa .</li><li>➤ seminiferous tubules</li><li>➤ testes</li><li>➤ maturation of sperm</li><li>➤ support</li><li>➤ nourish</li><li>➤ sperm cells</li><li>➤ facilitate</li><li>➤ spermiogenesis</li><li>➤ spermatids</li><li>➤ transformed</li><li>➤ mature spermatozoa</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 21-23</li><li>➤ Ref :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page no- 21-23</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is at the clinic for a routine gynecological examination. She inquiries about the process of oogenesis. Which of the following best describes the stage at which primary oocytes are arrested until puberty in females?", "options": [{"label": "A", "text": "Prophase of Meiosis I", "correct": true}, {"label": "B", "text": "Metaphase of Meiosis I", "correct": false}, {"label": "C", "text": "Prophase of Meiosis II", "correct": false}, {"label": "D", "text": "Metaphase of Meiosis II", "correct": false}], "correct_answer": "A. Prophase of Meiosis I", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture7_c21J7yK.jpg"], "explanation": "<p><strong>Ans. A) Prophase of Meiosis I</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Metaphase of Meiosis I stage occurs after the resumption of meiosis that begins with puberty . Each menstrual cycle, some primary oocytes progress from prophase to metaphase of Meiosis I , but they are not arrested in this stage from fetal life to puberty.</li><li>• Option B:</li><li>• after</li><li>• resumption</li><li>• meiosis</li><li>• begins</li><li>• puberty</li><li>• primary oocytes</li><li>• prophase</li><li>• metaphase</li><li>• Meiosis I</li><li>• Option C: Following ovulation , the secondary oocyte is arrested in metaphase of Meiosis II, not prophase. It will only complete Meiosis II if fertilization occurs .</li><li>• Option C:</li><li>• Following ovulation</li><li>• secondary oocyte</li><li>• arrested</li><li>• metaphase</li><li>• only complete</li><li>• Meiosis II</li><li>• fertilization occurs</li><li>• Option D: Metaphase of Meiosis II is the stage in which the secondary oocyte is arrested after ovulation and until fertilization , if it occurs. If fertilization does not occur, the oocyte degenerates .</li><li>• Option D:</li><li>• secondary oocyte</li><li>• arrested</li><li>• after ovulation</li><li>• until fertilization</li><li>• oocyte degenerates</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In females, oogenesis begins during fetal development . By birth , all oocytes have entered meiosis but are arrested in prophase of the first meiotic division . These primary oocytes remain in this state until puberty , at which point hormonal changes trigger the resumption of meiosis in a cyclical manner .</li><li>➤ In females, oogenesis begins during fetal development . By birth , all oocytes have entered meiosis but are arrested in prophase of the first meiotic division . These primary oocytes remain in this state until puberty , at which point hormonal changes trigger the resumption of meiosis in a cyclical manner .</li><li>➤ oogenesis</li><li>➤ during fetal development</li><li>➤ birth</li><li>➤ all oocytes</li><li>➤ meiosis</li><li>➤ arrested</li><li>➤ prophase</li><li>➤ first meiotic division</li><li>➤ until puberty</li><li>➤ hormonal changes</li><li>➤ trigger</li><li>➤ resumption</li><li>➤ meiosis</li><li>➤ cyclical manner</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page No- 23-25</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page No- 23-25</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A couple comes to the genetic counseling clinic after having a child with Down syndrome. They are concerned about the risk of chromosomal abnormalities in future pregnancies. The physician explains the utility of karyotyping in assessing chromosomal disorders. Which of the following best describes the primary purpose of karyotyping in clinical genetics?", "options": [{"label": "A", "text": "To identify Single Nucleotide Polymorphisms", "correct": false}, {"label": "B", "text": "To Evaluate the Number and Structure of Chromosomes", "correct": true}, {"label": "C", "text": "To detect Gene Expression Levels", "correct": false}, {"label": "D", "text": "To identify the Presence of Specific Genes", "correct": false}], "correct_answer": "B. To Evaluate the Number and Structure of Chromosomes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture8_H87dpjW.jpg"], "explanation": "<p><strong>Ans. B) To Evaluate the Number and Structure of Chromosomes.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Single Nucleotide Polymorphisms (SNPs) are variations in a single nucleotide that occur at a specific position in the genome . While important for understanding genetic diversity and disease susceptibility , identifying SNPs is not the primary purpose of karyotyping. Techniques like SNP array or whole genome sequencing are more suitable for this purpose.</li><li>• Option A:</li><li>• variations</li><li>• single nucleotide</li><li>• specific position</li><li>• genome</li><li>• understanding genetic diversity</li><li>• disease susceptibility</li><li>• SNP array</li><li>• whole genome sequencing</li><li>• Option C: Gene expression profiling is used to measure the activity ( the expression ) of thousands of genes at once, to create a global picture of cellular function . This is not achieved through karyotyping but rather through techniques like microarray analysis or RNA sequencing.</li><li>• Option C:</li><li>• Gene expression profiling</li><li>• measure</li><li>• activity</li><li>• the expression</li><li>• thousands</li><li>• genes</li><li>• create</li><li>• global picture</li><li>• cellular function</li><li>• Option D. While karyotyping can indicate the presence or absence of large segments of chromosomes (and thus the genes within those segments), it is not used to identify specific genes. Techniques such as PCR (polymerase chain reaction) or gene sequencing are more appropriate for identifying specific genes.</li><li>• Option D.</li><li>• karyotyping</li><li>• indicate</li><li>• presence</li><li>• absence</li><li>• large segments</li><li>• chromosomes</li><li>• PCR (polymerase chain reaction)</li><li>• gene sequencing</li><li>• more appropriate</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Karyotyping is a laboratory technique that allows for the visualization of an individual’s chromosomes . It is used to evaluate the number and structure of chromosomes , thus helping to identify chromosomal abnormalities such as aneuploidy (e.g., trisomy 21 in Down syndrome ), deletions , duplications , or translocations .</li><li>➤ Karyotyping is a laboratory technique that allows for the visualization of an individual’s chromosomes . It is used to evaluate the number and structure of chromosomes , thus helping to identify chromosomal abnormalities such as aneuploidy (e.g., trisomy 21 in Down syndrome ), deletions , duplications , or translocations .</li><li>➤ laboratory technique</li><li>➤ allows</li><li>➤ visualization</li><li>➤ individual’s chromosomes</li><li>➤ evaluate</li><li>➤ number</li><li>➤ structure</li><li>➤ chromosomes</li><li>➤ identify chromosomal abnormalities</li><li>➤ aneuploidy</li><li>➤ trisomy 21</li><li>➤ Down syndrome</li><li>➤ deletions</li><li>➤ duplications</li><li>➤ translocations</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page No- 26, 27</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page No- 26, 27</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old woman is undergoing in vitro fertilization (IVF) due to infertility. The embryologist informs her that the fertilized egg has reached a stage where it resembles a solid ball of cells. What is the term for this developmental stage?", "options": [{"label": "A", "text": "Blastocyst", "correct": false}, {"label": "B", "text": "Zygote", "correct": false}, {"label": "C", "text": "Morula", "correct": true}, {"label": "D", "text": "Blastomere", "correct": false}], "correct_answer": "C. Morula", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture9_BB8N8aY.jpg"], "explanation": "<p><strong>Ans. C) Morula</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The blastocyst stage occurs after the morula stage . It is characterized by the formation of a fluid-filled cavity ( blastocoel ) within the developing embryo and consists of an inner cell mass (which will give rise to the fetus ) and an outer layer of cells ( trophoblast ).</li><li>• Option A:</li><li>• after</li><li>• morula</li><li>• stage</li><li>• formation</li><li>• fluid-filled</li><li>• cavity</li><li>• blastocoel</li><li>• developing embryo</li><li>• consists</li><li>• inner cell mass</li><li>• give rise</li><li>• fetus</li><li>• outer layer of cells</li><li>• trophoblast</li><li>• Option B: The zygote is the initial cell formed when sperm fertilizes an egg . It is the earliest stage of embryonic development and undergoes several cleavage divisions to form the morula .</li><li>• Option B:</li><li>• initial cell</li><li>• sperm</li><li>• fertilizes</li><li>• egg</li><li>• earliest stage</li><li>• embryonic development</li><li>• cleavage divisions</li><li>• morula</li><li>• Option D: Blastomeres are individual cells that make up the morula . During cleavage divisions, the zygote divides into blastomeres , which then compact together to form the morula .</li><li>• Option D:</li><li>• individual cells</li><li>• make up</li><li>• morula</li><li>• blastomeres</li><li>• compact</li><li>• form</li><li>• morula</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The morula is a solid ball of cells resulting from multiple cleavage divisions of the zygote . It typically consists of 12-32 cells and is the stage just before the blastocyst .</li><li>➤ solid ball</li><li>➤ cells</li><li>➤ multiple cleavage divisions</li><li>➤ zygote</li><li>➤ 12-32 cells</li><li>➤ stage</li><li>➤ just before</li><li>➤ blastocyst</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 34-35</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 34-35</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman is trying to conceive and has been tracking her menstrual cycle closely. She suspects she may be pregnant and wants to understand the process of implantation. During implantation, the blastocyst primarily adheres to which of the following structures in the uterine wall?", "options": [{"label": "A", "text": "Endometrial Stroma", "correct": true}, {"label": "B", "text": "Endometrial Blood Vessels", "correct": false}, {"label": "C", "text": "Myometrial Smooth Muscle", "correct": false}, {"label": "D", "text": "Endometrial Glands", "correct": false}], "correct_answer": "A. Endometrial Stroma", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture10_j4xPlgJ.jpg"], "explanation": "<p><strong>Ans. A) Endometrial Stroma</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B: While blood vessels in the endometrium play a role in nourishing the developing embryo , they are not the primary site of blastocyst adherence during implantation.</li><li>• Option B:</li><li>• blood vessels</li><li>• endometrium</li><li>• nourishing</li><li>• developing embryo</li><li>• Option C: The myometrium is the muscular layer of the uterus , and it contracts during labor to expel the fetus . Implantation primarily occurs in the endometrial layer , not the myometrial layer.</li><li>• Option C:</li><li>• muscular layer</li><li>• uterus</li><li>• contracts</li><li>• labor</li><li>• expel</li><li>• fetus</li><li>• endometrial layer</li><li>• Option D: Endometrial glands secrete substances that can support the early embryo , but they are not the primary site of blastocyst adherence during implantation.</li><li>• Option D:</li><li>• secrete substances</li><li>• support</li><li>• early embryo</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During implantation, the blastocyst adheres to the endometrial stroma , which is the connective tissue framework of the endometrial lining . This is where the embryo will establish a connection with the maternal circulation .</li><li>➤ During implantation, the blastocyst adheres to the endometrial stroma , which is the connective tissue framework of the endometrial lining . This is where the embryo will establish a connection with the maternal circulation .</li><li>➤ blastocyst</li><li>➤ endometrial stroma</li><li>➤ connective tissue</li><li>➤ endometrial lining</li><li>➤ embryo</li><li>➤ establish</li><li>➤ connection</li><li>➤ maternal circulation</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page No- 43-45</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page No- 43-45</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old pregnant woman undergoes a routine prenatal ultrasound examination. The ultrasound reveals a severe congenital malformation in the developing fetus, characterized by the absence of the cranial vault, brain, and calvaria. This condition is most consistent with which of the following?", "options": [{"label": "A", "text": "Microcephaly", "correct": false}, {"label": "B", "text": "Hydrocephalus", "correct": false}, {"label": "C", "text": "Anencephaly", "correct": true}, {"label": "D", "text": "Encephalocele", "correct": false}], "correct_answer": "C. Anencephaly", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture11_LKwZPQI.jpg"], "explanation": "<p><strong>Ans. C) Anencephaly</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Microcephaly is characterized by an abnormally small head and brain size , but the cranial vault and calvaria are present . It is not the same as anencephaly.</li><li>• Option A:</li><li>• abnormally small head</li><li>• brain size</li><li>• cranial vault</li><li>• calvaria</li><li>• present</li><li>• Option B: Hydrocephalus involves an abnormal accumulation of cerebrospinal fluid within the brain's ventricles . It can lead to an enlarged head , but the cranial vault is present .</li><li>• Option B:</li><li>• abnormal accumulation</li><li>• cerebrospinal fluid</li><li>• brain's ventricles</li><li>• enlarged head</li><li>• present</li><li>• Option D: Encephalocele is a congenital condition where a portion of the brain protrudes through an opening in the skull . It is different from anencephaly , where the entire brain is missing .</li><li>• Option D:</li><li>• congenital condition</li><li>• brain protrudes</li><li>• opening</li><li>• skull</li><li>• different</li><li>• anencephaly</li><li>• entire brain</li><li>• missing</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anencephaly is a severe neural tube defect characterized by the absence of the cranial vault , brain tissue , and calvaria . It results in a malformed head with exposed neural tissue .</li><li>➤ severe neural tube defect</li><li>➤ absence</li><li>➤ cranial vault</li><li>➤ brain tissue</li><li>➤ calvaria</li><li>➤ malformed head</li><li>➤ exposed neural tissue</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page No- 88</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page No- 88</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-day-old newborn is examined due to a visible sac-like protrusion on the lower back. Further evaluation reveals that the protrusion contains only meninges and cerebrospinal fluid without neural tissue. Which of the following conditions is most likely present in this newborn?", "options": [{"label": "A", "text": "Meningocele", "correct": true}, {"label": "B", "text": "Meningomyelocele", "correct": false}, {"label": "C", "text": "Myeloschisis", "correct": false}, {"label": "D", "text": "Encephalocele", "correct": false}], "correct_answer": "A. Meningocele", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture12_cUtZwnZ.jpg"], "explanation": "<p><strong>Ans. A) Meningocele</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Meningomyelocele also involves the protrusion of the meninges , cerebrospinal fluid , and neural tissue through a vertebral defect . In this condition, both neural tissue and meninges are present in the sac .</li><li>• Option B:</li><li>• protrusion</li><li>• meninges</li><li>• cerebrospinal fluid</li><li>• neural tissue</li><li>• vertebral defect</li><li>• both neural tissue</li><li>• meninges</li><li>• present</li><li>• sac</li><li>• Option C: Myeloschisis, also known as open spina bifida , is the most severe form of spina bifida . It involves a cleft in the skin and exposes the neural tissue directly to the external environment . It is not characterized by a sac-like protrusion.</li><li>• Option C:</li><li>• open spina bifida</li><li>• most severe form</li><li>• spina bifida</li><li>• cleft</li><li>• skin</li><li>• exposes</li><li>• neural tissue</li><li>• external environment</li><li>• Option D: Encephalocele is a condition where brain tissue protrudes through a defect in the skull or cranial vault . It is different from meningocele , which does not involve neural tissue.</li><li>• Option D:</li><li>• brain tissue protrudes</li><li>• defect</li><li>• skull</li><li>• cranial vault</li><li>• meningocele</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meningocele is a congenital neural tube defect in which the meninges and cerebrospinal fluid protrude through a defect in the vertebral column . Importantly, there is no neural tissue within the protrusion, making it distinguishable from other conditions.</li><li>➤ congenital neural tube defect</li><li>➤ meninges</li><li>➤ cerebrospinal fluid</li><li>➤ defect</li><li>➤ vertebral column</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page No - 88-91</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page No - 88-91</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During embryonic development, the aortic arches play a crucial role in forming the major arteries of the head and neck region. The third aortic arch contributes to the formation of which important blood vessel?", "options": [{"label": "A", "text": "Common carotid artery", "correct": true}, {"label": "B", "text": "Internal carotid artery", "correct": false}, {"label": "C", "text": "External carotid artery", "correct": false}, {"label": "D", "text": "Vertebral artery", "correct": false}], "correct_answer": "A. Common carotid artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture13_IdM3ZKP.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture14_gqfW7Zv.jpg"], "explanation": "<p><strong>Ans. A) Common carotid artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: While the internal carotid artery is a branch of the common carotid artery , it primarily arises from the common carotid artery rather than directly from the third aortic arch.</li><li>• Option B:</li><li>• branch</li><li>• common carotid artery</li><li>• common carotid artery</li><li>• Option C: The external carotid artery is also a branch of the common carotid artery but does not directly arise from the third aortic arch.</li><li>• Option C:</li><li>• common carotid artery</li><li>• Option D: The vertebral artery arises from the subclavian artery , not from the aortic arches.</li><li>• Option D:</li><li>• subclavian artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The third aortic arch gives rise to the common carotid artery on each side , which later divides into the internal and external carotid arteries .</li><li>➤ third aortic</li><li>➤ arch</li><li>➤ common carotid artery</li><li>➤ each side</li><li>➤ internal</li><li>➤ external carotid arteries</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 433</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 433</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A third-year medical student is studying embryology in preparation for the USMLE Step 2 CK exam. She is focusing on the development of the diaphragm, a crucial muscle for respiration. Which of the following best describes the embryological origin of the diaphragm?", "options": [{"label": "A", "text": "Derivation solely from the Pleuroperitoneal Folds.", "correct": false}, {"label": "B", "text": "Formation from the Septum Transversum, Pleuroperitoneal Folds, Esophageal Mesentery, and Body Wall Musculature.", "correct": true}, {"label": "C", "text": "Development entirely from the Mesoderm of the Body Wall.", "correct": false}, {"label": "D", "text": "Origination from the Neural Crest Cells.", "correct": false}], "correct_answer": "B. Formation from the Septum Transversum, Pleuroperitoneal Folds, Esophageal Mesentery, and Body Wall Musculature.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture15_9ppKYhp.jpg"], "explanation": "<p><strong>Ans. B) Formation from the</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: This is incorrect . While the pleuroperitoneal folds contribute to the formation of the diaphragm , they are not its sole source. The diaphragm is formed from multiple embryologic components .</li><li>• Option A:</li><li>• incorrect</li><li>• pleuroperitoneal folds</li><li>• formation</li><li>• diaphragm</li><li>• multiple embryologic components</li><li>• Option C: This is incorrect . Although the body wall musculature contributes to the diaphragm's peripheral muscle fibers , it is not the only source of the diaphragm's development.</li><li>• Option C:</li><li>• incorrect</li><li>• body wall musculature</li><li>• diaphragm's peripheral muscle fibers</li><li>• Option D: This is incorrect . Neural crest cells contribute to the development of many structures in the body, but they are not involved in the formation of the diaphragm.</li><li>• Option D:</li><li>• incorrect</li><li>• Neural crest cells</li><li>• many structures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The diaphragm develops from four major components : the septum transversum (forming the central tendon), the pleuroperitoneal folds (contributing to the posterolateral parts), the mesenchyme surrounding the esophagus (forming the crura and other connective tissues), and the musculature of the body wall .</li><li>➤ four major components</li><li>➤ septum transversum</li><li>➤ pleuroperitoneal folds</li><li>➤ mesenchyme surrounding the esophagus</li><li>➤ musculature of the body wall</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 253-258</li><li>➤ Ref :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page no- 253-258</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A fourth-year medical student is focusing on the development of the anal canal, understanding its relevance in various congenital anomalies. Which of the following best describes the embryologic development of the anal canal?", "options": [{"label": "A", "text": "It is entirely derived from the Proctodeum.", "correct": false}, {"label": "B", "text": "The Anal Canal develops solely from the Hindgut.", "correct": false}, {"label": "C", "text": "It is formed by the Fusion of the Proctodeum and the Hindgut.", "correct": true}, {"label": "D", "text": "The Anal Canal originates from the Midgut.", "correct": false}], "correct_answer": "C. It is formed by the Fusion of the Proctodeum and the Hindgut.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture16_s0kssX8.jpg"], "explanation": "<p><strong>Ans. C) It is formed by the Fusion of the Proctodeum and the Hindgut.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: This is incorrect . The proctodeum (the invagination of the ectoderm ) contributes to the formation of the lower part of the anal canal , but not the entire anal canal.</li><li>• Option A:</li><li>• incorrect</li><li>• proctodeum</li><li>• invagination</li><li>• ectoderm</li><li>• lower part</li><li>• anal canal</li><li>• Option B: This is incorrect . The upper part of the anal canal is derived from the hindgut , but the entire anal canal also includes a portion derived from the proctodeum .</li><li>• Option B:</li><li>• incorrect</li><li>• upper part</li><li>• hindgut</li><li>• entire anal canal</li><li>• portion</li><li>• proctodeum</li><li>• Option D: This is incorrect . The midgut does not contribute to the development of the anal canal.</li><li>• Option D:</li><li>• incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anal canal develops from two sources : the upper part from the hindgut and the lower part from the proctodeum . The junction of these two parts, known as the pectinate line , is clinically significant.</li><li>➤ anal canal</li><li>➤ two sources</li><li>➤ upper part</li><li>➤ hindgut</li><li>➤ lower part</li><li>➤ proctodeum</li><li>➤ junction</li><li>➤ pectinate line</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 262-266</li><li>➤ Ref :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page no- 262-266</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is studying the embryological development of the gastrointestinal tract, with a focus on the rectum. Which of the following statements best describes the embryologic development of the rectum?", "options": [{"label": "A", "text": "The Rectum develops entirely from the Hindgut.", "correct": true}, {"label": "B", "text": "It originates from the Fusion of the Hindgut and Allantois.", "correct": false}, {"label": "C", "text": "The Rectum is derived from the Midgut.", "correct": false}, {"label": "D", "text": "It is formed by the division of the Cloaca into the Urogenital Sinus and Anorectal Canal.", "correct": false}], "correct_answer": "A. The Rectum develops entirely from the Hindgut.", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) The Rectum develops entirely from the Hindgut.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B: This is incorrect . The allantois is an embryonic structure involved in early fluid exchange between the embryo and the yolk sac , and it does not contribute to the formation of the rectum.</li><li>• Option B:</li><li>• incorrect</li><li>• allantois</li><li>• embryonic structure</li><li>• early fluid exchange</li><li>• embryo</li><li>• yolk sac</li><li>• Option C: This is incorrect . The midgut gives rise to the lower part of the duodenum , jejunum , ileum , cecum , appendix , ascending colon , and the proximal two-thirds of the transverse colon , not the rectum.</li><li>• Option C:</li><li>• incorrect</li><li>• lower part</li><li>• duodenum</li><li>• jejunum</li><li>• ileum</li><li>• cecum</li><li>• appendix</li><li>• ascending colon</li><li>• proximal two-thirds</li><li>• transverse colon</li><li>• Option D: This is partially correct but not complete. The cloaca , the terminal end of the hindgut , is divided by the urorectal septum into the urogenital sinus and anorectal canal . The upper part of the anorectal canal becomes the rectum , but this option does not fully encompass the origin of the rectum, which is the hindgut.</li><li>• Option D:</li><li>• partially correct</li><li>• cloaca</li><li>• terminal end</li><li>• hindgut</li><li>• divided</li><li>• urorectal septum</li><li>• urogenital sinus</li><li>• anorectal canal</li><li>• upper part</li><li>• anorectal canal</li><li>• rectum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The hindgut is the portion of the embryonic gut tube that gives rise to the distal one-third of the transverse colon , the descending colon , sigmoid colon , rectum , and upper part of the anal canal .</li><li>➤ hindgut</li><li>➤ portion</li><li>➤ embryonic gut tube</li><li>➤ rise</li><li>➤ distal one-third</li><li>➤ transverse colon</li><li>➤ descending colon</li><li>➤ sigmoid colon</li><li>➤ rectum</li><li>➤ upper part</li><li>➤ anal canal</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 362-366</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page no- 362-366</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is reviewing the process of spermiogenesis. He understands that this process is crucial for the formation of mature spermatozoa. Which of the following best describes a key feature of spermiogenesis?", "options": [{"label": "A", "text": "It involves mitotic divisions of spermatogonia.", "correct": false}, {"label": "B", "text": "The process includes a reduction in chromosome number by meiosis.", "correct": false}, {"label": "C", "text": "Spermiogenesis is characterized by the transformation of spermatids into spermatozoa.", "correct": true}, {"label": "D", "text": "It is marked by the growth and maturation of the primary spermatocyte.", "correct": false}], "correct_answer": "C. Spermiogenesis is characterized by the transformation of spermatids into spermatozoa.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/10/picture17_vMBTSB4.jpg"], "explanation": "<p><strong>Ans. C) Spermiogenesis is characterized by the transformation of spermatids into spermatozoa.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: This is incorrect . Mitotic divisions of spermatogonia are a part of spermatocytogenesis , which occurs before spermiogenesis . Spermiogenesis is a later stage that does not involve mitosis.</li><li>• Option A:</li><li>• incorrect</li><li>• spermatocytogenesis</li><li>• before spermiogenesis</li><li>• later stage</li><li>• Option B: This is incorrect . The reduction in chromosome number occurs during the process of meiosis which takes place in spermatocytes before spermiogenesis . Spermiogenesis involves the maturation of spermatids , which already have a haploid set of chromosomes .</li><li>• Option B:</li><li>• incorrect</li><li>• reduction</li><li>• during the process</li><li>• meiosis</li><li>• spermatocytes</li><li>• before</li><li>• spermiogenesis</li><li>• maturation</li><li>• spermatids</li><li>• haploid set</li><li>• chromosomes</li><li>• Option D: This is incorrect . The growth and maturation of primary spermatocytes occur during the earlier stages of spermatogenesis , not during spermiogenesis.</li><li>• Option D:</li><li>• incorrect</li><li>• growth</li><li>• maturation</li><li>• earlier stages</li><li>• spermatogenesis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Spermiogenesis is the final stage of spermatogenesis , where spermatids undergo physical and structural changes to become mature spermatozoa , including the development of the flagella , condensation of the nucleus , and formation of the acrosome .</li><li>➤ final stage</li><li>➤ spermatogenesis</li><li>➤ spermatids</li><li>➤ physical</li><li>➤ structural changes</li><li>➤ become mature spermatozoa</li><li>➤ development</li><li>➤ flagella</li><li>➤ condensation</li><li>➤ nucleus</li><li>➤ formation</li><li>➤ acrosome</li><li>➤ Ref : Larsen’s Human Embryology, 6 th Edition, Page no- 21-23</li><li>➤ Ref</li><li>➤ :</li><li>➤ Larsen’s Human Embryology, 6 th Edition, Page no- 21-23</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 82 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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About anatomical position, which of the following statements is true?", "options": [{"label": "A", "text": "The Palms of the Hands are facing Posteriorly.", "correct": false}, {"label": "B", "text": "The Thumb’s are oriented laterally.", "correct": true}, {"label": "C", "text": "The Feet are dorsiflexed at the ankles.", "correct": false}, {"label": "D", "text": "The Elbows are fully flexed.", "correct": false}], "correct_answer": "B. The Thumb’s are oriented laterally.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-162519.jpeg"], "explanation": "<p><strong>Ans. B) The Thumbs are oriented Laterally.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The palms of the hands are facing anteriorly , not posteriorly. This allows for a clear view of the anatomical structures of the body.</li><li>• Option A.</li><li>• palms of the hands</li><li>• facing anteriorly</li><li>• allows</li><li>• clear view</li><li>• Option C. The feet are not dorsiflexed at the ankles in the anatomical position. Instead, they are in a neutral position , with the toes pointing forward .</li><li>• Option C.</li><li>• neutral position</li><li>• toes pointing forward</li><li>• Option D. The elbows are not fully flexed; they are extended in the anatomical position. This extension allows for accurate descriptions of the upper limb’s anatomical relationships .</li><li>• Option D.</li><li>• extended</li><li>• accurate descriptions</li><li>• upper limb’s anatomical relationships</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the anatomical position, the thumbs are oriented laterally . This position serves as a standardized reference for describing the location and orientation of anatomical structures in the human body.</li><li>➤ thumbs</li><li>➤ oriented laterally</li><li>➤ standardized reference</li><li>➤ location</li><li>➤ orientation</li><li>➤ anatomical structures</li><li>➤ Ref: BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 11, 12</li><li>➤ Ref:</li><li>➤ BD Chaurasia’s Handbook of General Anatomy, 7 th edition, Page no- 11, 12</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following describes the movements known as pronation and supination?", "options": [{"label": "A", "text": "The Flexing of the arm with respect to the Forearm around the Elbow.", "correct": false}, {"label": "B", "text": "The Swivelling of the foot to the Medial and Lateral Directions.", "correct": false}, {"label": "C", "text": "The Downward &amp; Upward rotation of Hand when Elbow is Semi Flexed.", "correct": true}, {"label": "D", "text": "The Rotation at the shoulder that causes the arm to describe a Cone Shape.", "correct": false}], "correct_answer": "C. The Downward & Upward rotation of Hand when Elbow is Semi Flexed.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-163858.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture17.jpg"], "explanation": "<p><strong>Ans. C) The Downward &amp; Upward rotation of Hand when Elbow is Semi Flexed.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Flexing of the Arm with Respect to the Forearm around the Elbow : This describes flexion and extension , not pronation or supination. Flexion refers to decreasing the angle between the forearm and arm , while extension is increasing this angle .</li><li>• Option A. The Flexing of the Arm with Respect to the Forearm around the Elbow</li><li>• flexion</li><li>• extension</li><li>• Flexion</li><li>• decreasing</li><li>• angle</li><li>• forearm</li><li>• arm</li><li>• extension</li><li>• increasing</li><li>• angle</li><li>• Option B. The Swivelling of the Foot to the Medial and Lateral Directions : This is describing inversion and eversion of the foot . Inversion involves turning the sole of the foot inward , while eversion is turning it outward . These movements occur at the ankle and subtalar joints .</li><li>• Option B. The Swivelling of the Foot to the Medial and Lateral Directions</li><li>• inversion</li><li>• eversion</li><li>• foot</li><li>• turning</li><li>• sole</li><li>• foot inward</li><li>• eversion</li><li>• turning</li><li>• outward</li><li>• ankle</li><li>• subtalar joints</li><li>• Option D. The Rotation at the Shoulder that Causes the Arm to Describe a Cone Shape : This is describing circumduction , a circular movement of the limb that combines flexion , extension, abduction , and adduction . It is not specific to pronation or supination.</li><li>• Option D. The Rotation at the Shoulder that Causes the Arm to Describe a Cone Shape</li><li>• circumduction</li><li>• circular movement</li><li>• limb</li><li>• combines flexion</li><li>• extension, abduction</li><li>• adduction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The Twisting of the Wrist While the Elbow is Held Motionless : This correctly describes pronation and supination. These movements occur primarily at the radioulnar joint . In pronation , the radius rotates over the ulna so the palm faces downward . In supination , the radius and ulna are parallel , and the palm faces upward .</li><li>➤ The Twisting of the Wrist While the Elbow is Held Motionless</li><li>➤ primarily</li><li>➤ radioulnar joint</li><li>➤ pronation</li><li>➤ radius</li><li>➤ rotates over the ulna</li><li>➤ palm</li><li>➤ downward</li><li>➤ supination</li><li>➤ radius</li><li>➤ ulna are parallel</li><li>➤ palm faces upward</li><li>➤ Ref: Textbook of Upper limb and Thorax, 3 rd Edition, Vishram Singh, pg. 134</li><li>➤ Ref: Textbook of Upper limb and Thorax, 3 rd Edition, Vishram Singh, pg. 134</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents to the primary care clinic with complaints of facial pain and pressure, a persistent low-grade fever, and nasal congestion for the past two weeks. He also mentions postnasal drip and a reduced sense of smell. He denies any recent upper respiratory tract infections, but he recalls having similar symptoms in the past during allergy seasons. This clinical case is associated with which of the following pair of bone and its type?", "options": [{"label": "A", "text": "Mandible – Flat Bone", "correct": false}, {"label": "B", "text": "Occipital – Irregular Bone", "correct": false}, {"label": "C", "text": "Vertebra – Irregular Bone", "correct": false}, {"label": "D", "text": "Ethmoid – Pneumatic Bone", "correct": true}], "correct_answer": "D. Ethmoid – Pneumatic Bone", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ethmoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. Mandible is a flat bone of lower jaw and is not considered a pneumatic bone.</li><li>• Option A.</li><li>• lower jaw</li><li>• Option B. Occipital is a flat bone of does not contain pneumatic cells.</li><li>• Option B.</li><li>• does not</li><li>• Option C. Vertebrae are the bones of the spine and do not typically contain pneumatic cells.</li><li>• Option C.</li><li>• spine</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ethmoid bone is classified as a pneumatic bone due to the presence of ethmoidal air cells .</li><li>➤ presence of ethmoidal air cells</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 69</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 69</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents with anterior knee pain that worsens with activities like running and jumping. On physical examination, there is tenderness and swelling over the front of the knee. Palpation reveals a small, round, bony prominence at the centre of the knee. The patient reports no recent trauma. You will put the involved bone in which of the following type?", "options": [{"label": "A", "text": "Sphenoid", "correct": false}, {"label": "B", "text": "Hyoid", "correct": false}, {"label": "C", "text": "Ethmoid", "correct": false}, {"label": "D", "text": "Sesamoid", "correct": true}], "correct_answer": "D. Sesamoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sesamoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Sphenoid –</li><li>• Option A. Sphenoid</li><li>• It is a complex bone located at the base of the skull , in the middle of the cranial floor . It is not embedded within a tendon.</li><li>• It is a complex bone located at the base of the skull , in the middle of the cranial floor .</li><li>• complex bone</li><li>• base of the skull</li><li>• middle</li><li>• cranial floor</li><li>• It is not embedded within a tendon.</li><li>• Option B. Hyoid –</li><li>• Option B. Hyoid</li><li>• U-shaped bone located in the anterior neck that does not directly articulate with any other bone. It serves as an anchoring structure for the tongue and muscles in the neck and throat but is not embedded within a tendon.</li><li>• U-shaped bone located in the anterior neck that does not directly articulate with any other bone.</li><li>• U-shaped bone</li><li>• anterior neck</li><li>• It serves as an anchoring structure for the tongue and muscles in the neck and throat but is not embedded within a tendon.</li><li>• anchoring structure</li><li>• tongue</li><li>• muscles</li><li>• neck</li><li>• throat</li><li>• Option C. Ethmoid –</li><li>• Option C. Ethmoid</li><li>• It is located between the eyes and at the roof of the nasal cavity . It is part of the cranial floor and contributes to the medial wall of the orbit , the nasal septum , and the nasal cavity .</li><li>• It is located between the eyes and at the roof of the nasal cavity .</li><li>• eyes</li><li>• roof of the nasal cavity</li><li>• It is part of the cranial floor and contributes to the medial wall of the orbit , the nasal septum , and the nasal cavity .</li><li>• cranial floor</li><li>• medial wall</li><li>• orbit</li><li>• nasal septum</li><li>• nasal cavity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sesamoid : Sesamoid bones like patella are small, round bones that are embedded within tendons . They are found in locations where a tendon passes over a joint , such as the knee, hand, and foot. It helps to overcome compressive forces and modify pressure , reduce friction , and occasionally alter the direction of muscle pull .</li><li>➤ Sesamoid</li><li>➤ small, round bones</li><li>➤ embedded within tendons</li><li>➤ tendon passes over a joint</li><li>➤ overcome compressive forces</li><li>➤ modify pressure</li><li>➤ reduce friction</li><li>➤ occasionally</li><li>➤ direction of muscle pull</li><li>➤ Ref: T extbook of General Anatomy, 2 nd edition, Vishram Singh, pg. 69</li><li>➤ Ref: T extbook of General Anatomy, 2 nd edition, Vishram Singh, pg. 69</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following bone of the skull articulates to form a synovial joint?", "options": [{"label": "A", "text": "The Sphenoid", "correct": false}, {"label": "B", "text": "The Maxilla", "correct": false}, {"label": "C", "text": "The Mandible", "correct": true}, {"label": "D", "text": "The Hyoid", "correct": false}], "correct_answer": "C. The Mandible", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-164542.jpg"], "explanation": "<p><strong>Ans. C) The Mandible</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Sphenoid</li><li>• Option A.</li><li>• The Sphenoid</li><li>• It is a complex bone located at the base of the skull , forming part of the cranial floor. It does not form a synovial joint; rather, it articulates with other cranial bones through sutures .</li><li>• It is a complex bone located at the base of the skull , forming part of the cranial floor.</li><li>• complex bone</li><li>• base of the skull</li><li>• It does not form a synovial joint; rather, it articulates with other cranial bones through sutures .</li><li>• through sutures</li><li>• Option B. The Maxilla</li><li>• Option B. The Maxilla</li><li>• It forms the upper jaw and is involved in forming the roof of the mouth, floors of the orbits , and sides and floor of the nasal cavity . The maxilla is fused to other bones of the face and does not form a synovial joint.</li><li>• It forms the upper jaw and is involved in forming the roof of the mouth, floors of the orbits , and sides and floor of the nasal cavity .</li><li>• upper jaw</li><li>• forming the roof</li><li>• floors</li><li>• orbits</li><li>• sides</li><li>• floor of the nasal cavity</li><li>• The maxilla is fused to other bones of the face and does not form a synovial joint.</li><li>• Option D. The Hyoid</li><li>• Option D. The Hyoid</li><li>• It is a U-shaped bone in the neck that supports the tongue and provides attachment for muscles associated with swallowing . It is not directly attached to other bones but is suspended by ligaments and muscles . The hyoid does not form a synovial joint.</li><li>• It is a U-shaped bone in the neck that supports the tongue and provides attachment for muscles associated with swallowing .</li><li>• U-shaped bone</li><li>• neck</li><li>• supports</li><li>• tongue</li><li>• swallowing</li><li>• It is not directly attached to other bones but is suspended by ligaments and muscles .</li><li>• suspended</li><li>• ligaments and muscles</li><li>• The hyoid does not form a synovial joint.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Mandible or lower jawbone , forms a synovial joint with the temporal bone of the skull known as the Temporo-Mandibular Joint (TMJ) . It is a hinge type of synovial joint that allows for the movement necessary for chewing, speaking , and other mouth movements.</li><li>➤ The Mandible</li><li>➤ lower jawbone</li><li>➤ synovial joint</li><li>➤ temporal bone</li><li>➤ Temporo-Mandibular Joint (TMJ)</li><li>➤ hinge</li><li>➤ chewing, speaking</li><li>➤ Ref: Textbook of Anatomy regional and clinical head, 2 nd edition, Vishram Singh, pg. 17</li><li>➤ Ref: Textbook of Anatomy regional and clinical head, 2 nd edition, Vishram Singh, pg. 17</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old patient presents with a painful, swollen finger after accidentally slamming it in a door. On examination, there is tenderness and deformity of the proximal interphalangeal (PIP) joint. Which bone of the hand is most likely to be fractured in this scenario?", "options": [{"label": "A", "text": "Short Bones", "correct": false}, {"label": "B", "text": "Metacarpals", "correct": false}, {"label": "C", "text": "Carpals", "correct": false}, {"label": "D", "text": "Phalanges", "correct": true}], "correct_answer": "D. Phalanges", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture6.jpg"], "explanation": "<p><strong>Ans. D) Phalanges</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Short Bones:-</li><li>• Option A. Short Bones:-</li><li>• They are defined by their cuboidal shape and are primarily found in the wrist and ankle . They are not the bones of the fingers.</li><li>• They are defined by their cuboidal shape and are primarily found in the wrist and ankle .</li><li>• cuboidal shape</li><li>• wrist</li><li>• ankle</li><li>• They are not the bones of the fingers.</li><li>• Option B. Metacarpals</li><li>• Option B. Metacarpals</li><li>• They are the five long bones located in the hand between the carpal bones and the fingers. Each metacarpal corresponds to a digit of the hand, but they are not the bones within the fingers themselves.</li><li>• They are the five long bones located in the hand between the carpal bones and the fingers.</li><li>• five long bones</li><li>• hand</li><li>• Each metacarpal corresponds to a digit of the hand, but they are not the bones within the fingers themselves.</li><li>• corresponds</li><li>• digit</li><li>• Option C. Carpals</li><li>• Option C.</li><li>• Carpals</li><li>• They are the eight small bones that make up the wrist, connecting the hand to the forearm . They are arranged in two rows and contribute to the wrist's complex range of movements . However, they are not the bones of the fingers.</li><li>• They are the eight small bones that make up the wrist, connecting the hand to the forearm .</li><li>• eight small bones</li><li>• connecting</li><li>• hand</li><li>• forearm</li><li>• They are arranged in two rows and contribute to the wrist's complex range of movements . However, they are not the bones of the fingers.</li><li>• two rows</li><li>• wrist's complex range</li><li>• movements</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phalanges :</li><li>➤ Phalanges</li><li>➤ They are the bones of the fingers ( and toes ). Each finger has three phalanges - the proximal , middle , and distal phalanges , except for the thumb , which has only two (proximal and distal) . These bones provide the structural framework of the fingers , allowing for their extensive range of motion and dexterity.</li><li>➤ They are the bones of the fingers ( and toes ).</li><li>➤ bones of the fingers</li><li>➤ and toes</li><li>➤ Each finger has three phalanges - the proximal , middle , and distal phalanges , except for the thumb , which has only two (proximal and distal) .</li><li>➤ three phalanges</li><li>➤ proximal</li><li>➤ middle</li><li>➤ distal phalanges</li><li>➤ except</li><li>➤ thumb</li><li>➤ only two (proximal and distal)</li><li>➤ These bones provide the structural framework of the fingers , allowing for their extensive range of motion and dexterity.</li><li>➤ structural framework</li><li>➤ fingers</li><li>➤ extensive range of motion and dexterity.</li><li>➤ Ref: Textbook of General Anatomy, 2 nd edition, Vishram Singh, pg. 69</li><li>➤ Ref: Textbook of General Anatomy, 2 nd edition, Vishram Singh, pg. 69</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following lists comprises bones that are part of the appendicular skeleton?", "options": [{"label": "A", "text": "Patella, Ethmoid, Femur, Coccyx, Tibia", "correct": false}, {"label": "B", "text": "Clavicle, Fibula, Metatarsal, Phalange, Radius", "correct": true}, {"label": "C", "text": "Humerus, Scapula, Occipital, Metacarpal, Sternum", "correct": false}, {"label": "D", "text": "Ulna, Radius, Phalange, Mandible, Coxal", "correct": false}], "correct_answer": "B. Clavicle, Fibula, Metatarsal, Phalange, Radius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-165532.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-165653.jpg"], "explanation": "<p><strong>Ans. B) Clavicle, Fibula, Metatarsal, Phalange, Radius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Patella, Ethmoid, Femur, Coccyx, Tibia</li><li>• Option A. Patella, Ethmoid, Femur, Coccyx, Tibia</li><li>• Patella (Kneecap) is part of the appendicular skeleton . Ethmoid is a cranial bone, part of the axial skeleton . Femur (Thigh bone) is part of the appendicular skeleton . Coccyx (Tailbone) is part of the axial skeleton . Tibia (Shinbone) is part of the appendicular skeleton . This list contains bones from both the axial and appendicular skeletons .</li><li>• Patella (Kneecap) is part of the appendicular skeleton .</li><li>• Patella</li><li>• appendicular skeleton</li><li>• Ethmoid is a cranial bone, part of the axial skeleton .</li><li>• Ethmoid</li><li>• axial skeleton</li><li>• Femur (Thigh bone) is part of the appendicular skeleton .</li><li>• Femur</li><li>• appendicular skeleton</li><li>• Coccyx (Tailbone) is part of the axial skeleton .</li><li>• Coccyx</li><li>• axial skeleton</li><li>• Tibia (Shinbone) is part of the appendicular skeleton .</li><li>• Tibia</li><li>• appendicular skeleton</li><li>• This list contains bones from both the axial and appendicular skeletons .</li><li>• both</li><li>• axial</li><li>• appendicular skeletons</li><li>• Option C. Humerus, Scapula, Occipital, Metacarpal, Sternum</li><li>• Option C. Humerus, Scapula, Occipital, Metacarpal, Sternum</li><li>• Humerus (Upper Arm Bone) is part of the appendicular skeleton . Scapula (Shoulder Blade) is part of the appendicular skeleton . Occipital is a cranial bone, part of the axial skeleton . Metacarpals are the bones in the hand, part of the appendicular skeleton . Sternum (Breastbone) is part of the axial skeleton . This list contains bones from both the axial and appendicular skeletons .</li><li>• Humerus (Upper Arm Bone) is part of the appendicular skeleton .</li><li>• Humerus</li><li>• appendicular skeleton</li><li>• Scapula (Shoulder Blade) is part of the appendicular skeleton .</li><li>• Scapula</li><li>• appendicular skeleton</li><li>• Occipital is a cranial bone, part of the axial skeleton .</li><li>• Occipital</li><li>• axial skeleton</li><li>• Metacarpals are the bones in the hand, part of the appendicular skeleton .</li><li>• Metacarpals</li><li>• appendicular skeleton</li><li>• Sternum (Breastbone) is part of the axial skeleton .</li><li>• Sternum</li><li>• axial skeleton</li><li>• This list contains bones from both the axial and appendicular skeletons .</li><li>• axial</li><li>• appendicular skeletons</li><li>• Option D. Ulna, Radius, Phalanges, Mandible, Coxal</li><li>• Option D. Ulna, Radius, Phalanges, Mandible, Coxal</li><li>• Ulna is a bone in the forearm, part of the appendicular skeleton . Radius is a bone in the forearm, part of the appendicular skeleton . Phalanges are the finger and toe bones, part of the appendicular skeleton . Mandible (Lower Jawbone) is part of the axial skeleton . Coxal (Hip Bone) is part of the pelvic girdle of the appendicular skeleton .</li><li>• Ulna is a bone in the forearm, part of the appendicular skeleton .</li><li>• Ulna</li><li>• appendicular skeleton</li><li>• Radius is a bone in the forearm, part of the appendicular skeleton .</li><li>• Radius</li><li>• appendicular skeleton</li><li>• Phalanges are the finger and toe bones, part of the appendicular skeleton .</li><li>• Phalanges</li><li>• appendicular skeleton</li><li>• Mandible (Lower Jawbone) is part of the axial skeleton .</li><li>• Mandible</li><li>• axial skeleton</li><li>• Coxal (Hip Bone) is part of the pelvic girdle of the appendicular skeleton .</li><li>• Coxal</li><li>• appendicular skeleton</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Skeleton system can be divided into 2 following parts: Axial Skeleton Appendicular Skeleton Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System ) Fibula is postaxial bone of lower limb ( Appendicular System ) Metatarsal are the bones in the foot, part of the Appendicular Skeleton . Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton . Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Skeleton system can be divided into 2 following parts: Axial Skeleton Appendicular Skeleton Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System ) Fibula is postaxial bone of lower limb ( Appendicular System ) Metatarsal are the bones in the foot, part of the Appendicular Skeleton . Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton . Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Skeleton system</li><li>➤ 2 following parts:</li><li>➤ Axial Skeleton Appendicular Skeleton Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System ) Fibula is postaxial bone of lower limb ( Appendicular System ) Metatarsal are the bones in the foot, part of the Appendicular Skeleton . Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton . Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Axial Skeleton</li><li>➤ Axial Skeleton</li><li>➤ Appendicular Skeleton Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System ) Fibula is postaxial bone of lower limb ( Appendicular System ) Metatarsal are the bones in the foot, part of the Appendicular Skeleton . Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton . Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Appendicular Skeleton</li><li>➤ Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System ) Fibula is postaxial bone of lower limb ( Appendicular System ) Metatarsal are the bones in the foot, part of the Appendicular Skeleton . Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton . Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Clavicle (Collar bone/ beauty bone) is part of pectoral girdle ( Appendicular System )</li><li>➤ Clavicle</li><li>➤ Appendicular System</li><li>➤ Fibula is postaxial bone of lower limb ( Appendicular System )</li><li>➤ Fibula</li><li>➤ Appendicular System</li><li>➤ Metatarsal are the bones in the foot, part of the Appendicular Skeleton .</li><li>➤ Metatarsal</li><li>➤ Appendicular Skeleton</li><li>➤ Phalange are the bones in the hand &amp; foot, part of the Appendicular Skeleton .</li><li>➤ Phalange</li><li>➤ Appendicular Skeleton</li><li>➤ Radius is preaxial bone of forearm ( Appendicular System )</li><li>➤ Radius</li><li>➤ Appendicular System</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 66</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 66</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents with complaints of joint pain, swelling, and limited range of motion in the knee joint. Physical examination reveals warmth and tenderness around the affected joint, and imaging studies show joint space narrowing and bone erosion. Which of the following category of joint is most likely associated with this patient's condition?", "options": [{"label": "A", "text": "Synarthrosis", "correct": false}, {"label": "B", "text": "Slightly Moveable Joint", "correct": false}, {"label": "C", "text": "Freely Moveable Joint", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Freely Moveable Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-165858.jpg"], "explanation": "<p><strong>Ans. C) Freely Moveable Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Synarthrosis (Fibrous Joint):</li><li>• Option A. Synarthrosis (Fibrous Joint):</li><li>• They are a type of joint where the bones are tightly connected and no movement. An example of a synarthrosis is the sutures of the skull . Synarthroses are the opposite of synovial joints , as they allow no movement.</li><li>• They are a type of joint where the bones are tightly connected and no movement.</li><li>• bones</li><li>• tightly connected</li><li>• An example of a synarthrosis is the sutures of the skull .</li><li>• synarthrosis</li><li>• sutures</li><li>• skull</li><li>• Synarthroses are the opposite of synovial joints , as they allow no movement.</li><li>• opposite</li><li>• synovial joints</li><li>• Option B. Slightly Movable Joint:</li><li>• Option B. Slightly Movable Joint:</li><li>• These joints are also known as amphiarthosis . It allows a small amount of movement, usually because the bones are connected by cartilage . An example is the joints between the vertebrae of the spine. While slightly moveable joints do allow some movement , they do not offer the range of motion seen in synovial joints.</li><li>• These joints are also known as amphiarthosis .</li><li>• amphiarthosis</li><li>• It allows a small amount of movement, usually because the bones are connected by cartilage .</li><li>• bones</li><li>• connected by cartilage</li><li>• An example is the joints between the vertebrae of the spine.</li><li>• While slightly moveable joints do allow some movement , they do not offer the range of motion seen in synovial joints.</li><li>• do allow some movement</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Freely Moveable Joint:</li><li>➤ Freely Moveable Joint:</li><li>➤ It allows a wide range of movement . Examples include the knee, hip, shoulder, and elbow . They are characterized by a synovial cavity filled with synovial fluid , which facilitates movement .</li><li>➤ It allows a wide range of movement . Examples include the knee, hip, shoulder, and elbow .</li><li>➤ wide range of movement</li><li>➤ knee, hip, shoulder, and elbow</li><li>➤ They are characterized by a synovial cavity filled with synovial fluid , which facilitates movement .</li><li>➤ synovial cavity</li><li>➤ synovial fluid</li><li>➤ facilitates movement</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 88</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 88</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents with unexplained fatigue and pallor. Laboratory tests reveal low hemoglobin levels and a decreased red blood cell count. Further evaluation shows a decrease in erythrocyte production in the bone marrow. Which of the following is most likely the content of the medullary canal of a long bone responsible for erythropoiesis in adults?", "options": [{"label": "A", "text": "Trabeculae", "correct": false}, {"label": "B", "text": "Lamellae", "correct": false}, {"label": "C", "text": "Marrow", "correct": true}, {"label": "D", "text": "Osteoblasts and osteoclasts", "correct": false}], "correct_answer": "C. Marrow", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture26_ysRyJ87.jpg"], "explanation": "<p><strong>Ans. C) Marrow</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Trabeculae:</li><li>• Option A. Trabeculae:</li><li>• Trabeculae are the small, needle-like pieces of bone that provide structural support within spongy bone. They are primarily found in the ends of long bones (epiphyses) and within the interior of other bones, not typically within the medullary canal.</li><li>• Trabeculae are the small, needle-like pieces of bone that provide structural support within spongy bone.</li><li>• They are primarily found in the ends of long bones (epiphyses) and within the interior of other bones, not typically within the medullary canal.</li><li>• Option B. Lamellae:</li><li>• Option B. Lamellae:</li><li>• They are thin layers of bone tissue that make up the concentric rings in compact bone. They are a part of the osteon or Haversian system, which is the structural unit of compact bone.</li><li>• They are thin layers of bone tissue that make up the concentric rings in compact bone.</li><li>• They are a part of the osteon or Haversian system, which is the structural unit of compact bone.</li><li>• Option D. Osteoblasts and Osteoclasts:</li><li>• Option D. Osteoblasts and Osteoclasts:</li><li>• Osteoblasts are cells that form new bone tissue, and osteoclasts are cells that break down old bone tissue. These cells are found throughout the bone, particularly in areas of bone remodeling.</li><li>• Osteoblasts are cells that form new bone tissue, and osteoclasts are cells that break down old bone tissue.</li><li>• These cells are found throughout the bone, particularly in areas of bone remodeling.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Marrow –</li><li>➤ Marrow –</li><li>➤ It is a soft, fatty tissue found inside the medullary canal. There are two types of bone marrow: Red marrow, which is involved in blood cell production Yellow marrow, which primarily stores fat.</li><li>➤ It is a soft, fatty tissue found inside the medullary canal.</li><li>➤ There are two types of bone marrow: Red marrow, which is involved in blood cell production Yellow marrow, which primarily stores fat.</li><li>➤ Red marrow, which is involved in blood cell production Yellow marrow, which primarily stores fat.</li><li>➤ Red marrow, which is involved in blood cell production</li><li>➤ Yellow marrow, which primarily stores fat.</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 73</li><li>➤ Ref:</li><li>➤ Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 73</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with a suspected fracture of the tibia. On imaging studies, blood vessels located within the compact bone are most critical for providing nourishment to the deeper regions of the bone? Where are these blood vessels located within compact bone?", "options": [{"label": "A", "text": "In the Canaliculi", "correct": false}, {"label": "B", "text": "In the Periosteum", "correct": false}, {"label": "C", "text": "In the Lacunae", "correct": false}, {"label": "D", "text": "In the Central Canal", "correct": true}], "correct_answer": "D. In the Central Canal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-172329.jpeg"], "explanation": "<p><strong>Ans. D) In the Central Canal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . In the Canaliculi :</li><li>• Option A</li><li>• In the Canaliculi</li><li>• Blood vessels are not typically found in the canaliculi of compact bone. Canaliculi are tiny channels or tunnels that allow for the exchange of nutrients and waste products between osteocytes and blood vessels . While they facilitate communication between cells and nearby blood vessels, the blood vessels themselves are not located within the canaliculi.</li><li>• Blood vessels are not typically found in the canaliculi of compact bone.</li><li>• Canaliculi are tiny channels or tunnels that allow for the exchange of nutrients and waste products between osteocytes and blood vessels .</li><li>• Canaliculi</li><li>• tiny channels</li><li>• tunnels</li><li>• exchange of nutrients</li><li>• waste products</li><li>• osteocytes</li><li>• blood vessels</li><li>• While they facilitate communication between cells and nearby blood vessels, the blood vessels themselves are not located within the canaliculi.</li><li>• facilitate communication</li><li>• Option B . In the Periosteum :</li><li>• Option B</li><li>• In the Periosteum</li><li>• Blood vessels are indeed found in the periosteum. The periosteum is a dense connective tissue membrane that covers the outer surface of bones and contains blood vessels, nerves , and other structures .</li><li>• Blood vessels are indeed found in the periosteum.</li><li>• The periosteum is a dense connective tissue membrane that covers the outer surface of bones and contains blood vessels, nerves , and other structures .</li><li>• periosteum</li><li>• dense connective tissue membrane</li><li>• outer surface</li><li>• bones</li><li>• blood vessels, nerves</li><li>• other structures</li><li>• Option C. In the Lacunae :</li><li>• Option C.</li><li>• In the Lacunae</li><li>• Blood vessels are not typically found within the lacunae. Lacunae are small spaces within the bone matrix where osteocytes reside . These spaces house bone cells but not blood vessels.</li><li>• Blood vessels are not typically found within the lacunae.</li><li>• Lacunae are small spaces within the bone matrix where osteocytes reside .</li><li>• small spaces</li><li>• bone matrix</li><li>• osteocytes reside</li><li>• These spaces house bone cells but not blood vessels.</li><li>• house bone cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Blood vessels are primarily found in the central canal , also known as the Haversian canal or osteonic canal . The central canal runs longitudinally through the center of each osteon and contains blood vessels , nerves , and connective tissue .</li><li>➤ Blood vessels are primarily found in the central canal , also known as the Haversian canal or osteonic canal .</li><li>➤ central canal</li><li>➤ Haversian canal</li><li>➤ osteonic canal</li><li>➤ The central canal runs longitudinally through the center of each osteon and contains blood vessels , nerves , and connective tissue .</li><li>➤ longitudinally</li><li>➤ center of each osteon</li><li>➤ blood vessels</li><li>➤ nerves</li><li>➤ connective tissue</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 72</li><li>➤ Ref:</li><li>➤ Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 72</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the context of young bones, which part is primarily responsible for longitudinal growth?", "options": [{"label": "A", "text": "Diaphysis", "correct": false}, {"label": "B", "text": "Epiphysis", "correct": false}, {"label": "C", "text": "Metaphysis", "correct": true}, {"label": "D", "text": "Periosteum", "correct": false}], "correct_answer": "C. Metaphysis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/anatomy-10.jpg"], "explanation": "<p><strong>Ans. C) Metaphysis.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Diaphysis</li><li>• Option A. Diaphysis</li><li>• Part of bone which ossify from primary centre of ossification known as diaphysis. It is the central shaft of a long bone and is not primarily responsible for longitudinal growth.</li><li>• Part of bone which ossify from primary centre of ossification known as diaphysis.</li><li>• ossify from primary centre</li><li>• It is the central shaft of a long bone and is not primarily responsible for longitudinal growth.</li><li>• central shaft</li><li>• Option B. Epiphysis</li><li>• Option B. Epiphysis</li><li>• Part of bone which ossify from secondary centre of ossification known as epiphysis. It refers to the ends of the long bone, and while it plays a role in joint function and stability , it is not the primary site for longitudinal growth.</li><li>• Part of bone which ossify from secondary centre of ossification known as epiphysis.</li><li>• ossify from secondary centre</li><li>• It refers to the ends of the long bone, and while it plays a role in joint function and stability , it is not the primary site for longitudinal growth.</li><li>• joint function</li><li>• stability</li><li>• Option D. Periosteum</li><li>• Option D. Periosteum</li><li>• It is a dense fibrous membrane that covers the outer surface of bones. While it is important for bone development and repair , it is not directly involved in longitudinal growth.</li><li>• It is a dense fibrous membrane that covers the outer surface of bones.</li><li>• dense fibrous membrane</li><li>• While it is important for bone development and repair , it is not directly involved in longitudinal growth.</li><li>• important for bone development and repair</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In young bones, the part primarily responsible for longitudinal growth is the metaphysis , which houses the epiphyseal plate (growth plate).</li><li>➤ In young bones, the part primarily responsible for longitudinal growth is the metaphysis , which houses the epiphyseal plate (growth plate).</li><li>➤ part primarily responsible</li><li>➤ longitudinal growth</li><li>➤ metaphysis</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where is the epiphyseal plate of a long bone located?", "options": [{"label": "A", "text": "In the Diaphysis", "correct": false}, {"label": "B", "text": "Between the Diaphysis and the Epiphysis", "correct": true}, {"label": "C", "text": "In the Epiphysis", "correct": false}, {"label": "D", "text": "In the Medullary Canal", "correct": false}], "correct_answer": "B. Between the Diaphysis and the Epiphysis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture28_pT1x3v4.jpg"], "explanation": "<p><strong>Ans. B) Between the Diaphysis and the Epiphysis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. In the Diaphysis: It is the shaft or central part of a long bone . The epiphyseal plate is not located within the diaphysis. Instead, the diaphysis is primarily composed of compact bone and contains the medullary cavity .</li><li>• Option A. In the Diaphysis:</li><li>• shaft</li><li>• central part</li><li>• long bone</li><li>• diaphysis</li><li>• primarily composed</li><li>• compact bone</li><li>• contains the medullary cavity</li><li>• Option C. In the Epiphysis: The epiphysis refers to the rounded end of a long bone . While the epiphyseal plate is adjacent to the epiphysis , it is not located within the epiphysis itself. The epiphysis is primarily made of spongy bone and contributes to joint formation .</li><li>• Option C. In the Epiphysis:</li><li>• rounded end</li><li>• long bone</li><li>• adjacent</li><li>• epiphysis</li><li>• primarily made</li><li>• spongy bone</li><li>• contributes to joint formation</li><li>• Option D. In the Medullary Canal: The medullary canal , or medullary cavity , is the central cavity of bone shafts where red and yellow bone marrow is stored .</li><li>• Option D. In the Medullary Canal:</li><li>• medullary canal</li><li>• medullary cavity</li><li>• central cavity</li><li>• bone shafts</li><li>• red and yellow bone marrow</li><li>• stored</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Between the Diaphysis and the Epiphysis: The epiphyseal plate is the area of growing tissue near the ends of the long bones. It is located between the diaphysis and the epiphysis of the bone. The plate is responsible for longitudinal growth of the bone, as new bone is added at this location during development.</li><li>➤ Between the Diaphysis and the Epiphysis:</li><li>➤ area of growing tissue</li><li>➤ diaphysis</li><li>➤ epiphysis</li><li>➤ responsible</li><li>➤ longitudinal growth</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 72</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 72</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the correct pair:", "options": [{"label": "A", "text": "1-d, 2-c, 3-b, 4-a", "correct": false}, {"label": "B", "text": "1- b, 2-a, 3-d, 4-c", "correct": true}, {"label": "C", "text": "1- a, 2-b, 3-d, 4-c", "correct": false}, {"label": "D", "text": "1- b, 2-a, 3-c, 4-d", "correct": false}], "correct_answer": "B. 1- b, 2-a, 3-d, 4-c", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture2.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture3_cvLUXMy.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/14/01.jpg"], "explanation": "<p><strong>Ans. B) 1- b, 2-a, 3-d, 4-c</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• 1. Pressure Epiphysis:</li><li>• 1. Pressure Epiphysis:</li><li>• Pressure epiphyses are regions of long bones where growth occurs due to the pressure applied to the epiphyseal plate . Growth is a result of compression forces . Example: The distal end of the femur is a pressure epiphysis . During childhood and adolescence , the weight-bearing activities apply pressure on this epiphysis, allowing for bone elongation .</li><li>• Pressure epiphyses are regions of long bones where growth occurs due to the pressure applied to the epiphyseal plate .</li><li>• long bones</li><li>• growth</li><li>• pressure</li><li>• epiphyseal plate</li><li>• Growth is a result of compression forces .</li><li>• Growth</li><li>• compression forces</li><li>• Example: The distal end of the femur is a pressure epiphysis .</li><li>• Example:</li><li>• distal end</li><li>• pressure epiphysis</li><li>• During childhood and adolescence , the weight-bearing activities apply pressure on this epiphysis, allowing for bone elongation .</li><li>• During childhood</li><li>• adolescence</li><li>• weight-bearing activities</li><li>• pressure</li><li>• allowing</li><li>• bone elongation</li><li>• 2. Traction Epiphysis:</li><li>• 2. Traction Epiphysis:</li><li>• Traction epiphyses are areas in long bones where growth happens in response to pulling or traction forces on the epiphyseal plate . These forces are typically exerted by tendons or muscles attached to the bone. Example: The proximal end of the tibia is a traction epiphysis . The action of the patellar tendon , connected to the tibial tuberosity , leads to traction forces that promote bone growth .</li><li>• Traction epiphyses are areas in long bones where growth happens in response to pulling or traction forces on the epiphyseal plate .</li><li>• growth happens</li><li>• response</li><li>• pulling</li><li>• traction forces</li><li>• epiphyseal plate</li><li>• These forces are typically exerted by tendons or muscles attached to the bone.</li><li>• typically exerted</li><li>• tendons</li><li>• muscles</li><li>• Example: The proximal end of the tibia is a traction epiphysis .</li><li>• Example:</li><li>• proximal end</li><li>• traction epiphysis</li><li>• The action of the patellar tendon , connected to the tibial tuberosity , leads to traction forces that promote bone growth .</li><li>• action</li><li>• patellar tendon</li><li>• tibial tuberosity</li><li>• traction forces</li><li>• promote bone growth</li><li>• 3. Atavistic Epiphysis:</li><li>• 3. Atavistic Epiphysis:</li><li>• Atavistic epiphyses are secondary centers of ossification that are rare and may resemble ancestral bone structures . They are considered vestigial . Example: The presence of an additional epiphysis in the elbow joint that is not typically seen in modern humans would be considered an atavistic epiphysis.</li><li>• Atavistic epiphyses are secondary centers of ossification that are rare and may resemble ancestral bone structures .</li><li>• secondary centers of ossification</li><li>• rare</li><li>• resemble ancestral bone structures</li><li>• They are considered vestigial .</li><li>• vestigial</li><li>• Example: The presence of an additional epiphysis in the elbow joint that is not typically seen in modern humans would be considered an atavistic epiphysis.</li><li>• Example:</li><li>• epiphysis</li><li>• elbow joint</li><li>• 4. Aberrant Epiphysis:</li><li>• 4. Aberrant Epiphysis:</li><li>• Aberrant epiphyses are anomalous growth centers or irregularities in bone development that deviate from the usual patterns. Example: An individual with an extra epiphyseal center in the metacarpal bone , not commonly observed in the general population, would have an aberrant epiphysis.</li><li>• Aberrant epiphyses are anomalous growth centers or irregularities in bone development that deviate from the usual patterns.</li><li>• anomalous growth centers</li><li>• irregularities</li><li>• bone development</li><li>• deviate</li><li>• Example: An individual with an extra epiphyseal center in the metacarpal bone , not commonly observed in the general population, would have an aberrant epiphysis.</li><li>• Example:</li><li>• extra epiphyseal center</li><li>• metacarpal bone</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Diagrammatic presentation:</li><li>➤ Diagrammatic presentation:</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 74</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which structure osteoclasts and osteoblasts are found?", "options": [{"label": "A", "text": "In the Periosteum", "correct": true}, {"label": "B", "text": "In the Haversian Canals", "correct": false}, {"label": "C", "text": "In the Lacunae of Osteons", "correct": false}, {"label": "D", "text": "In the Trabeculae of Osteons", "correct": false}], "correct_answer": "A. In the Periosteum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/anatomy-12.jpg"], "explanation": "<p><strong>Ans. A) In the Periosteum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. In the Haversian Canals: Haversian canals are a series of tubes around narrow channels formed by lamellae , found in the osteon of compact bone . While Haversian canals contain blood vessels and nerves , they are not the primary location for osteoblasts and osteoclasts.</li><li>• Option B. In the Haversian Canals:</li><li>• series of tubes</li><li>• narrow channels</li><li>• lamellae</li><li>• osteon of compact bone</li><li>• blood vessels</li><li>• nerves</li><li>• Option C. In the Lacunae of Osteons: Lacunae are small spaces within the osteon that contain osteocytes , which are mature bone cells . Osteoclasts and osteoblasts are not typically found in the lacunae. The lacunae primarily house osteocytes .</li><li>• Option C. In the Lacunae of Osteons:</li><li>• small spaces within</li><li>• osteon</li><li>• osteocytes</li><li>• mature bone cells</li><li>• lacunae primarily house osteocytes</li><li>• Option D. In the Trabeculae of Osteons: They are the spongy parts of bone that provide structural support and are found in the interior of bones . While trabeculae are involved in the bone remodeling process , osteoclasts and osteoblasts are more active in the periosteum and endosteum than within the trabeculae themselves.</li><li>• Option D. In the Trabeculae of Osteons:</li><li>• spongy parts of bone</li><li>• structural support</li><li>• found</li><li>• interior of bones</li><li>• involved</li><li>• bone remodeling process</li><li>• osteoclasts</li><li>• osteoblasts</li><li>• more active</li><li>• periosteum</li><li>• endosteum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The periosteum is a dense layer of vascular connective tissue enveloping the bones except at the surfaces of the joints . Both osteoblasts and osteoclasts are found in the periosteum . This layer is crucial for bone growth and repair , as these cells are actively involved in bone remodelling .</li><li>➤ dense layer</li><li>➤ vascular connective tissue</li><li>➤ bones</li><li>➤ except</li><li>➤ surfaces of the joints</li><li>➤ Both osteoblasts</li><li>➤ osteoclasts</li><li>➤ periosteum</li><li>➤ crucial</li><li>➤ bone growth</li><li>➤ repair</li><li>➤ bone remodelling</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 71</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 71</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient presents with chronic hip pain. On X-ray, you observe a bony projection extending from the femoral neck. There are several normal projections from bone which can mimic such clinical situation. Among these which of the following is NOT a projection from a bone surface?", "options": [{"label": "A", "text": "Trochanter", "correct": false}, {"label": "B", "text": "Tubercle", "correct": false}, {"label": "C", "text": "Trabeculae", "correct": true}, {"label": "D", "text": "Tuberosity", "correct": false}], "correct_answer": "C. Trabeculae", "question_images": [], "explanation_images": [], "explanation": "<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 21-years-old patient Suyash came to OPD with history of fall on hand. Now he is having pain at hand region. X ray of patient is given. Which of the following joint has been shown in his X-ray?", "options": [{"label": "A", "text": "Hinge Joint", "correct": false}, {"label": "B", "text": "Ball-and-Socket Joint", "correct": false}, {"label": "C", "text": "Ellipsoid Joint", "correct": true}, {"label": "D", "text": "Saddle Joint", "correct": false}], "correct_answer": "C. Ellipsoid Joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture17_Hir3S8k.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ellipsoid Joint.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hinge Joints, such as the elbow joint, primarily allow for flexion and extension movements in one plane .</li><li>• Option A.</li><li>• allow for flexion</li><li>• extension movements</li><li>• one plane</li><li>• Option B. Ball-and-Socket Joints, like the hip joint, allow for a wide range of motion , including flexion, extension, abduction, adduction, and rotation .</li><li>• Option B.</li><li>• allow</li><li>• wide range of motion</li><li>• including flexion, extension, abduction, adduction,</li><li>• rotation</li><li>• Option D. Saddle Joints, such as the carpometacarpal joint of the thumb, allow for movements in multiple directions , including flexion, extension, abduction, adduction , and circumduction .</li><li>• Option D.</li><li>• allow</li><li>• movements</li><li>• multiple directions</li><li>• flexion, extension, abduction, adduction</li><li>• circumduction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Wrist joint ( radiocarpal joint ) is classified as an ellipsoid joint , primarily allowing flexion , extension , and side-to-side movements without axial rotation.</li><li>➤ Wrist joint ( radiocarpal joint ) is classified as an ellipsoid joint , primarily allowing flexion , extension , and side-to-side movements without axial rotation.</li><li>➤ Wrist joint</li><li>➤ radiocarpal joint</li><li>➤ ellipsoid joint</li><li>➤ allowing flexion</li><li>➤ extension</li><li>➤ side-to-side movements</li><li>➤ Ref: Textbook of Anatomy Upper limb and Thorax Vishram Singh 3rd edition pg. 153</li><li>➤ Ref: Textbook of Anatomy Upper limb and Thorax Vishram Singh 3rd edition pg. 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient presents with a sprained ankle following a sports injury. Which type of connective tissue structure is most commonly affected in ankle sprains?", "options": [{"label": "A", "text": "Aponeuroses", "correct": false}, {"label": "B", "text": "Tendons", "correct": false}, {"label": "C", "text": "Fasciculi", "correct": false}, {"label": "D", "text": "Ligaments", "correct": true}], "correct_answer": "D. Ligaments", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Ligaments</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Aponeuroses - They are flat , broad tendinous sheets . They serve as a means for muscle attachment to the bones but are not directly involved in connecting bones at a joint .</li><li>• Option A. Aponeuroses -</li><li>• flat</li><li>• broad tendinous sheets</li><li>• muscle attachment</li><li>• bones</li><li>• .</li><li>• Option B. Tendon - They are strong , fibrous connective tissues that connect muscles to bones . They help in transmitting the force generated by muscles to bones, causing movement .</li><li>• Option B. Tendon -</li><li>• strong</li><li>• fibrous connective tissues</li><li>• connect muscles</li><li>• bones</li><li>• transmitting the force</li><li>• movement</li><li>• Option C. Fasciculi - It refers to bundles of muscle fibers within a muscle. They are part of the muscle's internal structure and are involved in muscle contraction and force generation .</li><li>• Option C. Fasciculi -</li><li>• bundles of muscle fibers</li><li>• muscle's internal structure</li><li>• involved</li><li>• muscle contraction</li><li>• force generation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ligaments are tough bands of fibrous connective tissue . They connect bones to other bones at a joint, providing stability and guiding joint movement .</li><li>➤ tough bands</li><li>➤ fibrous connective tissue</li><li>➤ connect bones</li><li>➤ providing stability</li><li>➤ guiding joint movement</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 18</li><li>➤ Ref:</li><li>➤ Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 18</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of joint is characterized by the presence of a cartilaginous pad or disc between the articulating bones and allows for limited movement?", "options": [{"label": "A", "text": "Suture Joint", "correct": false}, {"label": "B", "text": "Synovial Joint", "correct": false}, {"label": "C", "text": "Secondary Cartilaginous Joint", "correct": true}, {"label": "D", "text": "Fibrous Joint", "correct": false}], "correct_answer": "C. Secondary Cartilaginous Joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Secondary Cartilaginous Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :-</li><li>• Option A. Suture joints are fibrous joints found in the skull , where the bones are tightly interlocked and allow for no movement.</li><li>• Option A.</li><li>• fibrous joints</li><li>• skull</li><li>• tightly interlocked</li><li>• Option B. Synovial joints, like the knee or shoulder joint, have a joint cavity filled with synovial fluid and allow for a wide range of movements .</li><li>• Option B.</li><li>• joint cavity</li><li>• synovial fluid</li><li>• allow</li><li>• wide range of movements</li><li>• Option D. Fibrous joints, such as sutures or syndesmoses, are characterized by dense fibrous connective tissue and do not allow significant movement.</li><li>• Option D.</li><li>• dense fibrous connective tissue</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The secondary cartilaginous joints are the joints with fibrocartilaginous disc, which allows the limited movement.</li><li>➤ The secondary cartilaginous joints are the joints with fibrocartilaginous disc, which allows the limited movement.</li><li>➤ secondary cartilaginous joints</li><li>➤ fibrocartilaginous disc,</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 89</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of joint is characterized by the presence of fibrous connective tissue that tightly holds adjacent cranial bones together, allowing minimal to no movement?", "options": [{"label": "A", "text": "Synovial Joint", "correct": false}, {"label": "B", "text": "Cartilaginous Joint", "correct": false}, {"label": "C", "text": "Ball-and-Socket Joint", "correct": false}, {"label": "D", "text": "Sutural Joint", "correct": true}], "correct_answer": "D. Sutural Joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sutural Joint.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Synovial joints, like the knee or shoulder joint, have a synovial cavity filled with synovial fluid and allow for a wide range of movements .</li><li>• Option A.</li><li>• synovial cavity</li><li>• synovial fluid</li><li>• wide range of movements</li><li>• Option B. Cartilaginous joints, such as the pubic symphysis, are characterized by the presence of cartilage and allow limited movement .</li><li>• Option B.</li><li>• presence of cartilage</li><li>• allow limited movement</li><li>• Option C. Ball-and-socket joints, like the hip joint, allow for a wide range of motion in multiple planes , which is not characteristic of sutural joints.</li><li>• Option C.</li><li>• wide range of motion</li><li>• multiple planes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sutural joints are fibrous joints, found in the skull that provide stability and minimal to no movement .</li><li>➤ Sutural joints are fibrous joints, found in the skull that provide stability and minimal to no movement .</li><li>➤ Sutural joints</li><li>➤ fibrous joints,</li><li>➤ skull</li><li>➤ provide stability</li><li>➤ minimal</li><li>➤ no movement</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 89</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which type of joint allows for rotational movement of the forearm, specifically allowing pronation and supination?", "options": [{"label": "A", "text": "Hinge Joint", "correct": false}, {"label": "B", "text": "Ball-and-Socket Joint", "correct": false}, {"label": "C", "text": "Pivot Joint", "correct": true}, {"label": "D", "text": "Saddle Joint", "correct": false}], "correct_answer": "C. Pivot Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-170410.jpg"], "explanation": "<p><strong>Ans. C) Pivot Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hinge joints, such as the elbow joint , permit movement primarily in one plane (flexion and extension) and do not allow for the rotational movement seen in pronation and supination.</li><li>• Option A.</li><li>• elbow joint</li><li>• one plane (flexion and extension)</li><li>• Option B. Ball-and-socket joints, like the hip joint , allow for a wide range of motion in multiple planes and are not involved in the specific rotational movements of the middle radioulnar joint.</li><li>• Option B.</li><li>• hip joint</li><li>• wide range of motion</li><li>• multiple planes</li><li>• Option D. Saddle joints, such as the carpometacarpal joint of the thumb, allow for movements in multiple directions , including flexion, extension, abduction, adduction , and circumduction , but they do not primarily facilitate pronation and supination.</li><li>• Option D.</li><li>• carpometacarpal joint</li><li>• movements in multiple directions</li><li>• flexion, extension, abduction, adduction</li><li>• circumduction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle radioulnar joint is a pivot joint that enables rotational movements of the forearm , specifically pronation and supination .</li><li>➤ enables rotational movements</li><li>➤ forearm</li><li>➤ pronation</li><li>➤ supination</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is an example of a plane synovial joint in the human body?", "options": [{"label": "A", "text": "Hip Joint", "correct": false}, {"label": "B", "text": "Knee Joint", "correct": false}, {"label": "C", "text": "Elbow Joint", "correct": false}, {"label": "D", "text": "Costo-Transverse Joint", "correct": true}], "correct_answer": "D. Costo-Transverse Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-174318.jpeg"], "explanation": "<p><strong>Ans. D) Costo-Transverse Joint.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The hip joint is a ball-and-socket synovial joint that permits a wide range of movements .</li><li>• Option A.</li><li>• ball-and-socket synovial joint</li><li>• permits</li><li>• wide range</li><li>• movements</li><li>• Option B. The knee joint is a hinge synovial joint that primarily allows flexion and extension .</li><li>• Option B.</li><li>• hinge synovial joint</li><li>• allows flexion and extension</li><li>• Option C. The elbow joint is a hinge synovial joint that primarily allows flexion and extension .</li><li>• Option C.</li><li>• hinge synovial joint</li><li>• allows flexion</li><li>• extension</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The plane synovial joint , or gliding joint , allows sliding or gliding movements between flat articular surfaces .</li><li>➤ The plane synovial joint , or gliding joint , allows sliding or gliding movements between flat articular surfaces .</li><li>➤ plane synovial joint</li><li>➤ gliding joint</li><li>➤ sliding or gliding movements</li><li>➤ flat articular surfaces</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which two joints are responsible for the nodding and shaking movements of the head, respectively?", "options": [{"label": "A", "text": "Atlanto-Axial Joint and atlanto-Occipital Joint", "correct": true}, {"label": "B", "text": "Sternoclavicular Joint and Costovertebral Joint", "correct": false}, {"label": "C", "text": "Sacroiliac Joint and Temporomandibular Joint Hip Joint", "correct": false}, {"label": "D", "text": "Glenohumeral Joint and", "correct": false}], "correct_answer": "A. Atlanto-Axial Joint and atlanto-Occipital Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture8.jpg"], "explanation": "<p><strong>Ans. A) Atlanto-Axial Joint and Atlanto-Occipital Joint.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The sternoclavicular joint and costovertebral joint are not responsible for the primary movements of the head.</li><li>• Option B.</li><li>• not responsible</li><li>• Option C. The sacroiliac joint and hip joint are located in the pelvis and are not involved in head movements.</li><li>• Option C.</li><li>• pelvis</li><li>• not involved</li><li>• Option D. The glenohumeral joint is the shoulder joint , and the temporomandibular joint is the jaw joint , neither of which is primarily responsible for the movements of the head.</li><li>• Option D.</li><li>• shoulder joint</li><li>• jaw joint</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The atlanto-axial joint is responsible for shaking movements and the atlanto-occipital joint for nodding movements in head motion .</li><li>➤ The atlanto-axial joint is responsible for shaking movements and the atlanto-occipital joint for nodding movements in head motion .</li><li>➤ atlanto-axial joint</li><li>➤ shaking movements</li><li>➤ atlanto-occipital joint</li><li>➤ nodding movements</li><li>➤ head motion</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 93</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following according to the classification of arrangement of muscle fibres with their example for each type?", "options": [{"label": "A", "text": "1- d, 2- a, 3- b, 4- c", "correct": false}, {"label": "B", "text": "1- c, 2- d, 3- a, 4- b", "correct": false}, {"label": "C", "text": "1- d, 2- c, 3- b, 4- a", "correct": false}, {"label": "D", "text": "1- b, 2- a, 3- d, 4- c", "correct": true}], "correct_answer": "D. 1- b, 2- a, 3- d, 4- c", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/05/screenshot-2024-02-05-172103_StyTiBB.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture10.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-181335.jpeg"], "explanation": "<p><strong>Ans. D) 1- b, 2- a, 3- d, 4- c</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation: Different types of arrangement of muscle fibres shown in image:</li><li>• 1. Parallel Arrangement:</li><li>• 1. Parallel Arrangement:</li><li>• Muscle fibers run parallel to the long axis of the muscle. Example: Biceps brachii</li><li>• Muscle fibers run parallel to the long axis of the muscle.</li><li>• parallel</li><li>• long axis</li><li>• Example: Biceps brachii</li><li>• Example: Biceps brachii</li><li>• 2. Pennate Arrangement:</li><li>• 2. Pennate Arrangement:</li><li>• Muscle Fibers are obliquely oriented to the tendon , forming a feather-like pattern . Example: Rectus Femoris</li><li>• Muscle Fibers are obliquely oriented to the tendon , forming a feather-like pattern .</li><li>• obliquely</li><li>• tendon</li><li>• feather-like pattern</li><li>• Example: Rectus Femoris</li><li>• Example: Rectus Femoris</li><li>• 3. Cruciate Arrangement:</li><li>• 3. Cruciate Arrangement:</li><li>• Muscle fibres having 2 sets , which cross each other Example: Sternocleidomastoid</li><li>• Muscle fibres having 2 sets , which cross each other</li><li>• 2 sets</li><li>• cross each other</li><li>• Example: Sternocleidomastoid</li><li>• Example: Sternocleidomastoid</li><li>• 4. Spiral/ Twisted:</li><li>• 4. Spiral/ Twisted:</li><li>• Muscle fibres having only 1 set in which upper fibres runs down &amp; lower fibres runs upside in between attachments . Example: Latissimus Dorsi &amp; Pectoralis Major</li><li>• Muscle fibres having only 1 set in which upper fibres runs down &amp; lower fibres runs upside in between attachments .</li><li>• only 1 set</li><li>• upper fibres runs down</li><li>• lower fibres</li><li>• upside</li><li>• between attachments</li><li>• Example: Latissimus Dorsi &amp; Pectoralis Major</li><li>• Example: Latissimus Dorsi</li><li>• Pectoralis Major</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Arrangement of muscle fibre direction - Biceps brachii shows Parallel arrangement, Rectus femoris shows Pennate arrangement, Sternocleidomastoid shows Cruciate arrangement &amp; Latissimus dorsi shows Spiral arrangement.</li><li>➤ Arrangement of muscle fibre direction - Biceps brachii shows Parallel arrangement, Rectus femoris shows Pennate arrangement, Sternocleidomastoid shows Cruciate arrangement &amp; Latissimus dorsi shows Spiral arrangement.</li><li>➤ Arrangement of muscle fibre direction -</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following best describes the classification of muscle fibre arrangement known as \"Pennate Arrangement\"?", "options": [{"label": "A", "text": "Muscle Fibers run parallel to the long axis of the muscle.", "correct": false}, {"label": "B", "text": "Muscle Fibers are obliquely oriented to the tendon, forming a feather-like pattern.", "correct": true}, {"label": "C", "text": "Muscle Fibers encircle an opening or body cavity.", "correct": false}, {"label": "D", "text": "Muscle Fibers are arranged in a concentric circular pattern.", "correct": false}], "correct_answer": "B. Muscle Fibers are obliquely oriented to the tendon, forming a feather-like pattern.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture13_y9Wzeb8.jpg"], "explanation": "<p><strong>Ans. B) Muscle fibers are obliquely oriented to the tendon, forming a feather-like pattern.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• \" Pennate Arrangement \" refers to muscle fibers that are obliquely oriented to the tendon , creating a feather-like or fan-like pattern . This arrangement provides a greater number of muscle fibers in a given cross-sectional area , allowing for more force generation .</li><li>• \" Pennate Arrangement \" refers to muscle fibers that are obliquely oriented to the tendon , creating a feather-like or fan-like pattern .</li><li>• Pennate Arrangement</li><li>• muscle fibers</li><li>• obliquely oriented</li><li>• tendon</li><li>• feather-like</li><li>• fan-like pattern</li><li>• This arrangement provides a greater number of muscle fibers in a given cross-sectional area , allowing for more force generation .</li><li>• greater number</li><li>• muscle fibers</li><li>• cross-sectional area</li><li>• allowing</li><li>• force generation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The classification of \"Pennate Arrangement\" in Muscle Fibers involves Oblique orientation of fibers to the tendon , as seen in muscles like the Rectus Femoris.</li><li>➤ involves Oblique orientation of fibers to the tendon</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following best describes a muscle with a \"Strap-like with Tendinous intersections\" Fiber Arrangement, characterized by Uniform Width and Parallel Fibers?", "options": [{"label": "A", "text": "Biceps Brachii", "correct": false}, {"label": "B", "text": "Rectus Abdominis", "correct": true}, {"label": "C", "text": "Deltoid", "correct": false}, {"label": "D", "text": "Pectoralis Major", "correct": false}], "correct_answer": "B. Rectus Abdominis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-170931.jpg"], "explanation": "<p><strong>Ans. B) Rectus Abdominis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B:</li><li>• Option B:</li><li>• A \" Strap-like\" muscle , such as the Rectus Abdominis, is characterized by Uniform Width and Parallel muscle fibers running along the long axis of the muscle. The rectus abdominis is a prominent abdominal muscle that provides stability and support to the anterior abdominal wall . Its strap-like arrangement is well-suited for maintaining abdominal posture and assisting in various movements such as trunk flexion and stabilization . It is having ribbon like parallel arrangement and also in between tendinous intersections as shown in image:</li><li>• A \" Strap-like\" muscle , such as the Rectus Abdominis, is characterized by Uniform Width and Parallel muscle fibers running along the long axis of the muscle.</li><li>• Strap-like\" muscle</li><li>• Uniform Width</li><li>• Parallel muscle fibers</li><li>• long axis</li><li>• The rectus abdominis is a prominent abdominal muscle that provides stability and support to the anterior abdominal wall .</li><li>• prominent abdominal muscle</li><li>• stability</li><li>• support</li><li>• anterior abdominal wall</li><li>• Its strap-like arrangement is well-suited for maintaining abdominal posture and assisting in various movements such as trunk flexion and stabilization .</li><li>• well-suited</li><li>• maintaining abdominal posture</li><li>• trunk flexion</li><li>• stabilization</li><li>• It is having ribbon like parallel arrangement and also in between tendinous intersections as shown in image:</li><li>• ribbon like parallel arrangement</li><li>• in between tendinous intersections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \"Strap-like\" muscle fiber arrangement, exemplified by the rectus abdominis, features uniform width and parallel fibers along the muscle's long axis , providing stability and support to the abdominal wall.</li><li>➤ The \"Strap-like\" muscle fiber arrangement, exemplified by the rectus abdominis, features uniform width and parallel fibers along the muscle's long axis , providing stability and support to the abdominal wall.</li><li>➤ uniform width</li><li>➤ parallel fibers</li><li>➤ muscle's long axis</li><li>➤ providing stability</li><li>➤ support</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li><li>➤ Ref: Textbook of General Anatomy, 3 rd edition, Vishram Singh, pg. 123</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the typical fiber arrangement of lumbrical muscles in the hand?", "options": [{"label": "A", "text": "1 st &amp; 2 nd Lumbricals – Unipennate, 3 rd &amp; 4 th Lumbricals - Bipennate", "correct": true}, {"label": "B", "text": "1 st &amp; 2 nd Lumbricals – Biipennate, 3 rd &amp; 4 th Lumbricals - Unipennate", "correct": false}, {"label": "C", "text": "1 st &amp; 3 rd Lumbricals – Biipennate, 2 nd &amp; 4 th Lumbricals - Unipennate", "correct": false}, {"label": "D", "text": "2 nd &amp; 3 rd Lumbricals – Biipennate, 1 st &amp; 4 th Lumbricals - Unipennate", "correct": false}], "correct_answer": "A. 1 st & 2 nd Lumbricals – Unipennate, 3 rd & 4 th Lumbricals - Bipennate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture15_WI1aDpK.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture16_cefXEaI.jpg"], "explanation": "<p><strong>Ans. A) 1st&amp; 2ndLumbricals – Unipennate, 3rd&amp; 4thLumbricals - Bipennate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. 1 st &amp; 2 nd Lumbricals – Biipennate, 3 rd &amp; 4 th Lumbricals – Unipennate: It is just opposite of nature of lumbricals hence it is not the answer .</li><li>• Option B. 1 st &amp; 2 nd Lumbricals – Biipennate, 3 rd &amp; 4 th Lumbricals – Unipennate:</li><li>• not the answer</li><li>• Option C. 1 st &amp; 3 rd Lumbricals – Biipennate, 2 nd &amp; 4 th Lumbricals – Unipennate: It is also not matching according to direction of muscle fibres of lumbricals.</li><li>• Option C. 1 st &amp; 3 rd Lumbricals – Biipennate, 2 nd &amp; 4 th Lumbricals – Unipennate:</li><li>• also not matching</li><li>• Option D. It is indicating that 2 nd &amp; 3 rd Lumbricals – Biipennate, 1 st &amp; 4 th Lumbricals – Unipennate which is also incorrect .</li><li>• Option D. It is indicating that 2 nd &amp; 3 rd Lumbricals – Biipennate, 1 st &amp; 4 th Lumbricals –</li><li>• also incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ 1 st &amp; 2 nd Lumbrical muscles in the hand typically exhibit a \"Unipennate\" arrangement , while 3 rd &amp; 4 th Lumbrical muscles shows \"Bipennate\" arrangement . It is very important group of muscle because it is responsible for proper gripping by fingers &amp; hand .</li><li>➤ 1 st &amp; 2 nd Lumbrical muscles in the hand typically exhibit a \"Unipennate\" arrangement , while 3 rd &amp; 4 th Lumbrical muscles shows \"Bipennate\" arrangement .</li><li>➤ \"Unipennate\" arrangement</li><li>➤ \"Bipennate\" arrangement</li><li>➤ It is very important group of muscle because it is responsible for proper gripping by fingers &amp; hand .</li><li>➤ very important group of muscle</li><li>➤ responsible</li><li>➤ proper gripping</li><li>➤ fingers &amp; hand</li><li>➤ Ref: Textbook of Upper limb and Thorax, 3 rd edition, Vishram Singh, pg. 147</li><li>➤ Ref: Textbook of Upper limb and Thorax, 3 rd edition, Vishram Singh, pg. 147</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 36 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Which nerve is involved:", "options": [{"label": "A", "text": "Trigeminal Nerve", "correct": true}, {"label": "B", "text": "Facial Nerve", "correct": false}, {"label": "C", "text": "Transverse Cervical Nerve", "correct": false}, {"label": "D", "text": "Ventral Ramus of C2", "correct": false}], "correct_answer": "A. Trigeminal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-10.jpg"], "explanation": "<p><strong>Ans. A) Trigeminal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Facial nerve, or seventh cranial nerve (CN VII), primarily controls the muscles of facial expression . It also provides some sensory function for the external ear and has parasympathetic fibers . While the Facial nerve does affect the facial region, its primary role is motor control rather than sensation. The patient's symptoms are more aligned with sensory involvement, which is less indicative of Facial nerve pathology.</li><li>• Option B.</li><li>• seventh cranial nerve (CN VII),</li><li>• muscles of facial expression</li><li>• sensory function</li><li>• external ear</li><li>• parasympathetic fibers</li><li>• primary role</li><li>• motor control</li><li>• Option C. The Transverse Cervical nerve arises from the cervical plexus , typically from the second and third cervical nerves . It provides sensation to the anterior neck . The distribution of the lesion in the patient does not align with the innervation territory of the Transverse Cervical nerve, which is focused on the neck area and not the face.</li><li>• Option C.</li><li>• arises</li><li>• cervical plexus</li><li>• second</li><li>• third cervical nerves</li><li>• sensation</li><li>• anterior neck</li><li>• Option D. The Ventral ramus of the second cervical nerve (C2) forms part of the cervical plexus and contributes to the innervation of the neck . Similar to the Transverse Cervical nerve, the Ventral ramus of C2 is involved in innervating the neck area, not the facial regions described in the patient's symptoms.</li><li>• Option D.</li><li>• second cervical nerve (C2)</li><li>• cervical plexus</li><li>• contributes</li><li>• innervation of the neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches. The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches . The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches.</li><li>➤ The Trigeminal nerve, also known as the fifth cranial nerve (CN V), is primarily responsible for sensation in the face . It has three branches : the ophthalmic (V1), maxillary (V2), and mandibular (V3) branches.</li><li>➤ fifth cranial nerve (CN V),</li><li>➤ sensation in the face</li><li>➤ three branches</li><li>➤ ophthalmic (V1),</li><li>➤ maxillary (V2),</li><li>➤ mandibular (V3)</li><li>➤ The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches .</li><li>➤ The description of the lesions on the forehead , nose , and extending bilaterally to the cheeks correlates with the areas innervated by the Trigeminal nerve, specifically the ophthalmic and maxillary branches .</li><li>➤ description</li><li>➤ forehead</li><li>➤ nose</li><li>➤ extending bilaterally</li><li>➤ cheeks</li><li>➤ ophthalmic</li><li>➤ maxillary branches</li><li>➤ The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ The sensory involvement further supports this, as the Trigeminal nerve is a key sensory nerve for the face.</li><li>➤ sensory involvement</li><li>➤ sensory nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 63</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 63</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old male was brought unconscious to the ER following a motor vehicle accident. A linear skull fracture was seen on the lateral aspect of his skull along the junction of frontal, parietal, temporal and sphenoid bones in the X-ray. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "The fracture line involved Pterion", "correct": false}, {"label": "B", "text": "Middle Meningeal artery is related to Pterion", "correct": false}, {"label": "C", "text": "The Parietal emissary veins pass through the Parietal foramen and communicates with Sigmoid Sinus", "correct": true}, {"label": "D", "text": "Posteroinferior angle of the Parietal bone is called Asterion", "correct": false}], "correct_answer": "C. The Parietal emissary veins pass through the Parietal foramen and communicates with Sigmoid Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture26.jpg"], "explanation": "<p><strong>Ans. C) The parietal emissary veins pass through the parietal foramen and communicates with sigmoid sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The pterion is a region where the frontal , parietal , temporal , and sphenoid bones join . A fracture at the junction of these bones would involve the pterion .</li><li>• Option A</li><li>• pterion</li><li>• region</li><li>• frontal</li><li>• parietal</li><li>• temporal</li><li>• sphenoid</li><li>• bones</li><li>• join</li><li>• fracture</li><li>• junction</li><li>• involve</li><li>• the</li><li>• pterion</li><li>• Option B . The middle meningeal artery is closely related to the pterion . A fracture in this area can lead to the rupture of the middle meningeal artery and subsequent epidural hematoma , which is a serious complication.</li><li>• Option B</li><li>• middle</li><li>• meningeal</li><li>• artery</li><li>• related</li><li>• pterion</li><li>• fracture</li><li>• middle meningeal artery</li><li>• subsequent</li><li>• epidural</li><li>• hematoma</li><li>• Option D . The asterion is the point on the skull where the parietal , temporal , and occipital bones meet . It is located at the posteroinferior angle of the parietal bone .</li><li>• Option D</li><li>• asterion</li><li>• point</li><li>• on</li><li>• the</li><li>• skull</li><li>• parietal</li><li>• temporal</li><li>• occipital</li><li>• bones</li><li>• meet</li><li>• posteroinferior</li><li>• angle</li><li>• parietal</li><li>• bone</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The parietal emissary veins actually pass through the parietal foramina and communicate with the superior sagittal sinus , not the sigmoid sinus.</li><li>➤ parietal</li><li>➤ emissary</li><li>➤ veins</li><li>➤ pass</li><li>➤ through</li><li>➤ parietal</li><li>➤ foramina</li><li>➤ communicate</li><li>➤ superior</li><li>➤ sagittal</li><li>➤ sinus</li><li>➤ Ref : Gray’s Anatomy 41st Edition Pg No 423</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41st Edition Pg No 423</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 36-year-old auto driver was attacked by a mob over a family quarrel and received a stab wound at the front of the neck. He was rushed to the emergency department. The knife entrance wound was located on the right side of the neck just lateral to the tip of the greater cornu of the hyoid bone. During the physical examination the patient was asked to protrude his tongue, which deviated to the right. Which of the following statements would is incorrect regarding the physical signs in this patient?", "options": [{"label": "A", "text": "Paralysis of the right genioglossus muscle permitted the left genioglossus to pull the tongue forward and turned the tip to the right side", "correct": false}, {"label": "B", "text": "Genioglossus originates from the lower genial tubercles of the mandible", "correct": true}, {"label": "C", "text": "The hypoglossal nerve descends in the neck between the internal carotid artery and the internal jugular vein", "correct": false}, {"label": "D", "text": "At about the level of the tip of the greater cornu of the hyoid bone the hypoglossal nerve turns forward and crosses the internal and external carotid arteries and the lingual artery to enter the tongue", "correct": false}], "correct_answer": "B. Genioglossus originates from the lower genial tubercles of the mandible", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture1_pScJvi9.jpg"], "explanation": "<p><strong>Ans. B) Genioglossus originates from the lower genial tubercles of the mandible</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The genioglossus muscle is responsible for protruding the tongue . If the right genioglossus is paralyzed (due to injury to the right hypoglossal nerve), the left genioglossus would pull the tongue towards the left , causing the tip to deviate to the right side .</li><li>• Option A.</li><li>• protruding</li><li>• tongue</li><li>• right genioglossus</li><li>• paralyzed</li><li>• left genioglossus</li><li>• pull the tongue</li><li>• left</li><li>• tip to deviate</li><li>• right side</li><li>• Option C. The hypoglossal nerve (CN XII) does indeed pass between the internal carotid artery and the internal jugular vein in its course in the neck.</li><li>• Option C.</li><li>• pass between</li><li>• internal carotid artery</li><li>• internal jugular vein</li><li>• Option D. The hypoglossal nerve turns anteriorly around the level of the greater cornu of the hyoid bone and crosses various structures, including the carotid arteries and the lingual artery , to enter the tongue .</li><li>• Option D.</li><li>• anteriorly around</li><li>• level</li><li>• greater cornu</li><li>• hyoid bone</li><li>• carotid arteries</li><li>• lingual artery</li><li>• enter the tongue</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The genioglossus muscle actually originates from the superior genial tubercles of the mandible , not the lower. This error makes option B the incorrect statement.</li><li>➤ superior genial tubercles</li><li>➤ mandible</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 511</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 511</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old girl who had joined as a first-year student in a visual communication course was recently not happy with the pimples that developed over cheeks. She visited her dermatologist who noticed the severe acne on the face of that girl even before she complained. On examination, it was found that a small abscess was present just above her upper lip below the nose on the right side of her face. Her dermatologist gave her antibiotics and strictly warned her not to press the abscess. Which of the following facts concerning this patient is not correct?", "options": [{"label": "A", "text": "The skin area between the upper lip, and the side of the nose is called dangerous zone of face", "correct": false}, {"label": "B", "text": "Interference with a boil by squeezing or pricking it can lead to spread of the infection and thrombosis of the facial vein", "correct": false}, {"label": "C", "text": "The facial vein communicates with the cavernous sinus via the superior and inferior ophthalmic veins", "correct": false}, {"label": "D", "text": "Facial vein lies immediately in front of and has a tortuous course similar to facial artery", "correct": true}], "correct_answer": "D. Facial vein lies immediately in front of and has a tortuous course similar to facial artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture6_hd6MaIp.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture7_nx5LgSX.jpg"], "explanation": "<p><strong>Ans. D) Facial vein lies immediately in front of and has a tortuous course similar to facial artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The area described is often referred to as the \"dangerous area of the face\" due to its venous drainage pattern . Infections in this area can potentially spread to the cranial cavity because of the venous connections .</li><li>• Option A.</li><li>• \"dangerous area of the face\"</li><li>• venous drainage pattern</li><li>• Infections</li><li>• potentially spread</li><li>• cranial cavity</li><li>• venous connections</li><li>• Option B. Manipulating a boil or abscess in the facial area , particularly in the dangerous zone , can cause the infection to spread, leading to complications like thrombosis of the facial vein .</li><li>• Option B. Manipulating</li><li>• boil</li><li>• abscess</li><li>• facial area</li><li>• dangerous zone</li><li>• infection</li><li>• complications</li><li>• thrombosis</li><li>• facial vein</li><li>• Option C. The facial vein has connections with the cavernous sinus through the ophthalmic veins . This anatomical feature is significant because it provides a pathway for infection to spread from the face to the intracranial structures .</li><li>• Option C.</li><li>• connections</li><li>• cavernous sinus</li><li>• ophthalmic veins</li><li>• anatomical feature</li><li>• provides a pathway</li><li>• infection</li><li>• spread</li><li>• face</li><li>• intracranial structures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Although the facial vein is closely associated with the facial artery , it does not have a tortuous course like the facial artery. The facial artery is known for its tortuosity , which allows it to accommodate facial movements without kinking . In contrast, the facial vein has a relatively straighter course .</li><li>➤ Although the facial vein is closely associated with the facial artery , it does not have a tortuous course like the facial artery.</li><li>➤ Although the facial vein is closely associated with the facial artery , it does not have a tortuous course like the facial artery.</li><li>➤ associated</li><li>➤ facial artery</li><li>➤ does not</li><li>➤ tortuous course</li><li>➤ The facial artery is known for its tortuosity , which allows it to accommodate facial movements without kinking . In contrast, the facial vein has a relatively straighter course .</li><li>➤ The facial artery is known for its tortuosity , which allows it to accommodate facial movements without kinking . In contrast, the facial vein has a relatively straighter course .</li><li>➤ tortuosity</li><li>➤ accommodate facial movements</li><li>➤ kinking</li><li>➤ straighter course</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 500</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 500</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man was found on ophthalmoscopic examination to have edema of both optic discs (bilateral papilledema) and congestion of both retinal veins. The cause of the condition was found to be a rapidly expanding intracranial tumor. Which of the following statements is not correct?", "options": [{"label": "A", "text": "The Optic Nerves are surrounded by Sheaths derived from the Pia Mater, Arachnoid Mater, and Dura Mater", "correct": false}, {"label": "B", "text": "The Intracranial Subarachnoid space extends forward around the Optic Nerve as far as the back of the Eyeball.", "correct": false}, {"label": "C", "text": "The Ciliary Ganglion is situated between the proximal part of Medial Rectus and Optic Nerve", "correct": true}, {"label": "D", "text": "The Nerve to Medial Rectus is seen Inferior to the Optic Nerve", "correct": false}], "correct_answer": "C. The Ciliary Ganglion is situated between the proximal part of Medial Rectus and Optic Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The Ciliary Ganglion is situated between the proximal part of Medial Rectus and Optic Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The optic nerve is indeed surrounded by extensions of the three meningeal layers (pia, arachnoid, and dura), which provide it with a protective sheath .</li><li>• Option A</li><li>• optic nerve</li><li>• extensions</li><li>• three meningeal layers</li><li>• (pia, arachnoid,</li><li>• dura),</li><li>• protective sheath</li><li>• Option B. The subarachnoid space extends along the optic nerve up to the back of the eye. This anatomical feature is significant in the context of papilledema , where increased intracranial pressure can lead to optic disc swelling observable in an ophthalmoscopic examination .</li><li>• Option B.</li><li>• subarachnoid space</li><li>• extends</li><li>• optic nerve</li><li>• back of the eye.</li><li>• papilledema</li><li>• increased intracranial pressure</li><li>• optic disc swelling</li><li>• ophthalmoscopic</li><li>• examination</li><li>• Option D. The nerve to the medial rectus , a branch of the oculomotor nerve (CN III), is indeed located inferior to the optic nerve as it enters the orbit through the superior orbital fissure .</li><li>• Option D.</li><li>• medial rectus</li><li>• branch</li><li>• oculomotor nerve (CN III),</li><li>• inferior</li><li>• optic nerve</li><li>• enters the orbit</li><li>• superior orbital fissure</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ciliary ganglion is actually located in the posterior orbit in the lateral part of the optic nerve, not between the optic nerve and the medial rectus muscle . The ganglion is involved in the parasympathetic innervation of the eye , particularly controlling the pupillary sphincter and ciliary muscles .</li><li>➤ The ciliary ganglion is actually located in the posterior orbit in the lateral part of the optic nerve, not between the optic nerve and the medial rectus muscle .</li><li>➤ posterior orbit</li><li>➤ lateral</li><li>➤ optic nerve,</li><li>➤ not between</li><li>➤ optic nerve</li><li>➤ medial rectus muscle</li><li>➤ The ganglion is involved in the parasympathetic innervation of the eye , particularly controlling the pupillary sphincter and ciliary muscles .</li><li>➤ ganglion is involved</li><li>➤ parasympathetic innervation</li><li>➤ eye</li><li>➤ controlling</li><li>➤ pupillary sphincter</li><li>➤ ciliary muscles</li><li>➤ Ref : Gray’s Anatomy 41 st edition pg no666</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition pg no666</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old boy developed small painless swelling below and behind the angle of the jaw on the right side. His mother noticed this and took him to a paediatrician. On examination, the swelling was superficial, cool to touch, and showed no redness. Careful palpation of the neck revealed two firm lumps matted together beneath the anterior border of the right sternocleidomastoid muscle. Examination of the palatine tonsils showed moderate hypertrophy on both sides with a few pustules exuding from the tonsillar crypts on the right side. Which of the following statement is incorrect?", "options": [{"label": "A", "text": "Tuberculous infection results in the destruction of the node with the formation of pus that later erodes through the deep Fascia, producing a large cold Abscess beneath the Skin.", "correct": false}, {"label": "B", "text": "The Lymph drains from the Tonsil into the Jugulodigastric member of the Deep Cervical Lymph Nodes", "correct": false}, {"label": "C", "text": "Jugulo Digastric nodes are situated below the Anterior Belly of Digastric along and around the Internal Jugular Vein", "correct": true}, {"label": "D", "text": "Jugulodigastric nodes also receive afferent Lymphatics from Posterior third of Tongue", "correct": false}], "correct_answer": "C. Jugulo Digastric nodes are situated below the Anterior Belly of Digastric along and around the Internal Jugular Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture16.jpg"], "explanation": "<p><strong>Ans. C) Jugulo Digastric Nodes are situated below the Anterior Belly of Digastric along and around the internal Jugular Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tuberculous lymphadenitis can lead to caseation necrosis within the lymph node , resulting in the formation of a cold abscess. This type of abscess is typically not associated with signs of acute inflammation like warmth and redness , aligning with the description of the swelling as \"cool to touch , and showed no redness.\"</li><li>• Option A.</li><li>• lead to caseation necrosis</li><li>• lymph node</li><li>• formation</li><li>• cold abscess.</li><li>• not associated</li><li>• acute inflammation</li><li>• warmth</li><li>• redness</li><li>• aligning</li><li>• description</li><li>• swelling</li><li>• \"cool to touch</li><li>• showed no redness.\"</li><li>• Option B. The jugulodigastric node, also known as the tonsillar node , is a part of the deep cervical lymph nodes and commonly receives lymphatic drainage from the palatine tonsils .</li><li>• Option B.</li><li>• tonsillar node</li><li>• deep cervical lymph nodes</li><li>• lymphatic drainage</li><li>• palatine tonsils</li><li>• Option D. The jugulodigastric nodes indeed receive lymphatic drainage from various areas, including the posterior third of the tongue , which is significant in the context of infections or tumors in these regions .</li><li>• Option D.</li><li>• receive lymphatic drainage</li><li>• posterior third</li><li>• tongue</li><li>• infections</li><li>• tumors in these regions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The jugulodigastric nodes are actually situated below the posterior belly of the digastric muscle , not the anterior belly . They are located around the internal jugular vein , but their anatomical relation to the digastric muscle in the statement is misstated.</li><li>➤ The jugulodigastric nodes are actually situated below the posterior belly of the digastric muscle , not the anterior belly .</li><li>➤ situated below</li><li>➤ posterior belly</li><li>➤ digastric muscle</li><li>➤ anterior belly</li><li>➤ They are located around the internal jugular vein , but their anatomical relation to the digastric muscle in the statement is misstated.</li><li>➤ around</li><li>➤ internal jugular vein</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 462</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 462</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man was seen in the emergency department after being knocked down on the head with a heavy rod, in a street brawl. On examination, the patient was conscious and had a large dough like swelling over the back of the head that was restricted to the area over the occipital bone. The skin was intact, and the swelling fluctuate on palpation. Which of the following statement is incorrect?", "options": [{"label": "A", "text": "The hematoma was located in the Subcutaneous portion of the Occipital Bone.", "correct": true}, {"label": "B", "text": "The hematoma, although large, did not extend forward to the Orbital margins", "correct": false}, {"label": "C", "text": "The Occipital belly of Occipitofrontalis arise from lateral part of Superior Nuchal line and insert into Galea Aponeurotica", "correct": false}, {"label": "D", "text": "The Occipitalis muscle is supplied by Facial Nerve", "correct": false}], "correct_answer": "A. The hematoma was located in the Subcutaneous portion of the Occipital Bone.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture18.jpg"], "explanation": "<p><strong>Ans. A) The hematoma was located in the subcutaneous portion of the occipital bone.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. A hematoma on the back of the head (over the occipital bone ) typically would not extend forward all the way to the orbital margins due to the attachment of the galea aponeurotica and the way s ubcutaneous tissues are structured in the scalp.</li><li>• Option B.</li><li>• hematoma</li><li>• back of the head</li><li>• occipital bone</li><li>• not</li><li>• extend forward</li><li>• orbital margins</li><li>• attachment</li><li>• galea aponeurotica</li><li>• ubcutaneous tissues</li><li>• Option C. The occipital belly of the occipitofrontalis muscle does indeed originate from the lateral part of the superior nuchal line of the occipital bone and inserts into the galea aponeurotica .</li><li>• Option C.</li><li>• originate</li><li>• lateral part</li><li>• superior nuchal line</li><li>• occipital bone</li><li>• inserts</li><li>• galea aponeurotica</li><li>• Option D. The occipitalis muscle, which is part of the occipitofrontalis muscle , is innervated by the facial nerve (CN VII).</li><li>• Option D.</li><li>• part</li><li>• occipitofrontalis muscle</li><li>• facial nerve (CN VII).</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A \" doughlike swelling \" that fluctuates on palpation , resulting from trauma , is suggestive of a subcutaneous hematoma . However, specifying that it is located \"in the subcutaneous portion of the occipital bone\" is anatomically confusing. The subcutaneous tissue is the layer of tissue directly under the skin , not part of the bone. Hematomas in this context are usually in the subcutaneous tissue overlying the occipital bone , not within the bone itself.</li><li>➤ A \" doughlike swelling \" that fluctuates on palpation , resulting from trauma , is suggestive of a subcutaneous hematoma . However, specifying that it is located \"in the subcutaneous portion of the occipital bone\" is anatomically confusing.</li><li>➤ doughlike swelling</li><li>➤ fluctuates on palpation</li><li>➤ trauma</li><li>➤ subcutaneous hematoma</li><li>➤ The subcutaneous tissue is the layer of tissue directly under the skin , not part of the bone. Hematomas in this context are usually in the subcutaneous tissue overlying the occipital bone , not within the bone itself.</li><li>➤ subcutaneous tissue</li><li>➤ layer of tissue</li><li>➤ under the skin</li><li>➤ overlying the occipital bone</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 476</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 476</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female had complaints of nasal stuffiness, pain over her upper jaw. On examination there was tenderness over the right and left cheek bones. The below is the CT of the patient. All the following open into the probed space except?", "options": [{"label": "A", "text": "Maxillary Sinus", "correct": false}, {"label": "B", "text": "Sphenoidal Sinus", "correct": true}, {"label": "C", "text": "Frontal Sinus", "correct": false}, {"label": "D", "text": "Ethmoidal Sinus (middle)", "correct": false}], "correct_answer": "B. Sphenoidal Sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/07/9.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture72.jpg"], "explanation": "<p><strong>Ans. B) Sphenoidal sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The maxillary sinus drains into the nasal cavity via the maxillary ostium , which opens into the semilunar hiatus located in the middle meatus of the nasal cavity .</li><li>• Option A.</li><li>• drains</li><li>• nasal cavity</li><li>• maxillary ostium</li><li>• opens</li><li>• semilunar hiatus</li><li>• middle meatus</li><li>• nasal cavity</li><li>• Option C. Frontal Sinus: The frontal sinus drains into the nasal cavity through the frontonasal duct, which opens into the middle meatus, typically in the region of the infundibulum.</li><li>• Option C. Frontal Sinus:</li><li>• Option D. Ethmoidal Sinus: The middle ethmoidal sinuses (or middle ethmoidal air cells) drain into the middle meatus of the nasal cavity, specifically into the ethmoid bulla. Top of Form</li><li>• Option D. Ethmoidal Sinus:</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Sphenoidal Sinus: The sphenoidal sinus opens into the sphenoethmoidal recess, which is located above the superior concha, not the middle meatus.</li><li>• Sphenoidal Sinus: The sphenoidal sinus opens into the sphenoethmoidal recess, which is located above the superior concha, not the middle meatus.</li><li>• Sphenoidal Sinus:</li><li>• Ref : Gray’s Anatomy 41 st Edition Pg No 565</li><li>• Ref :</li><li>• Gray’s Anatomy 41 st Edition Pg No 565</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Secretomotor Fibres for Sublingual Salivary Gland comes from:", "options": [{"label": "A", "text": "Nucleus Tractus Solitarius", "correct": false}, {"label": "B", "text": "Superior Salivatory Nucleus", "correct": true}, {"label": "C", "text": "Inferior Salivatory Nucleus", "correct": false}, {"label": "D", "text": "Nucleus Ambiguous", "correct": false}], "correct_answer": "B. Superior Salivatory Nucleus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132502.jpg"], "explanation": "<p><strong>Ans. B) Superior Salivatory Nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Nucleus Tractus Solitarius ( Medulla ) – receives taste sensations carried by VII, IX and Xth nerve .</li><li>• Option A:</li><li>• Medulla</li><li>• receives taste sensations</li><li>• VII, IX</li><li>• Xth nerve</li><li>• Option C: Inferior Salivatory Nucleus ( Medulla ) provides preganglionic parasympathetic secretomotor fibres that pass through Glossopharyngeal to supply parotid salivary gland .</li><li>• Option C:</li><li>• Medulla</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• Glossopharyngeal</li><li>• supply parotid salivary gland</li><li>• Option D: Nucleus ambiguus provides the special visceral efferent fibres that pass via IX, X and XI cranial nerves to supply the muscles derived from 3 rd , 4 th and 6 th pharyngeal arches .</li><li>• Option D:</li><li>• special visceral efferent fibres</li><li>• IX, X</li><li>• XI cranial nerves</li><li>• supply</li><li>• muscles</li><li>• 3 rd</li><li>• 4 th</li><li>• 6 th pharyngeal arches</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superior salivatory nucleus ( Pons ) provides preganglionic parasympathetic secretomotor fibres that pass through facial nerve to supply submandibular and sublingual salivary gland .</li><li>➤ Superior salivatory nucleus</li><li>➤ Pons</li><li>➤ preganglionic parasympathetic secretomotor fibres</li><li>➤ facial nerve</li><li>➤ submandibular</li><li>➤ sublingual salivary gland</li><li>➤ These preganglionic parasympathetic fibers leave the brainstem with the facial nerve ( cranial nerve VII ). They then branch off via the chorda tympani nerve in the middle ear . The chorda tympani nerve joins the lingual nerve (a branch of the mandibular division of the trigeminal nerve , cranial nerve V3 ) in the infratemporal fossa . The fibers synapse in the submandibular ganglion , which is located near the submandibular gland . Postganglionic fibers from the submandibular ganglion then innervate both the submandibular and sublingual salivary glands , stimulating saliva secretion .</li><li>➤ These preganglionic parasympathetic fibers leave the brainstem with the facial nerve ( cranial nerve VII ).</li><li>➤ leave</li><li>➤ brainstem</li><li>➤ facial nerve</li><li>➤ cranial nerve VII</li><li>➤ They then branch off via the chorda tympani nerve in the middle ear .</li><li>➤ branch off</li><li>➤ chorda tympani</li><li>➤ nerve</li><li>➤ middle ear</li><li>➤ The chorda tympani nerve joins the lingual nerve (a branch of the mandibular division of the trigeminal nerve , cranial nerve V3 ) in the infratemporal fossa .</li><li>➤ chorda tympani nerve</li><li>➤ lingual nerve</li><li>➤ mandibular division</li><li>➤ trigeminal nerve</li><li>➤ cranial nerve V3</li><li>➤ infratemporal fossa</li><li>➤ The fibers synapse in the submandibular ganglion , which is located near the submandibular gland .</li><li>➤ submandibular ganglion</li><li>➤ submandibular gland</li><li>➤ Postganglionic fibers from the submandibular ganglion then innervate both the submandibular and sublingual salivary glands , stimulating saliva secretion .</li><li>➤ Postganglionic fibers</li><li>➤ submandibular ganglion</li><li>➤ both</li><li>➤ submandibular</li><li>➤ sublingual salivary glands</li><li>➤ saliva secretion</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 124</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 124</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-month-old boy accidentally swallowed a small magnet of his toy car. He began to suffocate and was rushed to the hospital, where an x-ray examination showed the impaction of a foreign body in the larynx. Which of the following statements is NOT true?", "options": [{"label": "A", "text": "Rima Glottis is the narrowest part of Larynx", "correct": false}, {"label": "B", "text": "Lateral Cricoarytenoid is the safety Muscle of Larynx", "correct": true}, {"label": "C", "text": "Vocal folds are pearly white in colour", "correct": false}, {"label": "D", "text": "Each Vocal fold contains vocal Ligament and Vocalis Muscle", "correct": false}], "correct_answer": "B. Lateral Cricoarytenoid is the safety Muscle of Larynx", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture8_Kfhx6Lg.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture9_cIMZgAs.jpg"], "explanation": "<p><strong>Ans. B) Lateral Cricoarytenoid is the safety muscle of Larynx</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The rima glottidis, the opening between the vocal folds , is indeed the narrowest part of the larynx in children . This is particularly relevant in cases of foreign body aspiration , as objects often become lodged at this narrowest point .</li><li>• Option A.</li><li>• opening between</li><li>• vocal folds</li><li>• narrowest part</li><li>• larynx</li><li>• children</li><li>• relevant</li><li>• foreign body aspiration</li><li>• objects</li><li>• lodged</li><li>• narrowest point</li><li>• Option C. In a healthy individual , the vocal folds are typically a pearly white color , owing to the lack of blood vessels in the vocal ligament and the overlying mucosa .</li><li>• Option C.</li><li>• healthy individual</li><li>• pearly white color</li><li>• lack of blood vessels</li><li>• vocal ligament</li><li>• overlying mucosa</li><li>• Option D. Each vocal fold comprises the vocal ligament and the vocalis muscle , which is part of the thyroarytenoid muscle . These structures are essential for the production of sound .</li><li>• Option D.</li><li>• vocal fold</li><li>• vocal ligament</li><li>• vocalis muscle</li><li>• thyroarytenoid muscle</li><li>• production of sound</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The safety muscle of the larynx is the Posterior Crico-Arytenoid Muscle , not the lateral Cricoarytenoid muscle.</li><li>➤ The safety muscle of the larynx is the Posterior Crico-Arytenoid Muscle , not the lateral Cricoarytenoid muscle.</li><li>➤ safety muscle</li><li>➤ larynx</li><li>➤ Posterior Crico-Arytenoid Muscle</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg no:591</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg no:591</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 77-year-old male visited the surgery OPD after she noticed a hard painless lump in the left side of her neck. On examination the lump was found to be an enlarged lymph node in the posterior triangle of neck. An open excision biopsy was done. Three days following the procedure the patient had difficulty in raising her arm over forehead as in combing. The surgeon confirmed loss of hyperabduction in the left side. Which of the following is not true?", "options": [{"label": "A", "text": "The excision biopsy has injured the Spinal Accessory Nerve", "correct": false}, {"label": "B", "text": "Posterior boundary of Posterior Triangle is formed by Anterior margin of Trapezius", "correct": false}, {"label": "C", "text": "The trunks of Brachial Plexus are found between Scalenus Medius&amp; Posterior", "correct": true}, {"label": "D", "text": "The Spinal Accessory nerve lies in the roof of Posterior triangle", "correct": false}], "correct_answer": "C. The trunks of Brachial Plexus are found between Scalenus Medius& Posterior", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-16-184835.jpg"], "explanation": "<p><strong>Ans. C) The trunks of brachial plexus are found between scalenus medius &amp; posterior</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The difficulty in raising the arm and the loss of hyperabduction are symptoms consistent with injury to the spinal accessory nerve , which innervates the trapezius muscle . The trapezius is responsible for elevating the shoulder and extending the head , and its dysfunction would lead to such symptoms.</li><li>• Option A</li><li>• difficulty</li><li>• raising the arm</li><li>• loss of hyperabduction</li><li>• injury</li><li>• spinal accessory nerve</li><li>• innervates</li><li>• trapezius muscle</li><li>• trapezius</li><li>• elevating the shoulder</li><li>• extending the head</li><li>• Option B. The posterior triangle of the neck is bounded posteriorly by the anterior margin of the trapezius muscle .</li><li>• Option B.</li><li>• posterior triangle</li><li>• neck</li><li>• bounded posteriorly</li><li>• anterior margin</li><li>• trapezius muscle</li><li>• Option D. The spinal accessory nerve traverses the posterior triangle of the neck , running superficially and is therefore considered to be in the 'roof' of this anatomical region. It makes it susceptible to injury during procedures in this area.</li><li>• Option D.</li><li>• spinal accessory</li><li>• traverses</li><li>• posterior triangle</li><li>• neck</li><li>• superficially</li><li>• 'roof'</li><li>• susceptible</li><li>• injury</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The trunks of the brachial plexus are actually located between the anterior and middle scalene muscles , not between the middle and posterior scalenes.</li><li>• The trunks of the brachial plexus are actually located between the anterior and middle scalene muscles , not between the middle and posterior scalenes.</li><li>• located</li><li>• anterior</li><li>• middle</li><li>• scalene muscles</li><li>• Posterior triangle– boundaries</li><li>• Posterior triangle– boundaries</li><li>• Re f: Gray’s Anatomy 41 st Edition Pg No 444</li><li>• Re</li><li>• f: Gray’s Anatomy 41 st Edition Pg No 444</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old man presented with a complaint of rapidly growing painful swelling on the face below the right ear lobule. On examination the left ear lobule was found to be lifted by the swelling. There was inability to close the right eye, blow the cheek and angle of mouth deviated to left side. Which of the following statements is not true pertaining to the above case?", "options": [{"label": "A", "text": "The structure swollen is the Parotid Gland", "correct": false}, {"label": "B", "text": "Parotid swelling are usually less painful", "correct": true}, {"label": "C", "text": "The Facial Nerve divides into five branches within Parotid Gland", "correct": false}, {"label": "D", "text": "Inability to close eye is due to paralysis of Orbicularis Oculi that is innervated by Facial Nerve", "correct": false}], "correct_answer": "B. Parotid swelling are usually less painful", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture20.jpg"], "explanation": "<p><strong>Ans. B) Parotid swelling are usually less painful</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The location of the swelling below the ear lobule and the associated facial nerve symptoms ( inability to close the eye, deviation of the mouth ) suggest that the swelling involves the parotid gland, which is also where the facial nerve (CN VII) is located.</li><li>• Option A.</li><li>• location</li><li>• swelling below the ear</li><li>• lobule</li><li>• associated facial nerve</li><li>• inability to close the eye, deviation of the mouth</li><li>• facial nerve (CN VII)</li><li>• Option C. The facial nerve divides into five main branches within the parotid gland : temporal, zygomatic, buccal, marginal mandibular , and cervical .</li><li>• Option C.</li><li>• five main branches</li><li>• parotid gland</li><li>• temporal, zygomatic, buccal, marginal mandibular</li><li>• cervical</li><li>• Option D. The inability to close the eye ( lagophthalmos ) in this patient is due to paralysis of the orbicularis oculi muscle , which is innervated by the facial nerve . Damage to the facial nerve can lead to paralysis of the muscles it innervates , including the orbicularis oculi .</li><li>• Option D.</li><li>• lagophthalmos</li><li>• paralysis</li><li>• orbicularis oculi muscle</li><li>• innervated</li><li>• facial nerve</li><li>• Damage</li><li>• facial nerve</li><li>• paralysis</li><li>• muscles</li><li>• innervates</li><li>• orbicularis oculi</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Parotid gland swellings are often less painful when they are due to chronic conditions like benign tumors or Sjogren's syndrome . However, acute infections or malignant growths in the parotid gland can be painful .</li><li>➤ Parotid gland swellings are often less painful when they are due to chronic conditions like benign tumors or Sjogren's syndrome . However, acute infections or malignant growths in the parotid gland can be painful .</li><li>➤ Parotid gland swellings are often less painful when they are due to chronic conditions like benign tumors or Sjogren's syndrome . However, acute infections or malignant growths in the parotid gland can be painful .</li><li>➤ chronic conditions</li><li>➤ benign tumors</li><li>➤ Sjogren's syndrome</li><li>➤ acute infections</li><li>➤ malignant growths</li><li>➤ parotid gland</li><li>➤ painful</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 504</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 504</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 19-year-old girl returned home after college. She sat down to sip down the coffee prepared by her mother. As soon as she sipped her first mouth, she felt a burning sensation over the tip of the dorsum of the tongue. Which one is true about the nerve responsible for this burning sensation experienced by this girl?", "options": [{"label": "A", "text": "It is a branch of Mandibular Nerve", "correct": false}, {"label": "B", "text": "It is responsible for Saliva secretion from Parotid Gland", "correct": false}, {"label": "C", "text": "It receives taste sensation from all the 3 Papillae present in Tongue", "correct": false}, {"label": "D", "text": "It courses through the Tympanic Membrane", "correct": true}], "correct_answer": "D. It courses through the Tympanic Membrane", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It courses through the Tympanic Membrane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The sensation on the tip of the tongue , particularly taste sensation , is not mediated by a branch of the mandibular nerve (V3) . The mandibular nerve primarily provides general sensation to the anterior two-thirds of the tongue but not taste sensation.</li><li>• Option A</li><li>• sensation</li><li>• tip</li><li>• tongue</li><li>• taste sensation</li><li>• not</li><li>• mediated</li><li>• mandibular nerve (V3)</li><li>• provides</li><li>• sensation</li><li>• anterior two-thirds</li><li>• tongue</li><li>• not taste sensation.</li><li>• Option B. The nerve responsible for taste sensation at the tip of the tongue is not involved in saliva secretion from the parotid gland . Saliva secretion from the parotid gland is primarily controlled by the glossopharyngeal nerve (CN IX).</li><li>• Option B.</li><li>• nerve responsible</li><li>• taste sensation</li><li>• not involved</li><li>• saliva secretion</li><li>• parotid gland</li><li>• Saliva secretion</li><li>• glossopharyngeal nerve (CN IX).</li><li>• Option C. The nerve that provides taste sensation to the tip of the tongue (the chorda tympani, a branch of the facial nerve) primarily innervates the fungiform papillae located at the tip and sides of the tongue. It does not receive taste sensation from all three types of papillae on the tongue.</li><li>• Option C.</li><li>• taste sensation</li><li>• tip of the tongue</li><li>• innervates</li><li>• fungiform papillae</li><li>• tip</li><li>• sides</li><li>• tongue.</li><li>• not receive taste sensation</li><li>• three types of papillae</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The nerve responsible for taste sensation at the tip of the tongue is the chorda tympani , a branch of the facial nerve (CN VII ).</li><li>➤ The nerve responsible for taste sensation at the tip of the tongue is the chorda tympani , a branch of the facial nerve (CN VII ).</li><li>➤ taste sensation</li><li>➤ tip of the tongue</li><li>➤ chorda tympani</li><li>➤ facial nerve (CN VII</li><li>➤ While it does not course through the tympanic membrane , it does pass through the middle ear near the tympanic membrane. It arises from the facial nerve about 6mm above stylomastoid foramen and then passes through the tympanic membrane between it mucus and fibrous layers . Chorda tympani carries preganglionic secretomotor fibres for submandibular and sublingual salivary gland . Taste buds of circumvallate papillae innervated by glossopharyngeal nerve , taste buds of fungiform papillae alone innervated by chorda tympani nerve , filiform papillae has no taste buds .</li><li>➤ While it does not course through the tympanic membrane , it does pass through the middle ear near the tympanic membrane.</li><li>➤ not course through</li><li>➤ tympanic membrane</li><li>➤ pass through</li><li>➤ middle ear</li><li>➤ It arises from the facial nerve about 6mm above stylomastoid foramen and then passes through the tympanic membrane between it mucus and fibrous layers .</li><li>➤ arises</li><li>➤ facial nerve</li><li>➤ 6mm above</li><li>➤ stylomastoid foramen</li><li>➤ passes</li><li>➤ tympanic membrane</li><li>➤ mucus</li><li>➤ fibrous layers</li><li>➤ Chorda tympani carries preganglionic secretomotor fibres for submandibular and sublingual salivary gland .</li><li>➤ Chorda tympani</li><li>➤ preganglionic secretomotor</li><li>➤ submandibular</li><li>➤ sublingual salivary gland</li><li>➤ Taste buds of circumvallate papillae innervated by glossopharyngeal nerve , taste buds of fungiform papillae alone innervated by chorda tympani nerve , filiform papillae has no taste buds .</li><li>➤ Taste buds</li><li>➤ circumvallate papillae</li><li>➤ innervated</li><li>➤ glossopharyngeal nerve</li><li>➤ taste buds</li><li>➤ fungiform papillae</li><li>➤ innervated</li><li>➤ chorda tympani nerve</li><li>➤ filiform papillae</li><li>➤ no taste buds</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 502</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st Edition Pg No 502</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A four-year-old girl was brought to the pediatric OPD with complaints of fever, sore throat and runny nose for the past two weeks. Her mother reported that she also complained of pain in the left ear at night. On examination of the oral cavity the tonsils were found to be enlarged. Examination of her ears with the otoscope showed both eardrums were congested and looked reddish especially on the left. She was prescribed with decongestant medication and analgesics and requested to come for a review a week later. If this patient was left untreated all of the following possible complications will occur, except?", "options": [{"label": "A", "text": "Conductive hearing loss", "correct": false}, {"label": "B", "text": "Mastoiditis", "correct": false}, {"label": "C", "text": "Meningitis", "correct": false}, {"label": "D", "text": "Sialolithiasis", "correct": true}], "correct_answer": "D. Sialolithiasis", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sialolithiasis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Conductive Hearing loss. This can occur due to the e ffusion and congestion of the middle ear associated with otitis media, which can impede sound transmission.</li><li>• Option A. Conductive Hearing loss.</li><li>• ffusion and congestion of the middle ear</li><li>• Option B. Mastoiditis is a potential complication of untreated or inadequately treated acute otitis media . It occurs when the infection spreads to the mastoid bone located behind the ear . Mastoiditis can lead to severe pain , swelling, and potentially serious complications, including the spread of infection to nearby structures .</li><li>• Option B.</li><li>• complication</li><li>• untreated</li><li>• inadequately treated acute otitis media</li><li>• infection spreads</li><li>• mastoid bone</li><li>• behind the ear</li><li>• severe pain</li><li>• swelling,</li><li>• potentially serious complications,</li><li>• spread of infection</li><li>• nearby structures</li><li>• Option C. Meningitis is a rare but serious complication of untreated middle ear infections when the infection spreads from the ear to the lining of the brain and spinal cord . It can lead to life-threatening symptoms , including high fever, severe headache , neck stiffness , and altered mental status .</li><li>• Option C.</li><li>• rare</li><li>• serious complication</li><li>• untreated middle ear infections</li><li>• spreads</li><li>• ear</li><li>• lining of the brain</li><li>• spinal cord</li><li>• life-threatening symptoms</li><li>• high fever, severe headache</li><li>• neck stiffness</li><li>• altered mental status</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ When evaluating a case of otitis media and tonsillitis, it is important to recognize potential complications associated with the untreated condition, such as conductive hearing loss, mastoiditis, and, in severe cases, meningitis. Sialolithiasis , the formation of salivary stones, is not associated with these conditions.</li><li>➤ When evaluating a case of otitis media and tonsillitis, it is important to recognize potential complications associated with the untreated condition, such as conductive hearing loss, mastoiditis, and, in severe cases, meningitis.</li><li>➤ When evaluating a case of otitis media and tonsillitis, it is important to recognize potential complications associated with the untreated condition, such as conductive hearing loss, mastoiditis, and, in severe cases, meningitis.</li><li>➤ conductive hearing loss, mastoiditis, and, in severe cases, meningitis.</li><li>➤ Sialolithiasis , the formation of salivary stones, is not associated with these conditions.</li><li>➤ Sialolithiasis , the formation of salivary stones, is not associated with these conditions.</li><li>➤ Sialolithiasis</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 275</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 275</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy presented to ENT OPD with complaints of ear pain and throat pain for the past three days. On examination of the oral cavity showed enlargement of tonsils He had a history of similar episodes in the past which had all been treated successfully with antibiotics; however, the infections had become progressively more severe and he had missed a considerable amount of school attendance. This episode of tonsillitis also managed with antibiotics successfully, but tonsillectomy was suggested to eliminate the problem once and for all. The boy was readmitted to the hospital for surgery two weeks after his most recent infection had cleared up. Intraoperatively, suddenly there was a massive amount of bleeding. In a while the surgeon identified the bleeder and ligated it, following which the wound was closed and the patient's recovery was uneventful. Which of the following statements is true pertaining to the above case?", "options": [{"label": "A", "text": "The Earache was due to spread of the infection to inner Ear", "correct": false}, {"label": "B", "text": "Lymphatics from tonsil drain into Jugulo Omohyoid nodes", "correct": true}, {"label": "C", "text": "The Vagus Nerve has high chance of injury during Tonsillectomy", "correct": false}, {"label": "D", "text": "Internal Carotid artery is usually safe during Tonsillectomy", "correct": false}], "correct_answer": "B. Lymphatics from tonsil drain into Jugulo Omohyoid nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture11_oNwCXJw.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture12_GqN9QAR.jpg"], "explanation": "<p><strong>Ans. B) Lymphatics from tonsil drain into Jugulo Omohyoid nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Earache (otalgia) is a common symptom associated with tonsillitis and throat infections. However, it is usually not related to the spread of infection to the inner ear. Ear pain in tonsillitis is often referred pain , meaning that the pain in the ear is felt due to shared nerve pathways , but the infection typically does not reach the inner ear .</li><li>• Option A.</li><li>• symptom</li><li>• tonsillitis</li><li>• throat</li><li>• infections.</li><li>• Ear pain in tonsillitis</li><li>• referred pain</li><li>• shared nerve</li><li>• pathways</li><li>• infection</li><li>• does not</li><li>• inner ear</li><li>• Option C. Tonsillectomy is a surgical procedure that involves the removal of the tonsils , which are located in the throat. While the vagus nerve does pass through the neck and throat area , it is typically not at high risk of injury during routine tonsillectomy procedures. Surgeons performing tonsillectomy take care to avoid damaging important structures in the throat .</li><li>• Option C.</li><li>• surgical procedure</li><li>• removal of the tonsils</li><li>• vagus nerve</li><li>• pass</li><li>• neck and throat area</li><li>• not</li><li>• high risk of injury</li><li>• avoid damaging</li><li>• structures</li><li>• throat</li><li>• Option D. The palatine tonsil is supplied by five arterial branches : the ascending palatine and tonsillar branches of the facial artery , the palatine branch of the ascending pharyngeal artery, the dorsal lingual branch of the lingual artery , and the descending palatine branch of the maxillary artery.</li><li>• Option D.</li><li>• palatine tonsil</li><li>• five arterial branches</li><li>• ascending palatine</li><li>• tonsillar branches</li><li>• facial artery</li><li>• palatine branch</li><li>• ascending pharyngeal artery,</li><li>• dorsal lingual branch</li><li>• lingual artery</li><li>• descending palatine</li><li>• branch</li><li>• maxillary artery.</li><li>• The primary source of hemorrhage , however, is usually the external palatine vein (Para-Tonsillar Vein) . The internal carotid artery is usually safe during the procedure. (If compare ICA Vs ECA) - The Internal Carotid Artery lies 2.5cm behind and lateral to tonsillar Sinus (External carotid artery is not affected because it divides into its terminal branches opposite the neck of Mandible into the Superficial Temporal Artery &amp; Maxillary artery.</li><li>• The primary source of hemorrhage , however, is usually the external palatine vein (Para-Tonsillar Vein) . The internal carotid artery is usually safe during the procedure.</li><li>• hemorrhage</li><li>• external palatine vein (Para-Tonsillar Vein)</li><li>• internal carotid artery</li><li>• safe</li><li>• (If compare ICA Vs ECA) - The Internal Carotid Artery lies 2.5cm behind and lateral to tonsillar Sinus (External carotid artery is not affected because it divides into its terminal branches opposite the neck of Mandible into the Superficial Temporal Artery &amp; Maxillary artery.</li><li>• (If compare ICA Vs ECA) - The Internal Carotid Artery lies 2.5cm behind and lateral to tonsillar Sinus (External carotid artery is not affected because it divides into its terminal branches opposite the neck of Mandible into the Superficial Temporal Artery &amp; Maxillary artery.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The palatine tonsils drain into the jugulodigastric lymph nodes, important for understanding the spread of infection and lymph node involvement in tonsillitis. Recurrent tonsillitis that affects daily activities such as school attendance might be managed surgically through tonsillectomy, which while generally safe, carries risks such as significant bleeding typically from the tonsillar branch of the facial artery, not the internal carotid artery</li><li>➤ The palatine tonsils drain into the jugulodigastric lymph nodes, important for understanding the spread of infection and lymph node involvement in tonsillitis.</li><li>➤ Recurrent tonsillitis that affects daily activities such as school attendance might be managed surgically through tonsillectomy, which while generally safe, carries risks such as significant bleeding typically from the tonsillar branch of the facial artery, not the internal carotid artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 129</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 129</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male was admitted to ER following a traffic accident complaining of anterior neck pain. The patient stated that he was sitting in the back seat of an automobile with his seatbelt unfastened at the time of a head-on collision. As a result, he hit his head on the edge of the front seat, which forced his neck back. Neck movements were unrestricted but the patient was extremely agitated because of conspicuous neck pain. In addition, his right cricoid bone was tender during palpation. No loss of consciousness had occurred, and the Glasgow Coma Scale was 15/15. The patient’s pupils were equal and reactive to light, and no midline bony tenderness was detected in the cervical spine upon palpation. Anteroposterior and lateral cervical radiographs obtained on admission showed normal cervical spine, and neck structures. A lateral cervical radiograph demonstrated a slight fracture line and displacement of the hyoid bone. Which of the following statements is incorrect pertaining to the above case?", "options": [{"label": "A", "text": "The Hyoid bone is a non-articulating bone", "correct": false}, {"label": "B", "text": "Hyoid is attached to Thyroid cartilage", "correct": false}, {"label": "C", "text": "Hyoid is positioned in Anterior midline of Neck", "correct": false}, {"label": "D", "text": "Greater horn of the Hyoid bone originates from the second Pharyngeal arch", "correct": true}], "correct_answer": "D. Greater horn of the Hyoid bone originates from the second Pharyngeal arch", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture4_YKKWDC9.jpg"], "explanation": "<p><strong>Ans. D) Greater horn of the Hyoid bone originates from the second Pharyngeal arch</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hyoid bone does not articulate with the surrounding bones. It doesn’t contribute to any joints in the neck .</li><li>• Option A.</li><li>• surrounding bones.</li><li>• joints</li><li>• neck</li><li>• Option B. The hyoid bone is anatomically connected to the thyroid cartilage by the thyrohyoid membrane. This connection plays a role in the movement and function of the larynx and pharynx .</li><li>• Option B.</li><li>• thyrohyoid membrane.</li><li>• connection</li><li>• movement</li><li>• function</li><li>• larynx</li><li>• pharynx</li><li>• Options C. The hyoid bone is located in the front part of the neck and lies at the base of the mandible , above the thyroid cartilage. It is positioned in the anterior midline , which means it's centrally located at the front of the neck .</li><li>• Options C.</li><li>• located</li><li>• front part</li><li>• neck</li><li>• base</li><li>• mandible</li><li>• thyroid cartilage.</li><li>• anterior midline</li><li>• centrally</li><li>• front</li><li>• neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The greater horn of the hyoid bone actually develops from the third pharyngeal arch , not the second. The second pharyngeal arch contributes to the formation of other structures in the neck , but not the greater horn of the hyoid bone.</li><li>➤ The greater horn of the hyoid bone actually develops from the third pharyngeal arch , not the second. The second pharyngeal arch contributes to the formation of other structures in the neck , but not the greater horn of the hyoid bone.</li><li>➤ The greater horn of the hyoid bone actually develops from the third pharyngeal arch , not the second. The second pharyngeal arch contributes to the formation of other structures in the neck , but not the greater horn of the hyoid bone.</li><li>➤ third pharyngeal arch</li><li>➤ second.</li><li>➤ second pharyngeal</li><li>➤ arch</li><li>➤ formation</li><li>➤ structures</li><li>➤ neck</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 14</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 14</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 66-year-old woman with a long history of chronic pancreatitis underwent subtotal pancreatectomy. A subclavian venipuncture was performed postoperatively in order to administer intravenous fluid and it resulted in a right pneumothorax. Which of the following statements is correct pertaining to the above case?", "options": [{"label": "A", "text": "Subclavian vein is separated from the Subclavian artery by Scalenus medius muscle", "correct": false}, {"label": "B", "text": "It is present in the Anterior Triangle", "correct": false}, {"label": "C", "text": "It receives the Suprascapular vein", "correct": false}, {"label": "D", "text": "It lies behind the Clavicle and in front of the apex of the lung", "correct": true}], "correct_answer": "D. It lies behind the Clavicle and in front of the apex of the lung", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture13_9fcTOck.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture14.jpg"], "explanation": "<p><strong>Ans. D) It lies behind the Cavicle and in front of the apex of the Lung</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The subclavian vein and artery are not separated by the scalenus medius muscle . The subclavian vein runs anterior to the scalenus anterior muscle , while the subclavian artery and the brachial plexus pass between the scalenus anterior and scalenus medius muscles . This anatomical arrangement is crucial during procedures like a subclavian venipuncture to avoid inadvertent arterial puncture or nerve damage.</li><li>• Option A.</li><li>• are not</li><li>• separated</li><li>• scalenus medius muscle</li><li>• subclavian vein</li><li>• anterior</li><li>• scalenus anterior muscle</li><li>• subclavian artery</li><li>• brachial plexus</li><li>• scalenus anterior</li><li>• scalenus medius muscles</li><li>• procedures</li><li>• subclavian venipuncture</li><li>• nerve damage.</li><li>• Option B. The subclavian vein is not located within the anterior triangle of the neck. The anterior triangle is bounded by the midline of the neck, the inferior border of the mandible , and the anterior border of the sternocleidomastoid muscle . The subclavian vein runs more inferiorly, beneath the clavicle , and is not encompassed within the anterior triangle.</li><li>• Option B.</li><li>• not located</li><li>• anterior triangle</li><li>• bounded</li><li>• midline</li><li>• neck,</li><li>• inferior border</li><li>• mandible</li><li>• anterior border</li><li>• sternocleidomastoid muscle</li><li>• inferiorly,</li><li>• beneath</li><li>• clavicle</li><li>• Option C. The subclavian vein does not directly receive the suprascapular vein. The suprascapular vein usually drains into the external jugular vein or directly into the brachiocephalic vein . The subclavian vein, on the other hand, primarily receives blood from the upper limb via the axillary vein.</li><li>• Option C.</li><li>• does not</li><li>• suprascapular vein</li><li>• external jugular vein</li><li>• brachiocephalic vein</li><li>• blood</li><li>• upper limb</li><li>• axillary vein.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The subclavian vein lies posterior to the clavicle and anterior to the apex of the lung . This anatomical relationship is particularly relevant in the case described, as a subclavian venipuncture could lead to a pneumothorax if the needle inadvertently punctures the apex of the lung, which is located just behind the clavicle at the level of the first rib.</li><li>➤ The subclavian vein lies posterior to the clavicle and anterior to the apex of the lung . This anatomical relationship is particularly relevant in the case described, as a subclavian venipuncture could lead to a pneumothorax if the needle inadvertently punctures the apex of the lung, which is located just behind the clavicle at the level of the first rib.</li><li>➤ posterior</li><li>➤ clavicle</li><li>➤ anterior</li><li>➤ apex</li><li>➤ lung</li><li>➤ subclavian venipuncture</li><li>➤ pneumothorax</li><li>➤ punctures</li><li>➤ apex</li><li>➤ lung,</li><li>➤ behind</li><li>➤ clavicle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male was treated for the facial trauma he had sustained following a fall from his bike. After treatment he returned home, he found that he had difficulty in chewing his food. On examination it was found that his lower jaw deviated to the left side. Which of the following statements is true pertaining to the nerve injured in this case?", "options": [{"label": "A", "text": "It lies in the lateral wall of Cavernous Sinus", "correct": false}, {"label": "B", "text": "It exits the Cranial cavity through the foramen Spinosum of the skull", "correct": false}, {"label": "C", "text": "In the foramen it is accompanied by Nervous Spinosum", "correct": false}, {"label": "D", "text": "It supplies the Masseter muscle", "correct": true}], "correct_answer": "D. It supplies the Masseter muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture29.jpg"], "explanation": "<p><strong>Ans. D) It supplies the Masseter muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The nerve injured in this case is the mandibular division of the trigeminal nerve . It does not lie in the lateral wall of the cavernous sinus.</li><li>• Option A.</li><li>• nerve injured</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• does not</li><li>• lateral wall</li><li>• cavernous sinus.</li><li>• Option B. The nerve exiting through the foramen spinosum is the middle meningeal artery , not a nerve. The mandibular branch of the trigeminal nerve , which innervates the masticatory muscles , exits the cranial cavity through the foramen ovale.</li><li>• Option B.</li><li>• middle meningeal artery</li><li>• mandibular branch</li><li>• trigeminal nerve</li><li>• innervates</li><li>• masticatory muscles</li><li>• exits</li><li>• cranial cavity</li><li>• foramen ovale.</li><li>• Option C. Structures passing through foramen ovale along with mandibular nerve include accessory meningeal artery , lesser petrosal nerve and emissary veins .</li><li>• Option C.</li><li>• foramen ovale</li><li>• mandibular nerve</li><li>• accessory meningeal artery</li><li>• lesser petrosal nerve</li><li>• emissary veins</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The mandibular branch of the trigeminal nerve (V3) innervates the muscles of mastication, including the masseter muscle . The masseter is one of the primary muscles involved in chewing . Injury to the mandibular branch of the trigeminal nerve could lead to weakness or paralysis of the masseter muscle , resulting in difficulty chewing and deviation of the jaw towards the injured side , as seen in this patient.</li><li>➤ The mandibular branch of the trigeminal nerve (V3) innervates the muscles of mastication, including the masseter muscle . The masseter is one of the primary muscles involved in chewing .</li><li>➤ mandibular branch</li><li>➤ trigeminal nerve (V3)</li><li>➤ muscles of mastication,</li><li>➤ masseter muscle</li><li>➤ chewing</li><li>➤ Injury to the mandibular branch of the trigeminal nerve could lead to weakness or paralysis of the masseter muscle , resulting in difficulty chewing and deviation of the jaw towards the injured side , as seen in this patient.</li><li>➤ Injury</li><li>➤ mandibular branch</li><li>➤ trigeminal nerve</li><li>➤ weakness</li><li>➤ paralysis</li><li>➤ masseter muscle</li><li>➤ difficulty chewing</li><li>➤ deviation</li><li>➤ jaw towards</li><li>➤ injured side</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 387</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 387</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 53-year-old visited the surgery OPD with the complaints of a small swelling over her neck on the right side for the past two months. She also complained of loss of appetite, severe weight loss in the past few months. On examination it was found to be an enlargement of one of the deep cervical lymph nodes. Lymph node biopsy of her deep cervical nodes on the right side of her neck. Immediately following surgery, she complains of weakness in her right shoulder. On examination, her left shoulder droops and she is unable to raise the point of her shoulder. She does not feel any numbness in her shoulder, back, or neck. Which of the following statements is true about the nerve injured in this patient?", "options": [{"label": "A", "text": "It carries both motor and sensory fibres", "correct": false}, {"label": "B", "text": "It arises from the medullary part of brainstem", "correct": false}, {"label": "C", "text": "It passes through foramen magnum", "correct": true}, {"label": "D", "text": "It has the root value C3 C4 and C5", "correct": false}], "correct_answer": "C. It passes through foramen magnum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture5_o93va7f.jpg"], "explanation": "<p><strong>Ans. C) It passes through foramen magnum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. While many nerves carry both motor and sensory fibers , the specific symptoms described suggest a primarily motor nerve involvement. The nerve most likely injured given these symptoms is the accessory nerve, which primarily carries motor fibers.</li><li>• Option A.</li><li>• many nerves</li><li>• motor</li><li>• sensory fibers</li><li>• injured</li><li>• accessory nerve,</li><li>• motor fibers.</li><li>• Option B. The accessory nerve does not arise from the medullary part of the brainstem. It has a cranial component that originates from the medulla oblongata and a spinal component that originates from the upper cervical spinal cord (C1-C5) . The cranial component quickly joins the spinal component , and it's the spinal part that innervates the trapezius and sternocleidomastoid muscles.</li><li>• Option B.</li><li>• accessory nerve</li><li>• not</li><li>• medullary part</li><li>• brainstem.</li><li>• cranial component</li><li>• originates</li><li>• medulla oblongata</li><li>• spinal component</li><li>• originates</li><li>• upper cervical spinal cord (C1-C5)</li><li>• cranial component</li><li>• spinal component</li><li>• spinal part</li><li>• innervates</li><li>• trapezius</li><li>• sternocleidomastoid muscles.</li><li>• Option D. The phrenic nerve , which innervates the diaphragm, has the root values of C3, C4 , and C5 . The accessory nerve, as mentioned, has spinal roots from C1 to C5.</li><li>• Option D.</li><li>• phrenic nerve</li><li>• innervates</li><li>• diaphragm,</li><li>• root values</li><li>• C3, C4</li><li>• C5</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Spinal part of the accessory nerve ascends from the cervical spinal cord , enters the cranial cavity through the foramen magnum , and then exits the skull through the jugular foramen . The injury described is consistent with damage to the accessory nerve , which would affect the trapezius muscle leading to the inability to raise the shoulder or maintain shoulder symmetry.</li><li>• Spinal part of the accessory nerve ascends from the cervical spinal cord , enters the cranial cavity through the foramen magnum , and then exits the skull through the jugular foramen .</li><li>• Spinal part</li><li>• accessory nerve</li><li>• cervical spinal cord</li><li>• cranial cavity</li><li>• foramen magnum</li><li>• exits</li><li>• jugular foramen</li><li>• The injury described is consistent with damage to the accessory nerve , which would affect the trapezius muscle leading to the inability to raise the shoulder or maintain shoulder symmetry.</li><li>• injury</li><li>• damage</li><li>• accessory nerve</li><li>• trapezius muscle</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 413</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 413</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-5, B-1, C-8, D-6", "correct": false}, {"label": "B", "text": "A-7, B-4, C-8, D-1", "correct": false}, {"label": "C", "text": "A-7, B-3, C-2, D-4", "correct": false}, {"label": "D", "text": "A-5, B-1, C-8, D-3", "correct": true}], "correct_answer": "D. A-5, B-1, C-8, D-3", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-111959.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture22.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-112828.jpg"], "explanation": "<p><strong>Ans. D) A-5, B-1, C-8, D-3</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Lingual Artery</li><li>• Option</li><li>• A. Lingual Artery</li><li>• The lingual artery is closely associated with the hyoglossus muscle , which it runs deep to in its course towards the tongue . Therefore, the correct match for the lingual artery is with \"5. Hyoglossus. \"</li><li>• The lingual artery is closely associated with the hyoglossus muscle , which it runs deep to in its course towards the tongue . Therefore, the correct match for the lingual artery is with \"5. Hyoglossus. \"</li><li>• associated</li><li>• hyoglossus muscle</li><li>• deep</li><li>• towards</li><li>• tongue</li><li>• lingual artery</li><li>• Hyoglossus.</li><li>• Option B. Subclavian Artery</li><li>• Option</li><li>• B. Subclavian Artery</li><li>• The subclavian artery runs posterior to the scalenus anterior muscle . This anatomical relationship is important in the context of thoracic outlet syndrome and subclavian artery puncture. Thus, the correct match for the subclavian artery is \"1. Scalenus anterior .\"</li><li>• The subclavian artery runs posterior to the scalenus anterior muscle . This anatomical relationship is important in the context of thoracic outlet syndrome and subclavian artery puncture. Thus, the correct match for the subclavian artery is \"1. Scalenus anterior .\"</li><li>• posterior</li><li>• scalenus anterior muscle</li><li>• thoracic outlet syndrome</li><li>• subclavian artery puncture.</li><li>• subclavian artery</li><li>• Scalenus anterior</li><li>• Option C. Maxillary Artery</li><li>• Option</li><li>• C. Maxillary Artery</li><li>• The maxillary artery is a major artery of the face. It runs deep to the lower head of the lateral pterygoid muscle . Therefore, the appropriate match for the maxillary artery is \"8. Lateral pterygoid .\"</li><li>• The maxillary artery is a major artery of the face. It runs deep to the lower head of the lateral pterygoid muscle . Therefore, the appropriate match for the maxillary artery is \"8. Lateral pterygoid .\"</li><li>• major artery</li><li>• face.</li><li>• deep</li><li>• lower head</li><li>• lateral pterygoid muscle</li><li>• maxillary artery</li><li>• Lateral pterygoid</li><li>• Option D. Axillary Artery</li><li>• Option</li><li>• D. Axillary Artery</li><li>• The axillary artery is located in the axilla (armpit) and is closely related to the pectoralis minor muscle . It lies deep to this muscle at one point in its course. Hence, the correct match for the axillary artery is \"3. Pectoralis minor .\"</li><li>• The axillary artery is located in the axilla (armpit) and is closely related to the pectoralis minor muscle . It lies deep to this muscle at one point in its course. Hence, the correct match for the axillary artery is \"3. Pectoralis minor .\"</li><li>• located</li><li>• axilla</li><li>• pectoralis</li><li>• minor muscle</li><li>• deep</li><li>• muscle</li><li>• one point</li><li>• axillary artery</li><li>• Pectoralis minor</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This matches the Lingual artery with the Hyoglossus muscle , the Subclavian artery with the Scalenus anterior muscle , the Maxillary artery with the Lateral pterygoid muscle , and the Axillary artery with the Pectoralis minor muscle .</li><li>➤ Lingual artery</li><li>➤ Hyoglossus muscle</li><li>➤ Subclavian artery</li><li>➤ Scalenus anterior muscle</li><li>➤ Maxillary artery</li><li>➤ Lateral pterygoid muscle</li><li>➤ Axillary artery</li><li>➤ Pectoralis minor muscle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-1, B-4, C-8, D-3", "correct": false}, {"label": "B", "text": "A-4, B-5, C-1, D-2", "correct": true}, {"label": "C", "text": "A-8, B-6, C-4, D-1", "correct": false}, {"label": "D", "text": "A-6, B-4, C-2, D-8", "correct": false}], "correct_answer": "B. A-4, B-5, C-1, D-2", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-124007.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture35.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture36.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-124530.jpg"], "explanation": "<p><strong>Ans. B) A-4, B-5, C-1, D-2</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tensor Tympani innervated by the Trigeminal nerve (CN V) . Specifically, it is the mandibular branch of the trigeminal nerve that provides motor innervation to the tensor tympani muscle , which is involved in dampening the sounds we hear , such as our own chewing .</li><li>• Option A.</li><li>• innervated</li><li>• Trigeminal nerve (CN V)</li><li>• mandibular branch</li><li>• trigeminal nerve</li><li>• motor innervation</li><li>• tensor tympani muscle</li><li>• dampening</li><li>• sounds we hear</li><li>• chewing</li><li>• Option B. Posterior Belly of Digastric innervated by the Facial nerve (CN VII ). Although the digastric muscle has two bellies ( anterior and posterior ), each is innervated by a different nerve. The posterior belly is innervated by the facial nerve .</li><li>• Option B.</li><li>• innervated</li><li>• Facial nerve (CN VII</li><li>• digastric muscle</li><li>• two bellies</li><li>• anterior</li><li>• posterior</li><li>• posterior belly</li><li>• innervated</li><li>• facial nerve</li><li>• Option C. Lateral Cricoarytenoid innervated by the Vagus nerve (CN X ). Specifically, it's the recurrent laryngeal branch of the vagus nerve that innervates most of the intrinsic muscles of the larynx, including the lateral cricoarytenoid muscle .</li><li>• Option C.</li><li>• innervated</li><li>• Vagus nerve (CN X</li><li>• recurrent laryngeal branch</li><li>• vagus nerve</li><li>• innervates</li><li>• intrinsic muscles</li><li>• larynx,</li><li>• lateral cricoarytenoid muscle</li><li>• Option D. Styloglossus innervated by the Hypoglossal nerve (CN XII ). The styloglossus muscle , which retracts and elevates the tongue , is innervated by the hypoglossal nerve .</li><li>• Option D.</li><li>• innervated</li><li>• Hypoglossal nerve (CN XII</li><li>• styloglossus muscle</li><li>• retracts</li><li>• elevates</li><li>• tongue</li><li>• innervated</li><li>• hypoglossal nerve</li><li>• So, the correct pairings are:</li><li>• A. Tensor Tympani - 4. Trigeminal nerve B. Posterior Belly of Digastric - 5. Facial nerve C. Lateral Cricoarytenoid - 1. Vagus nerve D. Styloglossus - 2. Hypoglossal nerve</li><li>• A. Tensor Tympani - 4. Trigeminal nerve</li><li>• B. Posterior Belly of Digastric - 5. Facial nerve</li><li>• C. Lateral Cricoarytenoid - 1. Vagus nerve</li><li>• D. Styloglossus - 2. Hypoglossal nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-5, B-6, C-4, D-6", "correct": true}, {"label": "B", "text": "A-7, B-4, C-1, D-6", "correct": false}, {"label": "C", "text": "A-1, B-3, C-5, D-3", "correct": false}, {"label": "D", "text": "A-5, B-4, C-7, D-1", "correct": false}], "correct_answer": "A. A-5, B-6, C-4, D-6", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-130145.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-130859.jpg"], "explanation": "<p><strong>Ans. A) A-5, B-6, C-4, D-6</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The parotid gland's secretomotor innervation is provided by the glossopharyngeal nerve (CN IX ) via the otic ganglion . The preganglionic parasympathetic fibers originate in the inferior salivatory nucleus , travel with the glossopharyngeal nerve , synapse in the otic ganglion , and then the postganglionic fibers reach the parotid gland</li><li>• Option A:</li><li>• parotid gland's</li><li>• innervation</li><li>• glossopharyngeal nerve (CN IX</li><li>• otic ganglion</li><li>• preganglionic parasympathetic fibers</li><li>• inferior salivatory nucleus</li><li>• glossopharyngeal nerve</li><li>• synapse</li><li>• otic ganglion</li><li>• postganglionic fibers</li><li>• parotid gland</li><li>• Option B. The nasal glands are innervated by the pterygopalatine ganglion (also known as Meckel's ganglion ). The preganglionic parasympathetic fibers from the facial nerve (CN VII ) synapse in the pterygopalatine ganglion , and the postganglionic fibers innervate the nasal glands .</li><li>• Option B.</li><li>• nasal glands</li><li>• innervated</li><li>• pterygopalatine ganglion</li><li>• Meckel's ganglion</li><li>• preganglionic parasympathetic fibers</li><li>• facial nerve (CN VII</li><li>• synapse</li><li>• pterygopalatine ganglion</li><li>• postganglionic fibers</li><li>• nasal glands</li><li>• Option C. The submandibular gland receives its secretomotor innervation from the facial nerve (CN VII) via the submandibular ganglion . However, since Langley's ganglion is not a specific anatomical structure but rather a term sometimes used to refer to any peripheral autonomic ganglion , it's possible that this is meant to represent the submandibular ganglion in this context.</li><li>• Option C.</li><li>• submandibular gland</li><li>• secretomotor innervation</li><li>• facial nerve (CN VII)</li><li>• submandibular ganglion</li><li>• Langley's ganglion</li><li>• peripheral autonomic ganglion</li><li>• submandibular ganglion</li><li>• Option D. The lacrimal gland is innervated by the facial nerve (CN VII) via the pterygopalatine ganglion ( Meckel's ganglion ). The preganglionic fibers from the facial nerve synapse in the pterygopalatine ganglion , and the postganglionic fibers reach the lacrimal gland .</li><li>• Option D.</li><li>• lacrimal gland</li><li>• innervated</li><li>• facial nerve (CN VII)</li><li>• pterygopalatine ganglion</li><li>• Meckel's ganglion</li><li>• preganglionic fibers</li><li>• facial nerve synapse</li><li>• pterygopalatine ganglion</li><li>• postganglionic fibers</li><li>• lacrimal gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 98,119,249</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 98,119,249</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Match the following:", "options": [{"label": "A", "text": "A-6, B-4, C-7, D-6", "correct": false}, {"label": "B", "text": "A-4, B-3, C-1, D-7", "correct": false}, {"label": "C", "text": "A-2, B-3, C-1, D-4", "correct": true}, {"label": "D", "text": "A-4, B-5, C-8, D-1", "correct": false}], "correct_answer": "C. A-2, B-3, C-1, D-4", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-131820.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture38.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-132219.jpg"], "explanation": "<p><strong>Ans. C) A-2, B-3, C-1, D-4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The internal jugular vein is a major vein that drains blood from the brain , face , and neck . One of its tributaries is the Retromandibular vein , which drains blood from the area of the mandible .</li><li>• Option A.</li><li>• internal jugular vein</li><li>• major vein</li><li>• drains blood</li><li>• brain</li><li>• face</li><li>• neck</li><li>• tributaries</li><li>• Retromandibular vein</li><li>• drains blood</li><li>• area of the mandible</li><li>• Option B. The external jugular vein drains the scalp and deep portions of the face . It is formed by the union of the posterior division of the retromandibular vein with the posterior auricular vein . However, none of the options listed specifically correspond to the tributaries of the external jugular vein.</li><li>• Option B.</li><li>• external jugular vein</li><li>• scalp</li><li>• deep</li><li>• face</li><li>• formed by</li><li>• union</li><li>• posterior division</li><li>• retromandibular vein</li><li>• posterior auricular vein</li><li>• Option C. The subclavian vein is a large vein that receives blood from the arm through the axillary vein and from the skin and muscles of the upper chest and neck . The Suprascapular vein , draining the suprascapular region , is a tributary of the subclavian vein .</li><li>• Option C.</li><li>• subclavian vein</li><li>• large vein</li><li>• receives blood</li><li>• arm</li><li>• axillary vein</li><li>• skin</li><li>• muscles</li><li>• upper chest</li><li>• neck</li><li>• Suprascapular vein</li><li>• suprascapular region</li><li>• subclavian vein</li><li>• Option D. The brachiocephalic veins are formed by the union of the internal jugular and subclavian veins . They do not directly receive blood from the veins listed in the options. Among the options provided, none are direct tributaries of the brachiocephalic vein .</li><li>• Option D.</li><li>• brachiocephalic veins</li><li>• union</li><li>• internal jugular</li><li>• subclavian veins</li><li>• not</li><li>• receive blood</li><li>• veins</li><li>• direct tributaries</li><li>• brachiocephalic vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a preganglionic nerve?", "options": [{"label": "A", "text": "Auriculotemporal Nerve", "correct": false}, {"label": "B", "text": "Zygomaticotemporal Nerve", "correct": false}, {"label": "C", "text": "Short Ciliary Nerves", "correct": false}, {"label": "D", "text": "Chorda Tympani Nerve", "correct": true}], "correct_answer": "D. Chorda Tympani Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture40.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture41.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture42.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture43.jpg"], "explanation": "<p><strong>Ans. D) Chorda Tympani Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The auriculotemporal nerve is a branch of the mandibular nerve (V3 ), which is a division of the trigeminal nerve ( cranial nerve V ). It is primarily a sensory nerve and supplies sensation to the auricle and temporal region of the scalp . It is not a preganglionic nerve .</li><li>• Option A.</li><li>• auriculotemporal nerve</li><li>• mandibular nerve (V3</li><li>• division</li><li>• trigeminal nerve</li><li>• cranial nerve V</li><li>• primarily a sensory nerve</li><li>• supplies sensation</li><li>• auricle</li><li>• temporal region</li><li>• scalp</li><li>• not</li><li>• preganglionic nerve</li><li>• Option B. The zygomaticotemporal nerve is a branch of the zygomatic nerve , itself a branch of the maxillary nerve (V2 ), which is a division of the trigeminal nerve ( cranial nerve V ). This nerve provides sensory innervation to the skin of the temporal region . Like the auriculotemporal nerve , it is not a preganglionic nerve .</li><li>• Option</li><li>• B.</li><li>• zygomaticotemporal nerve</li><li>• zygomatic nerve</li><li>• maxillary nerve (V2</li><li>• division</li><li>• trigeminal nerve</li><li>• cranial nerve V</li><li>• sensory innervation</li><li>• skin</li><li>• temporal region</li><li>• auriculotemporal nerve</li><li>• not</li><li>• preganglionic nerve</li><li>• Option C. The short ciliary nerves arise from the ciliary ganglion and carry postganglionic parasympathetic , sympathetic , and sensory fibers to the eyeball . These nerves are involved in the innervation of the eye , including the control of the pupil and lens . They are not preganglionic nerves .</li><li>• Option C.</li><li>• short ciliary nerves</li><li>• ciliary ganglion</li><li>• postganglionic parasympathetic</li><li>• sympathetic</li><li>• sensory fibers</li><li>• eyeball</li><li>• innervation</li><li>• eye</li><li>• control</li><li>• pupil</li><li>• lens</li><li>• preganglionic nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The chorda tympani nerve is a branch of the facial nerve . It carries taste sensations from the anterior two-thirds of the tongue and also carries preganglionic parasympathetic fibers to the submandibular and sublingual salivary glands . These parasympathetic fibers synapse in the submandibular ganglion before innervating the glands . Therefore, the chorda tympani contains preganglionic fibers .</li><li>➤ The chorda tympani nerve is a branch of the facial nerve .</li><li>➤ chorda tympani</li><li>➤ facial nerve</li><li>➤ It carries taste sensations from the anterior two-thirds of the tongue and also carries preganglionic parasympathetic fibers to the submandibular and sublingual salivary glands .</li><li>➤ taste sensations</li><li>➤ anterior two-thirds</li><li>➤ tongue</li><li>➤ preganglionic parasympathetic fibers</li><li>➤ submandibular</li><li>➤ sublingual salivary glands</li><li>➤ These parasympathetic fibers synapse in the submandibular ganglion before innervating the glands . Therefore, the chorda tympani contains preganglionic fibers .</li><li>➤ synapse</li><li>➤ submandibular ganglion</li><li>➤ innervating</li><li>➤ glands</li><li>➤ chorda tympani</li><li>➤ preganglionic fibers</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The surface landmark to cannulate internal jugular vein:", "options": [{"label": "A", "text": "Subclavian triangle", "correct": false}, {"label": "B", "text": "Sedillot’s triangle", "correct": true}, {"label": "C", "text": "Scaleno Vertebral triangle", "correct": false}, {"label": "D", "text": "Suboccipital triangle", "correct": false}], "correct_answer": "B. Sedillot’s triangle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture46.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture47.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture48.jpg"], "explanation": "<p><strong>Ans. B) Sedillot’s triangle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Subclavian triangle, also known as the supraclavicular or omoclavicular triangle , is located beneath the clavicle and is primarily associated with the subclavian vein and artery . While this triangle is important for accessing the subclavian vein , it is not the primary landmark for cannulating the internal jugular vein.</li><li>• Option A.</li><li>• supraclavicular</li><li>• omoclavicular triangle</li><li>• beneath</li><li>• clavicle</li><li>• subclavian vein</li><li>• artery</li><li>• triangle</li><li>• accessing</li><li>• subclavian vein</li><li>• cannulating</li><li>• internal jugular vein.</li><li>• Option C. The scaleno vertebral triangle is not a standard anatomical term used in the context of vascular access or cannulation . Therefore, it is not relevant for the cannulation of the internal jugular vein.</li><li>• Option C.</li><li>• scaleno vertebral triangle</li><li>• not</li><li>• anatomical term</li><li>• vascular access</li><li>• cannulation</li><li>• Option D. The suboccipital triangle, located at the back of the neck , is primarily associated with the suboccipital muscles and the vertebral artery . It is not used as a landmark for internal jugular vein cannulation.</li><li>• Option D.</li><li>• back of the neck</li><li>• suboccipital muscles</li><li>• vertebral artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sedillot’s triangle , also known as the carotid triangle , is a key landmark for the cannulation of the internal jugular vein . This triangle is formed by the sternocleidomastoid muscle, the superior belly of the omohyoid muscle , and the posterior belly of the digastric muscle . The internal jugular vein is located deep to the sternocleidomastoid muscle within this triangle, making it a crucial landmark for cannulation.</li><li>➤ Sedillot’s triangle , also known as the carotid triangle , is a key landmark for the cannulation of the internal jugular vein .</li><li>➤ Sedillot’s triangle</li><li>➤ carotid triangle</li><li>➤ cannulation</li><li>➤ internal jugular vein</li><li>➤ This triangle is formed by the sternocleidomastoid muscle, the superior belly of the omohyoid muscle , and the posterior belly of the digastric muscle .</li><li>➤ triangle</li><li>➤ sternocleidomastoid muscle,</li><li>➤ superior belly</li><li>➤ omohyoid muscle</li><li>➤ posterior belly</li><li>➤ digastric muscle</li><li>➤ The internal jugular vein is located deep to the sternocleidomastoid muscle within this triangle, making it a crucial landmark for cannulation.</li><li>➤ located</li><li>➤ deep</li><li>➤ sternocleidomastoid muscle</li><li>➤ Stemocleidomastoid muscle: SM: stemal head; CM: Cleidal head</li><li>➤ Stemocleidomastoid muscle: SM: stemal head; CM: Cleidal head</li><li>➤ Red dot: triangle of sedillot CL: clavicle</li><li>➤ Red dot: triangle of sedillot CL: clavicle</li><li>➤ Triangle of Sedillot:</li><li>➤ Triangle of Sedillot:</li><li>➤ Medially -sternal head of sternocleidomastoid Laterally-clavicular head of sternocleidomastoid Base-Clavicle Content -Internal jugular vein.</li><li>➤ Medially -sternal head of sternocleidomastoid</li><li>➤ Laterally-clavicular head of sternocleidomastoid</li><li>➤ Base-Clavicle</li><li>➤ Content -Internal jugular vein.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct statement about the pointed structure:", "options": [{"label": "A", "text": "It arises by two heads", "correct": true}, {"label": "B", "text": "It inserts into the Sclera in front of the equator 5mm from Sclerocorneal junction", "correct": false}, {"label": "C", "text": "The nerve to this muscle carries the Preganglionic Parasympathetic fibres", "correct": false}, {"label": "D", "text": "Its paralysis results in internal Strabismus", "correct": false}], "correct_answer": "A. It arises by two heads", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-14.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) It arises by two heads</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The lateral rectus muscle inserts into the sclera of the eyeball . Its insertion is 7 mm from the limbus (the sclerocorneal junction ) and is located in front of the equator of the eyeball .</li><li>• Option B.</li><li>• lateral rectus muscle</li><li>• sclera</li><li>• eyeball</li><li>• insertion</li><li>• 7 mm</li><li>• limbus</li><li>• sclerocorneal junction</li><li>• front</li><li>• equator</li><li>• eyeball</li><li>• Option C. The lateral rectus muscle is innervated by the abducens nerve , which is a motor nerve and does not carry preganglionic parasympathetic fibers . The oculomotor nerve is the one that carries preganglionic parasympathetic fibers to the eye , but it does not innervate the lateral rectus .</li><li>• Option C.</li><li>• lateral rectus muscle</li><li>• innervated</li><li>• abducens nerve</li><li>• motor nerve</li><li>• not</li><li>• preganglionic parasympathetic fibers</li><li>• oculomotor nerve</li><li>• preganglionic parasympathetic fibers</li><li>• eye</li><li>• not</li><li>• innervate</li><li>• lateral rectus</li><li>• Option D. Paralysis of the lateral rectus typically results in an inability to abduct the eye leading to esotropia , where the eye turns inward . This is referred to as external strabismus .</li><li>• Option D. Paralysis</li><li>• lateral rectus</li><li>• inability</li><li>• abduct the eye</li><li>• esotropia</li><li>• eye turns inward</li><li>• external strabismus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It arises by two heads : This statement is correct for the lateral rectus muscle . The lateral rectus muscle typically originates from a two heads at the annulus of Zinn , which is a tendinous ring in the posterior part of the orbit .</li><li>➤ It arises by two heads : This statement is correct for the lateral rectus muscle .</li><li>➤ two heads</li><li>➤ correct</li><li>➤ lateral rectus muscle</li><li>➤ The lateral rectus muscle typically originates from a two heads at the annulus of Zinn , which is a tendinous ring in the posterior part of the orbit .</li><li>➤ lateral rectus muscle</li><li>➤ originates</li><li>➤ two heads</li><li>➤ annulus of Zinn</li><li>➤ tendinous ring</li><li>➤ posterior</li><li>➤ orbit</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient with complaints of recurrent swelling on one side of neck, pain while eating and subsides after a few hours. Imaging performed shows a sialolith. The postganglionic secretomotor fibres for the involved salivary gland is from?", "options": [{"label": "A", "text": "Nerve of Pterygoid Canal", "correct": false}, {"label": "B", "text": "Auriculotemporal Nerve", "correct": false}, {"label": "C", "text": "Lingual Nerve", "correct": true}, {"label": "D", "text": "Chorda Tympani Nerve", "correct": false}], "correct_answer": "C. Lingual Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture52.jpg"], "explanation": "<p><strong>Ans. C) Lingual Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The nerve of the pterygoid canal ( Vidian nerve ) carries postganglionic parasympathetic fibers from the pterygopalatine ganglion to the lacrimal gland and to the glands of the nasal cavity and palate . It does not provide secretomotor fibers to the major salivary glands .</li><li>• Option A.</li><li>• Vidian nerve</li><li>• postganglionic parasympathetic fibers</li><li>• pterygopalatine ganglion</li><li>• lacrimal gland</li><li>• nasal cavity</li><li>• palate</li><li>• not</li><li>• secretomotor fibers</li><li>• major salivary glands</li><li>• Option B. The auriculotemporal nerve is a branch of the mandibular nerve (V3 ), part of the trigeminal nerve . It provides postganglionic parasympathetic secretomotor fibers to the parotid gland . However, these fibers originate in the glossopharyngeal nerve , synapse in the otic ganglion , and then hitchhike with the auriculotemporal nerve to reach the parotid gland .</li><li>• Option B.</li><li>• branch</li><li>• mandibular nerve (V3</li><li>• trigeminal nerve</li><li>• postganglionic parasympathetic secretomotor fibers</li><li>• parotid gland</li><li>• originate</li><li>• glossopharyngeal nerve</li><li>• synapse</li><li>• otic ganglion</li><li>• hitchhike</li><li>• auriculotemporal nerve</li><li>• parotid gland</li><li>• Option D. The chorda tympani, a branch of the facial nerve , carries taste fibers from the anterior two-thirds of the tongue and preganglionic parasympathetic fibers to the submandibular and sublingual salivary glands . These fibers synapse in the submandibular ganglion , and the postganglionic fibers then innervate the submandibular and sublingual glands , providing secretomotor innervation .</li><li>• Option D.</li><li>• facial nerve</li><li>• taste fibers</li><li>• anterior two-thirds</li><li>• tongue</li><li>• preganglionic parasympathetic fibers</li><li>• submandibular</li><li>• sublingual salivary glands</li><li>• synapse</li><li>• submandibular ganglion</li><li>• postganglionic fibers</li><li>• innervate</li><li>• submandibular</li><li>• sublingual glands</li><li>• secretomotor innervation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lingual nerve is a branch of the mandibular nerve (V3 ). While it is primarily a sensory nerve for the anterior two-thirds of the tongue , it is joined by the chorda tympani nerve , which carries the preganglionic parasympathetic fibers for the submandibula r and sublingual glands. However, the lingual nerve itself does not carry these secretomotor fibers.</li><li>➤ The lingual nerve is a branch of the mandibular nerve (V3 ).</li><li>➤ mandibular nerve (V3</li><li>➤ While it is primarily a sensory nerve for the anterior two-thirds of the tongue , it is joined by the chorda tympani nerve , which carries the preganglionic parasympathetic fibers for the submandibula r and sublingual glands.</li><li>➤ sensory nerve</li><li>➤ anterior two-thirds</li><li>➤ tongue</li><li>➤ chorda tympani nerve</li><li>➤ preganglionic parasympathetic fibers</li><li>➤ submandibula</li><li>➤ sublingual glands.</li><li>➤ However, the lingual nerve itself does not carry these secretomotor fibers.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 124</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 124</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "False about the pointed structure:", "options": [{"label": "A", "text": "Contains taste buds", "correct": false}, {"label": "B", "text": "Contains mucus secreting gland", "correct": false}, {"label": "C", "text": "Perichondrium absent", "correct": true}, {"label": "D", "text": "Lined by pseudostratified columnar epithelium", "correct": false}], "correct_answer": "C. Perichondrium absent", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture14.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Perichondrium absent</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The epiglottis does contain taste buds on its laryngeal surface . These taste buds are involved in the sensory aspects of swallowing and help trigger the swallowing reflex .</li><li>• Option A.</li><li>• epiglottis</li><li>• taste buds</li><li>• laryngeal surface</li><li>• taste buds</li><li>• sensory aspects</li><li>• swallowing</li><li>• help trigger</li><li>• swallowing reflex</li><li>• Option B. The epiglottis contains mucus-secreting glands . These glands play a role in lubricating the larynx and the vocal cords , aiding in the protection of these structures and in the swallowing process .</li><li>• Option B.</li><li>• epiglottis</li><li>• mucus-secreting glands</li><li>• lubricating</li><li>• larynx</li><li>• vocal cords</li><li>• aiding</li><li>• protection</li><li>• structures</li><li>• swallowing process</li><li>• Option D. The laryngeal surface of the epiglottis is lined by pseudostratified ciliated columnar epithelium . This type of epithelium is typical in the upper respiratory tract , where it helps in the movement of mucus and trapped particles.</li><li>• Option D.</li><li>• laryngeal surface</li><li>• pseudostratified ciliated columnar epithelium</li><li>• epithelium</li><li>• upper respiratory tract</li><li>• helps</li><li>• movement</li><li>• mucus</li><li>• trapped particles.</li><li>• Note - Whole of Larynx is lined by Ciliated Columnar Epithelium except Vocal Cords &amp; Upper Surface of Epiglottis is lined by Stratified Squamous Epithelium.</li><li>• Note - Whole of Larynx is lined by Ciliated Columnar Epithelium except Vocal Cords &amp; Upper Surface of Epiglottis is lined by Stratified Squamous Epithelium.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The epiglottis , like other cartilaginous structures in the body, is covered by perichondrium, a dense layer of connective tissue that provides nutrients to the cartilage . The presence of perichondrium is a normal feature of cartilaginous structures , including the epiglottis</li><li>➤ epiglottis</li><li>➤ cartilaginous structures</li><li>➤ perichondrium,</li><li>➤ dense layer</li><li>➤ connective tissue</li><li>➤ nutrients</li><li>➤ cartilage</li><li>➤ presence</li><li>➤ perichondrium</li><li>➤ cartilaginous structures</li><li>➤ epiglottis</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 238</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure:", "options": [{"label": "A", "text": "Mental Nerve", "correct": false}, {"label": "B", "text": "Lingual Nerve", "correct": false}, {"label": "C", "text": "Inferior Alveolar Nerve", "correct": true}, {"label": "D", "text": "Buccal Nerve", "correct": false}], "correct_answer": "C. Inferior Alveolar Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-16.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture55.jpg"], "explanation": "<p><strong>Ans. C) Inferior Alveolar Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Mental nerve arises from an inferior alveolar nerve within the bony canal and emerge s through mental foramen to supply skin over the chin .</li><li>• Option A</li><li>• Mental nerve</li><li>• inferior alveolar nerve</li><li>• bony canal</li><li>• emerge</li><li>• mental foramen</li><li>• skin</li><li>• chin</li><li>• Option B. Lingual nerve lies in intimate relation to wharton's duc t.</li><li>• Option B.</li><li>• Lingual nerve</li><li>• intimate relation</li><li>• wharton's duc</li><li>• Option D . Buccal branch of mandibular nerve is sensory . It pierces buccinator to supply skin over cheek.</li><li>• Option D</li><li>• Buccal branch</li><li>• mandibular nerve</li><li>• sensory</li><li>• buccinator</li><li>• skin</li><li>• cheek.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior alveolar nerve passes through the mandibular foramen , it gives rise to nerve to mylohyoid before entering the foramen.</li><li>➤ Inferior alveolar nerve passes through the mandibular foramen , it gives rise to nerve to mylohyoid before entering the foramen.</li><li>➤ Inferior alveolar nerve</li><li>➤ mandibular foramen</li><li>➤ mylohyoid</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 146</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 146</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incorrectly matched pair with respect to its nerve supply of the marked structures in the given image:", "options": [{"label": "A", "text": "Facial Nerve", "correct": false}, {"label": "B", "text": "Trigeminal Nerve", "correct": false}, {"label": "C", "text": "Glossopharyngeal Nerve", "correct": true}, {"label": "D", "text": "Hypoglossal Nerve", "correct": false}], "correct_answer": "C. Glossopharyngeal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-17.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-18.jpg"], "explanation": "<p><strong>Ans. C) Glossopharyngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The marked structure A is Platysma which is innervated by cervical branch of facial nerve.</li><li>• Option A.</li><li>• Platysma</li><li>• cervical branch</li><li>• facial nerve.</li><li>• Option B. The marked structure B is Anterior belly of digastric which is supplied by mandibular division of trigeminal nerve .</li><li>• Option B.</li><li>• Anterior belly</li><li>• digastric</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• Option D. The marked structure D Is Styloglossus which is innervated by hypoglossal nerve .</li><li>• Option D.</li><li>• Styloglossus</li><li>• hypoglossal nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The marked structure C is Geniohyoid which is innervated by C1 fibres instead of Glossopharyngeal nerve .</li><li>➤ The marked structure C is Geniohyoid which is innervated by C1 fibres instead of Glossopharyngeal nerve .</li><li>➤ Geniohyoid</li><li>➤ C1 fibres</li><li>➤ Glossopharyngeal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 142</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the nerve supply of the marked structure in the given image?", "options": [{"label": "A", "text": "Lingual Nerve", "correct": false}, {"label": "B", "text": "Chorda Tympani", "correct": false}, {"label": "C", "text": "Glossopharyngeal Nerve", "correct": true}, {"label": "D", "text": "Vagus Nerve", "correct": false}], "correct_answer": "C. Glossopharyngeal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-164134.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture56.jpg"], "explanation": "<p><strong>Ans. C) Glossopharyngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The lingual nerve is a branch of the mandibular division of the trigeminal nerve (cranial nerve V3). It supplies general sensation (such as touch, pain, and temperature ) to the anterior two-thirds of the tongue . However, it does not supply the circumvallate papillae .</li><li>• Option A.</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• general sensation</li><li>• touch, pain,</li><li>• temperature</li><li>• anterior two-thirds</li><li>• tongue</li><li>• not supply</li><li>• circumvallate papillae</li><li>• Option B. The chorda tympani is a branch of the facial nerve (cranial nerve VII). It carries taste fibers from the anterior two-thirds of the tongue and also supplies parasympathetic fibers to the submandibular and sublingual glands . While it does carry taste sensations , these are not from the circumvallate papillae but from the anterior portion of the tongue.</li><li>• Option B.</li><li>• facial nerve</li><li>• taste fibers</li><li>• anterior two-thirds</li><li>• tongue</li><li>• parasympathetic fibers</li><li>• submandibular</li><li>• sublingual glands</li><li>• taste sensations</li><li>• circumvallate papillae</li><li>• anterior portion</li><li>• tongue.</li><li>• Option D. The vagus nerve ( cranial nerve X ) is involved in many autonomic functions of the body and provides sensory innervation to a small area of the root of the tongue. However, it does not supply the circumvallate papillae.</li><li>• Option D.</li><li>• cranial nerve X</li><li>• autonomic functions</li><li>• sensory innervation</li><li>• small area</li><li>• root</li><li>• tongue.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The glossopharyngeal nerve (cranial nerve IX) provides sensory and taste sensation to the posterior one-third of the tongue , which includes the circumvallate papillae . These papillae are located at the back of the tongue and are innervated by the glossopharyngeal nerve . Glossopharyngeal nerve receives taste sensation from circumvallate papillae and posterior 1/3 tongue.</li><li>• The glossopharyngeal nerve (cranial nerve IX) provides sensory and taste sensation to the posterior one-third of the tongue , which includes the circumvallate papillae . These papillae are located at the back of the tongue and are innervated by the glossopharyngeal nerve .</li><li>• The glossopharyngeal nerve (cranial nerve IX) provides sensory and taste sensation to the posterior one-third of the tongue , which includes the circumvallate papillae . These papillae are located at the back of the tongue and are innervated by the glossopharyngeal nerve .</li><li>• sensory</li><li>• taste sensation</li><li>• posterior one-third</li><li>• tongue</li><li>• circumvallate papillae</li><li>• papillae</li><li>• back</li><li>• tongue</li><li>• innervated</li><li>• glossopharyngeal nerve</li><li>• Glossopharyngeal nerve receives taste sensation from circumvallate papillae and posterior 1/3 tongue.</li><li>• Glossopharyngeal nerve receives taste sensation from circumvallate papillae and posterior 1/3 tongue.</li><li>• taste sensation</li><li>• circumvallate papillae</li><li>• posterior 1/3 tongue.</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 145</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 145</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the VAGUS nerve in the given image:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture21.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Recurrent laryngeal nerve runs in the trachea esophageal groove . It supplies all muscles of larynx except cricothyroid that is innervated by external laryngeal nerve .</li><li>• Option A.</li><li>• trachea esophageal groove</li><li>• muscles</li><li>• larynx except cricothyroid</li><li>• external laryngeal nerve</li><li>• Option B. Cervical part of the sympathetic trunk lies on the posterior aspect of the carotid sheath , whereas ansa cervicalis lies on the anterior wall of the carotid sheath .</li><li>• Option B.</li><li>• sympathetic trunk</li><li>• posterior</li><li>• carotid sheath</li><li>• ansa cervicalis</li><li>• anterior wall</li><li>• carotid sheath</li><li>• Option D. Trunks of brachial plexus lies in the posterior triangle between scalenus anterior and scalenus medius .</li><li>• Option D.</li><li>• posterior triangle</li><li>• scalenus</li><li>• anterior</li><li>• scalenus medius</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vagus lies within carotid sheath , between and behind the carotid arteries and internal jugular vein in carotid triangle .</li><li>➤ Vagus</li><li>➤ carotid sheath</li><li>➤ between</li><li>➤ behind</li><li>➤ carotid arteries</li><li>➤ internal jugular vein</li><li>➤ carotid triangle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 178</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 178</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve is thickened in the following image of a patient with Hansen's disease?", "options": [{"label": "A", "text": "Supraclavicular Nerves", "correct": false}, {"label": "B", "text": "Dorsal scapular Nerve", "correct": false}, {"label": "C", "text": "Great Auricular Nerve", "correct": true}, {"label": "D", "text": "Transverse Cervical Cutaneous Nerve", "correct": false}], "correct_answer": "C. Great Auricular Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture23.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture58.jpg"], "explanation": "<p><strong>Ans. C) Great Auricular Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. These nerves arise from the cervical plexus and provide sensory innervation to the skin of the upper chest and shoulder area . While they can be affected in Hansen's disease, they are not typically noted for being specifically thickened in this condition.</li><li>• Option A.</li><li>• cervical plexus</li><li>• provide sensory innervation</li><li>• skin</li><li>• upper chest</li><li>• shoulder area</li><li>• not typically</li><li>• specifically thickened</li><li>• Option B. This nerve arises from the brachial plexus and innervates certain muscles in the back , such as the rhomboid major and minor . Involvement of this nerve in Hansen's disease is less common and it is not known for thickening in the disease.</li><li>• Option B.</li><li>• brachial plexus</li><li>• innervates</li><li>• muscles</li><li>• back</li><li>• rhomboid major</li><li>• minor</li><li>• less common</li><li>• not known</li><li>• thickening</li><li>• Option D. Also known as the cutaneous cervical nerve , it arises from the cervical plexus and supplies the skin of the anterior neck . Like the supraclavicular nerves, it can be involved in Hansen's disease but is not particularly noted for thickening.</li><li>• Option D.</li><li>• cutaneous cervical nerve</li><li>• cervical plexus</li><li>• skin</li><li>• anterior neck</li><li>• can be involved</li><li>• not particularly</li><li>• thickening.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The great auricular nerve, arising from the cervical plexus , provides sensory innervation to the skin over the parotid gland , mastoid process , and the back of the ear . In Hansen's disease, this nerve is commonly affected and can become noticeably thickened. It is often used as a clinical sign in the diagnosis of leprosy .</li><li>➤ cervical plexus</li><li>➤ sensory innervation</li><li>➤ skin</li><li>➤ parotid gland</li><li>➤ mastoid process</li><li>➤ back</li><li>➤ ear</li><li>➤ clinical sign</li><li>➤ diagnosis</li><li>➤ leprosy</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 198</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 198</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following marked structure is innervated by loop of ansa cervicalis?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture59.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture60.jpg"], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Thyrohyoid muscle is not innervated by the ansa cervicalis. Instead, it receives innervation from fibers of the first cervical nerve ( C1 ) that travel with the hypoglossal nerve ( cranial nerve XII ). The thyrohyoid muscle elevates the larynx during swallowing .</li><li>• Option A.</li><li>• not innervated</li><li>• receives innervation</li><li>• first cervical nerve</li><li>• C1</li><li>• hypoglossal nerve</li><li>• cranial nerve XII</li><li>• thyrohyoid muscle</li><li>• larynx</li><li>• swallowing</li><li>• Option B. Superior Belly of Omohyoid muscle is indeed innervated by the superior root of the ansa cervicalis . The omohyoid muscle , which has two bellies , is involved in lowering the hyoid bone and larynx during swallowing and speaking .</li><li>• Option B.</li><li>• innervated</li><li>• superior root</li><li>• ansa cervicalis</li><li>• omohyoid muscle</li><li>• two bellies</li><li>• lowering</li><li>• hyoid bone</li><li>• larynx</li><li>• swallowing</li><li>• speaking</li><li>• Option D. Scalenus Medius muscle is not innervated by the ansa cervicalis . The scalene muscles , including the scalenus medius , are primarily innervated by direct branches from the cervical spinal nerves ( C3-C8 ). The scalene muscles are involved in lateral flexion of the neck and elevation of the first and second ribs during forced inspiration.</li><li>• Option D.</li><li>• not innervated</li><li>• ansa cervicalis</li><li>• scalene muscles</li><li>• scalenus medius</li><li>• direct branches</li><li>• cervical spinal nerves</li><li>• C3-C8</li><li>• lateral flexion</li><li>• neck</li><li>• elevation</li><li>• first</li><li>• second ribs</li><li>• forced inspiration.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior belly of the omohyoid muscle is also innervated by the ansa cervicalis , specifically by its inferior root . Like the superior belly , it functions in depressing the hyoid bone and larynx .</li><li>➤ inferior belly of the omohyoid muscle</li><li>➤ ansa cervicalis</li><li>➤ inferior root</li><li>➤ superior belly</li><li>➤ depressing</li><li>➤ hyoid bone</li><li>➤ larynx</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The following picture exhibit which cranial nerve palsy:", "options": [{"label": "A", "text": "III", "correct": false}, {"label": "B", "text": "VII", "correct": false}, {"label": "C", "text": "IV", "correct": false}, {"label": "D", "text": "VI", "correct": true}], "correct_answer": "D. VI", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture28.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture5_a1uCbex.jpg"], "explanation": "<p><strong>Ans. D) VI</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. III nerve palsy will result in ptosis , external squint , dilated pupil , loss of accommodation reflex .</li><li>• Option A.</li><li>• ptosis</li><li>• external squint</li><li>• dilated pupil</li><li>• loss of accommodation reflex</li><li>• Option B. Facial nerve: Facial nerve supplies the muscles of face . Injury to it leads to facial palsy .</li><li>• Option B.</li><li>• muscles of face</li><li>• Injury</li><li>• facial palsy</li><li>• Option C. Trochlear nerve: it supplies the superior oblique muscle of eye .</li><li>• Option C.</li><li>• superior oblique muscle</li><li>• eye</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Abducens nerve palsy causes inability to deviate the eyeball laterally due to paralysis of the rectus muscle. Abducens nerve enters orbit through the intermediate compartment of superior orbital fissure .</li><li>• Abducens nerve palsy causes inability to deviate the eyeball laterally due to paralysis of the rectus muscle.</li><li>• Abducens</li><li>• eyeball laterally</li><li>• paralysis</li><li>• rectus muscle.</li><li>• Abducens nerve enters orbit through the intermediate compartment of superior orbital fissure .</li><li>• Abducens</li><li>• orbit</li><li>• superior orbital fissure</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which cranial nerve emerges from pons and passes through the intermediate compartment of superior oblique fissure and innervates which of the pointed structure?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture30.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Superior rectus , innervated by upper division of Oculomotor nerve .</li><li>• Option B</li><li>• Superior rectus</li><li>• upper division</li><li>• Oculomotor nerve</li><li>• Option C . Superior oblique muscle -lies along junction of roof with medial wall , above medial rectus innervated by Trochlear nerve .</li><li>• Option C</li><li>• Superior oblique muscle</li><li>• roof with medial wall</li><li>• medial rectus</li><li>• Trochlear nerve</li><li>• Option D . Medial rectus innervated by lower division of Oculomotor nerve which also supplies inferior rectus and inferior oblique .</li><li>• Option D</li><li>• Medial rectus</li><li>• lower division</li><li>• Oculomotor nerve</li><li>• inferior rectus</li><li>• inferior oblique</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lateral rectus: Abducens nerve arises from lower pons , emerges at pontomedullary junction . Injury to it will cause lateral gaze palsy .</li><li>➤ Lateral rectus: Abducens nerve arises from lower pons , emerges at pontomedullary junction . Injury to it will cause lateral gaze palsy .</li><li>➤ lower pons</li><li>➤ pontomedullary junction</li><li>➤ lateral gaze palsy</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 256</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 256</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An Incision to Remove Submandibular Salivary Gland can damage all except:", "options": [{"label": "A", "text": "Hypoglossal Nerve", "correct": false}, {"label": "B", "text": "Lingual Nerve", "correct": false}, {"label": "C", "text": "Marginal Mandibular Nerve", "correct": false}, {"label": "D", "text": "Buccal Nerve", "correct": true}], "correct_answer": "D. Buccal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132525.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132540.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132620.jpg"], "explanation": "<p><strong>Ans. D) Buccal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Hypoglossal nerve rests over hyoglossus and is related to the medial surface and cervical branch of facial nerve to the inferior surface of the gland. The hypoglossal nerve ( CN XII ) runs close to the submandibular gland , especially as it travels in the submandibular region towards the tongue . It is responsible for motor innervation to the muscles of the tongue . Damage to this nerve during surgery can lead to tongue weakness or paralysis on the affected side .</li><li>• Option A:</li><li>• Hypoglossal nerve</li><li>• hyoglossus</li><li>• medial surface</li><li>• cervical branch</li><li>• facial nerve</li><li>• inferior surface</li><li>• hypoglossal nerve</li><li>• CN XII</li><li>• close</li><li>• submandibular gland</li><li>• travels</li><li>• submandibular region</li><li>• tongue</li><li>• motor innervation</li><li>• muscles</li><li>• tongue</li><li>• surgery</li><li>• tongue weakness</li><li>• paralysis</li><li>• affected side</li><li>• Option B: The lingual presents a triple relation to the duct of the submandibular gland . Initially lies above and lateral , then winds around its lower border , then ascends medial to it. The lingual nerve , a branch of the mandibular division of the trigeminal nerve ( CN V3 ), provides sensory innervation to the anterior two-thirds of the tongue and the floor of the mouth . It runs close to the submandibular gland and duct , making it susceptible to injury during submandibular gland surgery .</li><li>• Option B:</li><li>• lingual</li><li>• triple relation</li><li>• duct</li><li>• submandibular gland</li><li>• lies above</li><li>• lateral</li><li>• lower border</li><li>• ascends medial</li><li>• lingual nerve</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• CN V3</li><li>• sensory innervation</li><li>• anterior two-thirds</li><li>• tongue</li><li>• floor</li><li>• mouth</li><li>• close</li><li>• submandibular gland</li><li>• duct</li><li>• susceptible</li><li>• injury</li><li>• submandibular gland surgery</li><li>• Option C: An incision to remove submandibular gland is placed 2 to 4 cm below lower border of mandible to avoid injury to marginal mandibular nerve . The marginal mandibular branch of the facial nerve ( CN VII ) provides motor innervation to the muscles of the lower lip and chin . It runs just below the mandible and may be at risk during an incision for submandibular gland removal , especially if the incision is extended or dissection is carried too far anteriorly or superiorly .</li><li>• Option C:</li><li>• incision</li><li>• remove submandibular gland</li><li>• 2</li><li>• 4 cm below lower border</li><li>• mandible</li><li>• avoid injury</li><li>• marginal mandibular nerve</li><li>• facial nerve</li><li>• CN VII</li><li>• motor innervation</li><li>• muscles</li><li>• lower lip</li><li>• chin</li><li>• below</li><li>• mandible</li><li>• during</li><li>• incision</li><li>• submandibular gland removal</li><li>• incision</li><li>• extended</li><li>• dissection</li><li>• carried too far</li><li>• anteriorly</li><li>• superiorly</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Buccal Nerve, another branch of the mandibular division of the trigeminal nerve ( CN V3 ), provides sensory innervation to the skin over the buccal ( cheek ) region and the mucous membrane of the cheek .</li><li>➤ The Buccal Nerve, another branch of the mandibular division of the trigeminal nerve ( CN V3 ), provides sensory innervation to the skin over the buccal ( cheek ) region and the mucous membrane of the cheek .</li><li>➤ The Buccal Nerve, another branch of the mandibular division of the trigeminal nerve ( CN V3 ), provides sensory innervation to the skin over the buccal ( cheek ) region and the mucous membrane of the cheek .</li><li>➤ branch</li><li>➤ mandibular division</li><li>➤ trigeminal nerve</li><li>➤ CN V3</li><li>➤ sensory innervation</li><li>➤ skin</li><li>➤ buccal</li><li>➤ cheek</li><li>➤ region</li><li>➤ mucous membrane</li><li>➤ cheek</li><li>➤ Given its location, it is less likely to be in the field of surgical dissection for submandibular gland removal , which is more inferior and medial compared to the usual course of the buccal nerve .</li><li>➤ Given its location, it is less likely to be in the field of surgical dissection for submandibular gland removal , which is more inferior and medial compared to the usual course of the buccal nerve .</li><li>➤ Given its location, it is less likely to be in the field of surgical dissection for submandibular gland removal , which is more inferior and medial compared to the usual course of the buccal nerve .</li><li>➤ field</li><li>➤ surgical dissection</li><li>➤ submandibular gland</li><li>➤ removal</li><li>➤ more inferior</li><li>➤ medial</li><li>➤ usual course</li><li>➤ buccal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 121</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 121</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which muscle helps in opening of jaw?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-114.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture66.jpg"], "explanation": "<p><strong>Ans. D) Lateral Pterygoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The Masseter muscle is one of the strongest muscles in your body, relative to its size. Its primary action is the elevation of the mandible . When the Masseter contracts , it exerts a powerful force that is essential for chewing , allowing the teeth to crush and grind food .</li><li>• Option A</li><li>• strongest muscles</li><li>• elevation</li><li>• mandible</li><li>• Masseter contracts</li><li>• powerful force</li><li>• chewing</li><li>• allowing</li><li>• teeth</li><li>• crush</li><li>• grind food</li><li>• Option B. The Temporalis muscle assists in elevating the mandible, contributing to the closing of the jaw . Additionally, due to its attachment points and the direction of its fibers , it can help retract the mandible , pulling it backward if protruded . This retraction is important for the grinding motion during chewing .</li><li>• Option B.</li><li>• elevating</li><li>• mandible,</li><li>• closing</li><li>• jaw</li><li>• attachment points</li><li>• direction</li><li>• fibers</li><li>• help retract</li><li>• mandible</li><li>• pulling</li><li>• backward if protruded</li><li>• retraction</li><li>• grinding motion</li><li>• chewing</li><li>• Option C . The Medial Pterygoid muscle, similar to the Masseter , primarily acts to elevate the mandible , aiding in jaw closure. It also plays a role in the side-to-side movement of the jaw, which is important for the grinding of food .</li><li>• Option C</li><li>• Masseter</li><li>• elevate</li><li>• mandible</li><li>• aiding in jaw closure.</li><li>• side-to-side movement</li><li>• jaw,</li><li>• grinding</li><li>• food</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Lateral Pterygoid muscle has a different action from the other three muscles. It primarily contributes to the depression of the mandible and protrusion of the mandible. It is also involved in side-to-side movements of the jaw . The Lateral Pterygoid is unique among the masticatory muscles in that it helps to open the jaw , whereas the others are more involved in closing the jaw .</li><li>➤ depression</li><li>➤ mandible</li><li>➤ protrusion</li><li>➤ mandible.</li><li>➤ side-to-side movements</li><li>➤ jaw</li><li>➤ open the jaw</li><li>➤ closing the jaw</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 103</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 103</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Abduction of vocal cord is done by:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-115.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-183705.jpg"], "explanation": "<p><strong>Ans. D) D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The Cricothyroid muscle lengthens and tenses the vocal cords by tilting the thyroid cartilage forward relative to the cricoid cartilage . This action increases the pitch of the voice by making the vocal cords longer and tighter , which is essential for producing higher-frequency sounds .</li><li>• Option A</li><li>• lengthens</li><li>• tenses</li><li>• vocal cords</li><li>• tilting the thyroid cartilage</li><li>• forward</li><li>• cricoid cartilage</li><li>• increases</li><li>• pitch</li><li>• voice</li><li>• vocal cords longer</li><li>• tighter</li><li>• producing higher-frequency sounds</li><li>• Option B. The Thyroarytenoid muscle, including its internal part known as the vocalis muscle , shortens and relaxes the vocal cords . This action decreases the tension on the vocal cords , lowering the pitch of the voice . The Thyroarytenoid muscle is the main muscle within the body of the vocal cords and contributes to their mass and tension , affecting vocal quality .</li><li>• Option B.</li><li>• internal part</li><li>• vocalis muscle</li><li>• shortens</li><li>• relaxes</li><li>• vocal cords</li><li>• decreases</li><li>• tension</li><li>• vocal cords</li><li>• lowering</li><li>• pitch</li><li>• voice</li><li>• main muscle</li><li>• body</li><li>• vocal cords</li><li>• mass</li><li>• tension</li><li>• vocal quality</li><li>• Option C . The Lateral Cricoarytenoid muscle adducts the vocal cords , meaning it brings them together. This action is crucial for phonation (producing sound) as it closes the glottis (the space between the vocal cords ). The muscle plays a key role in voice modulation and is active when speaking or singing .</li><li>• Option C</li><li>• adducts</li><li>• vocal cords</li><li>• crucial</li><li>• phonation</li><li>• closes</li><li>• glottis</li><li>• space between the vocal cords</li><li>• voice modulation</li><li>• active</li><li>• speaking</li><li>• singing</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior cricoarytenoid causes abduction of vocal cord. The Posterior Cricoarytenoid muscle is the only muscle in the larynx that abducts the vocal cords , meaning it pulls them apart. This action is essential for breathing , as it opens the glottis to allow air to flow into the lungs . It is the primary muscle responsible for keeping the airway open during respiration.</li><li>➤ Posterior cricoarytenoid causes abduction of vocal cord.</li><li>➤ Posterior cricoarytenoid</li><li>➤ The Posterior Cricoarytenoid muscle is the only muscle in the larynx that abducts the vocal cords , meaning it pulls them apart. This action is essential for breathing , as it opens the glottis to allow air to flow into the lungs . It is the primary muscle responsible for keeping the airway open during respiration.</li><li>➤ only muscle</li><li>➤ larynx</li><li>➤ abducts</li><li>➤ vocal cords</li><li>➤ breathing</li><li>➤ opens</li><li>➤ glottis</li><li>➤ allow air to flow into</li><li>➤ lungs</li><li>➤ primary muscle</li><li>➤ airway open</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Action of the pointed structure on vocal cord:", "options": [{"label": "A", "text": "Closure of Laryngeal inlet", "correct": false}, {"label": "B", "text": "Adduction", "correct": false}, {"label": "C", "text": "Opening of Laryngeal inlet", "correct": true}, {"label": "D", "text": "Relaxation", "correct": false}], "correct_answer": "C. Opening of Laryngeal inlet", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-116.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture68.jpg"], "explanation": "<p><strong>Ans. C) Opening of Laryngeal inlet</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Closure of laryngeal inlet is caused by aryepiglotticus muscle</li><li>• Option A</li><li>• Closure</li><li>• laryngeal inlet</li><li>• aryepiglotticus muscle</li><li>• Option B . Adduction of rima glottis is caused by transverse arytenoid , oblique arytenoid and lateral cricoarytenoid</li><li>• Option B</li><li>• Adduction</li><li>• rima glottis</li><li>• transverse arytenoid</li><li>• oblique arytenoid</li><li>• lateral cricoarytenoid</li><li>• Option D . Relaxation of vocal cord is caused by vocalis , thyroarytenoid</li><li>• Option D</li><li>• Relaxation</li><li>• vocalis</li><li>• thyroarytenoid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Thyroepiglottic causes opening of laryngeal inlet . The thyroepiglottic muscle plays a role in the opening of the laryngeal inlet , which is the entrance to the larynx (voice box) from the pharynx (throat). This muscle is part of the internal laryngeal muscles and is involved in the regulation of the laryngeal opening . When the thyroepiglottic muscle contracts , it pulls the epiglottis away from the laryngeal inlet , thereby widening the opening . This action is important for allowing air to pass freely into the larynx during breathing and helps in preventing aspiration of food and liquids into the airway during swallowing . The thyroepiglottic muscle, along with other muscles and structures of the larynx, works in a coordinated manner to protect the airway and to control the passage of air and food appropriately.</li><li>➤ Thyroepiglottic causes opening of laryngeal inlet .</li><li>➤ opening</li><li>➤ laryngeal inlet</li><li>➤ The thyroepiglottic muscle plays a role in the opening of the laryngeal inlet , which is the entrance to the larynx (voice box) from the pharynx (throat). This muscle is part of the internal laryngeal muscles and is involved in the regulation of the laryngeal opening .</li><li>➤ opening</li><li>➤ laryngeal inlet</li><li>➤ entrance</li><li>➤ larynx</li><li>➤ pharynx</li><li>➤ muscle</li><li>➤ internal laryngeal muscles</li><li>➤ regulation</li><li>➤ laryngeal opening</li><li>➤ When the thyroepiglottic muscle contracts , it pulls the epiglottis away from the laryngeal inlet , thereby widening the opening . This action is important for allowing air to pass freely into the larynx during breathing and helps in preventing aspiration of food and liquids into the airway during swallowing . The thyroepiglottic muscle, along with other muscles and structures of the larynx, works in a coordinated manner to protect the airway and to control the passage of air and food appropriately.</li><li>➤ contracts</li><li>➤ pulls</li><li>➤ epiglottis away</li><li>➤ laryngeal inlet</li><li>➤ widening the opening</li><li>➤ allowing air</li><li>➤ pass freely</li><li>➤ larynx</li><li>➤ breathing</li><li>➤ preventing aspiration</li><li>➤ food</li><li>➤ liquids</li><li>➤ airway</li><li>➤ swallowing</li><li>➤ to protect</li><li>➤ airway</li><li>➤ passage</li><li>➤ air</li><li>➤ food</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The probed space receives the opening of:", "options": [{"label": "A", "text": "Nasolacrimal Duct", "correct": true}, {"label": "B", "text": "Maxillary Sinus", "correct": false}, {"label": "C", "text": "Middle Ethmoidal Sinus", "correct": false}, {"label": "D", "text": "Posterior Ethmoidal Sinus", "correct": false}], "correct_answer": "A. Nasolacrimal Duct", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture39.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture69.jpg"], "explanation": "<p><strong>Ans. A) Nasolacrimal Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Maxillary sinus opens into middle meatus into the floor of hiatus semilunaris .</li><li>• Option B.</li><li>• Maxillary sinus</li><li>• middle meatus</li><li>• floor</li><li>• hiatus semilunaris</li><li>• Option C. Middle ethmoidal sinus opens into middle meatus on surface of bulla ethmoidalis .</li><li>• Option C.</li><li>• Middle ethmoidal sinus</li><li>• middle meatus</li><li>• surface</li><li>• bulla ethmoidalis</li><li>• Option D . Posterior ethmoidal cells opens into superior meatus</li><li>• Option D</li><li>• Posterior ethmoidal cells</li><li>• superior meatus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Inferior meatus receives the opening of nasolacrimal duct . The inferior meatus is indeed the location within the nasal cavity where the nasolacrimal duct opens . The nasolacrimal duct is responsible for draining tears from the lacrimal sac , which collects tears from the eyes , into the nasal cavity . This duct allows for the tears, along with any debris or foreign particles collected from the eye surface , to be flushed into the nasal cavity and then swallowed or expelled . The opening of the nasolacrimal duct into the inferior meatus is a key component of the lacrimal apparatus , which is involved in tear production and drainage . This anatomical arrangement explains why your nose may run when you cry , as tears from the eyes overflow into the nasal cavity . Issues with the nasolacrimal duct, such as blockages , can lead to tear drainage problems , resulting in watery eyes or infections .</li><li>➤ Inferior meatus receives the opening of nasolacrimal duct .</li><li>➤ Inferior meatus</li><li>➤ opening</li><li>➤ nasolacrimal duct</li><li>➤ The inferior meatus is indeed the location within the nasal cavity where the nasolacrimal duct opens . The nasolacrimal duct is responsible for draining tears from the lacrimal sac , which collects tears from the eyes , into the nasal cavity . This duct allows for the tears, along with any debris or foreign particles collected from the eye surface , to be flushed into the nasal cavity and then swallowed or expelled .</li><li>➤ within</li><li>➤ the nasal cavity</li><li>➤ nasolacrimal duct opens</li><li>➤ nasolacrimal duct</li><li>➤ draining tears</li><li>➤ lacrimal sac</li><li>➤ collects</li><li>➤ from the eyes</li><li>➤ nasal cavity</li><li>➤ debris</li><li>➤ foreign particles collected</li><li>➤ eye</li><li>➤ surface</li><li>➤ flushed</li><li>➤ nasal cavity</li><li>➤ swallowed</li><li>➤ expelled</li><li>➤ The opening of the nasolacrimal duct into the inferior meatus is a key component of the lacrimal apparatus , which is involved in tear production and drainage . This anatomical arrangement explains why your nose may run when you cry , as tears from the eyes overflow into the nasal cavity . Issues with the nasolacrimal duct, such as blockages , can lead to tear drainage problems , resulting in watery eyes or infections .</li><li>➤ opening</li><li>➤ nasolacrimal duct</li><li>➤ inferior meatus</li><li>➤ lacrimal apparatus</li><li>➤ tear production</li><li>➤ drainage</li><li>➤ anatomical arrangement</li><li>➤ why your nose</li><li>➤ run when you cry</li><li>➤ overflow</li><li>➤ nasal cavity</li><li>➤ blockages</li><li>➤ tear drainage problems</li><li>➤ watery eyes</li><li>➤ infections</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 217</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 217</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the rightly matched pair:", "options": [{"label": "A", "text": "A-Hyoglossus", "correct": false}, {"label": "B", "text": "B-Genioglossus", "correct": false}, {"label": "C", "text": "C-Masseter", "correct": false}, {"label": "D", "text": "D-Mylohyoid", "correct": true}], "correct_answer": "D. D-Mylohyoid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/screenshot-2023-06-09-154439.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) D-Mylohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Genioglossus forms the bulk of the tongue extending from the tip to root of the tongue .</li><li>• Option A</li><li>• Genioglossus</li><li>• bulk</li><li>• tongue</li><li>• tip</li><li>• root</li><li>• tongue</li><li>• Option B. Hyoglossus divides the course of lingual artery into three parts</li><li>• Option B.</li><li>• Hyoglossus</li><li>• lingual artery</li><li>• three parts</li><li>• Option C . Masseter muscle is a thick , quadrilateral muscle located on each side of the face . It originates from the zygomatic arch (the bony arch at the side of the skull ) and inserts into the angle and lower border of the mandible (lower jawbone).</li><li>• Option C</li><li>• Masseter</li><li>• thick</li><li>• quadrilateral muscle</li><li>• each side</li><li>• face</li><li>• zygomatic arch</li><li>• bony arch</li><li>• side</li><li>• skull</li><li>• inserts</li><li>• angle</li><li>• lower border</li><li>• mandible</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mylohyoid divides the submandibular salivary gland into a superficial and deep part .</li><li>➤ Mylohyoid</li><li>➤ submandibular salivary gland</li><li>➤ superficial</li><li>➤ deep part</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 142</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are tributaries of the pinned structure, except?", "options": [{"label": "A", "text": "Superior Ophthalmic Vein", "correct": false}, {"label": "B", "text": "Petrosquamous Sinus", "correct": true}, {"label": "C", "text": "Sphenoparietal Sinus", "correct": false}, {"label": "D", "text": "Superficial Middle Cerebral Vein", "correct": false}], "correct_answer": "B. Petrosquamous Sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture45.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture1_LeYPmtb.jpg"], "explanation": "<p><strong>Ans. B) Petrosquamous Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The superior ophthalmic veins pass through the medial compartment of superior orbital fissure to open into the cavernous sinus .</li><li>• Option A</li><li>• superior ophthalmic veins</li><li>• medial compartment</li><li>• superior orbital fissure</li><li>• cavernous sinus</li><li>• Option C . Sphenoparietal sinus is located along the posterior border of lesser wing of sphenoid .</li><li>• Option C</li><li>• Sphenoparietal sinus</li><li>• posterior border</li><li>• lesser wing</li><li>• sphenoid</li><li>• Option D . Cavernous sinus communicates with the superior sagittal sinus via superficial middle cerebral vein superior anastomotic vein .</li><li>• Option D</li><li>• Cavernous sinus</li><li>• superior sagittal sinus</li><li>• superficial middle cerebral</li><li>• superior anastomotic vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cavernous sinus , a large collection of thin-walled veins located on either side of the pituitary gland , receives blood from multiple tributaries . These tributaries include:</li><li>➤ cavernous sinus</li><li>➤ large collection</li><li>➤ thin-walled veins</li><li>➤ pituitary gland</li><li>➤ blood</li><li>➤ multiple tributaries</li><li>➤ Superior Ophthalmic Vein : Drains the orbit and parts of the face into the cavernous sinus . Inferior Ophthalmic Vein : Although it can be variable, this vein often drains into the cavernous sinus , providing an additional pathway for venous blood from the orbit . Sphenoparietal Sinus : Runs along the edge of the lesser wing of the sphenoid bone and drains blood from the surface of the brain into the cavernous sinus. Middle Cerebral Vein : Sometimes the middle cerebral vein, through its superficial and deep tributaries, can drain into the cavernous sinus , although this can be variable. Emissary Veins : These veins pass through various foramina in the skull and can connect the extracranial venous system with the cavernous sinus , serving as potential routes for infection spread.</li><li>➤ Superior Ophthalmic Vein : Drains the orbit and parts of the face into the cavernous sinus .</li><li>➤ Superior Ophthalmic Vein</li><li>➤ orbit</li><li>➤ face</li><li>➤ the cavernous sinus</li><li>➤ Inferior Ophthalmic Vein : Although it can be variable, this vein often drains into the cavernous sinus , providing an additional pathway for venous blood from the orbit .</li><li>➤ Inferior Ophthalmic Vein</li><li>➤ cavernous sinus</li><li>➤ venous blood</li><li>➤ orbit</li><li>➤ Sphenoparietal Sinus : Runs along the edge of the lesser wing of the sphenoid bone and drains blood from the surface of the brain into the cavernous sinus.</li><li>➤ Sphenoparietal Sinus</li><li>➤ lesser wing</li><li>➤ sphenoid bone</li><li>➤ blood</li><li>➤ brain</li><li>➤ cavernous sinus.</li><li>➤ Middle Cerebral Vein : Sometimes the middle cerebral vein, through its superficial and deep tributaries, can drain into the cavernous sinus , although this can be variable.</li><li>➤ Middle Cerebral Vein</li><li>➤ superficial</li><li>➤ deep</li><li>➤ cavernous sinus</li><li>➤ Emissary Veins : These veins pass through various foramina in the skull and can connect the extracranial venous system with the cavernous sinus , serving as potential routes for infection spread.</li><li>➤ Emissary Veins</li><li>➤ foramina</li><li>➤ extracranial venous system</li><li>➤ cavernous sinus</li><li>➤ infection spread.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 351.</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 351.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following nerve innervate the muscle attached to the pointed structure except:", "options": [{"label": "A", "text": "IX", "correct": false}, {"label": "B", "text": "X", "correct": true}, {"label": "C", "text": "VII", "correct": false}, {"label": "D", "text": "XII", "correct": false}], "correct_answer": "B. X", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture2.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture3_MfcLXDI.jpg"], "explanation": "<p><strong>Ans. B) X</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . IX nerve innervates Stylopharyngeus muscle</li><li>• Option A</li><li>• Stylopharyngeus muscle</li><li>• Option C. VII nerve innervates Stylohyoid muscle</li><li>• Option C.</li><li>• Stylohyoid muscle</li><li>• Option D . XII nerve innervates Styloglossus</li><li>• Option D</li><li>• Styloglossus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Stylohyoid, styloglossus, stylopharyngeus muscle originates from the styloid process .</li><li>➤ Stylohyoid, styloglossus, stylopharyngeus muscle originates from the styloid process .</li><li>➤ Stylohyoid, styloglossus, stylopharyngeus muscle</li><li>➤ styloid process</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pinned structure?", "options": [{"label": "A", "text": "It is a continuation of transverse sinus", "correct": false}, {"label": "B", "text": "It passes through the anterior compartment of jugular foramen to continue as internal jugular vein", "correct": true}, {"label": "C", "text": "It receives the cerebellar veins", "correct": false}, {"label": "D", "text": "Thrombosis of this structure can lead to hydrocephalus", "correct": false}], "correct_answer": "B. It passes through the anterior compartment of jugular foramen to continue as internal jugular vein", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture47.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture4_uvAOhws.jpg"], "explanation": "<p><strong>Ans. B) It passes through the anterior compartment of jugular foramen to continue as internal jugular vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The superior sagittal sinus becomes continuous with right transverse sinus and straight sinus becomes continuous with left transverse sinus</li><li>• Option A</li><li>• superior sagittal sinus</li><li>• continuous</li><li>• right transverse sinus</li><li>• straight sinus</li><li>• left transverse sinus</li><li>• Option C. It also receives the labyrinthine veins</li><li>• Option C.</li><li>• labyrinthine veins</li><li>• Option D. Sigmoid sinus is separated from the posterior wall of mastoid antrum by a thin plate of bone and mastoid air cells . It can get thrombosed in middle ear infection . Thrombosis may extend to superior sagittal sinus along transverse sinus leading to hydrocephalus .</li><li>• Option D.</li><li>• posterior wall</li><li>• mastoid antrum</li><li>• thin plate</li><li>• bone</li><li>• mastoid air cells</li><li>• thrombosed</li><li>• middle ear infection</li><li>• Thrombosis</li><li>• superior sagittal sinus</li><li>• transverse sinus</li><li>• hydrocephalus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The statement that the sigmoid sinus passes through the anterior compartment of the jugular foramen to continue as the internal jugular vein is not accurate. In fact, the sigmoid sinus passes through the posterior compartment of the jugular foramen to become the internal jugular vein .</li><li>➤ sigmoid sinus</li><li>➤ posterior compartment</li><li>➤ jugular foramen</li><li>➤ internal jugular vein</li><li>➤ The jugular foramen is divided into three compartments ( anterior, intermediate , and posterior ) by fibrous or bony septa . The anterior compartment transmits the inferior petrosal sinus , the intermediate compartment transmits the glossopharyngeal nerve (CN IX), vagus nerve (CN X), and accessory nerve (CN XI), and the posterior compartment is where the sigmoid sinus continues as the internal jugular vein . This anatomical arrangement is important for the drainage of venous blood from the brain to the neck and ultimately to the heart .</li><li>➤ jugular foramen</li><li>➤ three compartments</li><li>➤ anterior, intermediate</li><li>➤ posterior</li><li>➤ fibrous</li><li>➤ bony septa</li><li>➤ anterior compartment transmits</li><li>➤ inferior petrosal sinus</li><li>➤ intermediate compartment transmits</li><li>➤ glossopharyngeal nerve</li><li>➤ vagus nerve</li><li>➤ accessory nerve</li><li>➤ posterior compartment</li><li>➤ sigmoid sinus</li><li>➤ internal jugular vein</li><li>➤ venous blood</li><li>➤ brain</li><li>➤ neck</li><li>➤ heart</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 350</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 350</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures does not occupy the interval shown by the pointed structure in the image given below?", "options": [{"label": "A", "text": "Pharyngeal branches of Vagus", "correct": false}, {"label": "B", "text": "Styloid process of Temporal bone", "correct": false}, {"label": "C", "text": "A part of Parotid gland", "correct": false}, {"label": "D", "text": "Stylohyoid", "correct": true}], "correct_answer": "D. Stylohyoid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/14/whatsapp-image-2024-02-14-at-112136-am.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stylohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The interval pointed in the above image is the space between internal &amp; external carotid arteries in the upper part of the neck .</li><li>• Option A.</li><li>• above image</li><li>• space</li><li>• internal</li><li>• external carotid arteries</li><li>• upper part</li><li>• neck</li><li>• Option B. Styloid process with styloglossus , stylopharyngeus &amp; glossopharyngeal nerve lie in this interval .</li><li>• Option B.</li><li>• Styloid process</li><li>• styloglossus</li><li>• stylopharyngeus</li><li>• glossopharyngeal</li><li>• interval</li><li>• Option C. The posteromedial surface of parotid gland is related here.</li><li>• Option C.</li><li>• posteromedial surface</li><li>• parotid gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Stylohyoid arises from posterior surface of styloid process midway between its tip and base and is supplied by facial nerve. The statement that the stylohyoid muscle occupies the space between the internal and external carotid arteries in the upper part of the neck is not accurate . The stylohyoid is a slender muscle that runs from the styloid process of the temporal bone to the hyoid bone . Its primary function is to elevate the hyoid bone , which aids in swallowing and speech . The internal and external carotid arteries are major blood vessels in the neck that supply blood to the head and neck . The internal carotid artery does not have branches in the neck , whereas the external carotid artery has several branches that supply various structures in the head and neck . The stylohyoid muscle is located more superficially compared to the carotid arteries , and it does not occupy the space between these arteries . Instead, structures such as the styloglossus and stylopharyngeus muscles , parts of the glossopharyngeal nerve , and the pharyngeal branch of the vagus nerve are found in closer relation to the space between the internal and external carotid arteries , especially as they ascend in the neck .</li><li>➤ Stylohyoid arises from posterior surface of styloid process midway between its tip and base and is supplied by facial nerve.</li><li>➤ Stylohyoid</li><li>➤ posterior surface</li><li>➤ styloid process</li><li>➤ midway</li><li>➤ tip</li><li>➤ base</li><li>➤ facial nerve.</li><li>➤ The statement that the stylohyoid muscle occupies the space between the internal and external carotid arteries in the upper part of the neck is not accurate . The stylohyoid is a slender muscle that runs from the styloid process of the temporal bone to the hyoid bone . Its primary function is to elevate the hyoid bone , which aids in swallowing and speech .</li><li>➤ stylohyoid muscle</li><li>➤ space</li><li>➤ internal</li><li>➤ external carotid arteries</li><li>➤ upper part</li><li>➤ neck</li><li>➤ not accurate</li><li>➤ stylohyoid</li><li>➤ slender muscle</li><li>➤ styloid process</li><li>➤ temporal bone</li><li>➤ hyoid bone</li><li>➤ elevate the hyoid bone</li><li>➤ swallowing</li><li>➤ speech</li><li>➤ The internal and external carotid arteries are major blood vessels in the neck that supply blood to the head and neck . The internal carotid artery does not have branches in the neck , whereas the external carotid artery has several branches that supply various structures in the head and neck .</li><li>➤ internal</li><li>➤ external carotid arteries</li><li>➤ major blood vessels</li><li>➤ neck</li><li>➤ blood</li><li>➤ head</li><li>➤ neck</li><li>➤ internal carotid artery</li><li>➤ not</li><li>➤ neck</li><li>➤ external carotid artery</li><li>➤ head</li><li>➤ neck</li><li>➤ The stylohyoid muscle is located more superficially compared to the carotid arteries , and it does not occupy the space between these arteries . Instead, structures such as the styloglossus and stylopharyngeus muscles , parts of the glossopharyngeal nerve , and the pharyngeal branch of the vagus nerve are found in closer relation to the space between the internal and external carotid arteries , especially as they ascend in the neck .</li><li>➤ stylohyoid muscle</li><li>➤ superficially</li><li>➤ carotid arteries</li><li>➤ space between</li><li>➤ arteries</li><li>➤ structures</li><li>➤ styloglossus</li><li>➤ stylopharyngeus muscles</li><li>➤ glossopharyngeal nerve</li><li>➤ pharyngeal branch</li><li>➤ vagus nerve</li><li>➤ internal</li><li>➤ external carotid arteries</li><li>➤ ascend</li><li>➤ neck</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is true about the pointed structure in the given diagram?", "options": [{"label": "A", "text": "Related to posteroinferior angle of Masseter", "correct": false}, {"label": "B", "text": "Winds around the Ramus of the Mandible upward &amp; forward", "correct": false}, {"label": "C", "text": "Facial Artery crosses Superficial to it", "correct": true}, {"label": "D", "text": "It is the lowermost branch of Facial Nerve", "correct": false}], "correct_answer": "C. Facial Artery crosses Superficial to it", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-119.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Facial Artery crosses Superficial to it</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Related to posteroinferior angle of masseter : This statement is incorrect. The marginal mandibular branch of the facial nerve does not relate directly to the posteroinferior angle of the masseter muscle . Instead, it runs in the facial region , below the mandible , and is more closely associated with the lower border of the mandible rather than the masseter muscle.</li><li>• Option A. Related to posteroinferior angle of masseter</li><li>• incorrect.</li><li>• marginal mandibular</li><li>• facial nerve</li><li>• posteroinferior angle</li><li>• masseter muscle</li><li>• facial region</li><li>• mandible</li><li>• lower border</li><li>• mandible</li><li>• masseter</li><li>• Option B. This statement is incorrect . The marginal mandibular branch does not wind around the ramus of the mandible upward and forward . Instead, it runs near the lower border of the mandible . It's the facial nerve's branches that emerge from the stylomastoid foramen and give off various branches, including the marginal mandibular branch , which runs horizontally forward beneath the lower border of the mandible .</li><li>• Option B.</li><li>• incorrect</li><li>• marginal mandibular branch</li><li>• not wind</li><li>• ramus</li><li>• mandible</li><li>• upward</li><li>• forward</li><li>• lower border</li><li>• mandible</li><li>• facial nerve's</li><li>• stylomastoid foramen</li><li>• marginal mandibular branch</li><li>• horizontally</li><li>• forward</li><li>• lower border</li><li>• mandible</li><li>• Option D. While the marginal mandibular branch is one of the lower branches of the facial nerve , which innervates the platysma muscle . The marginal mandibular branch , however, is the lowest branch that controls the muscles affecting the lips .</li><li>• Option D.</li><li>• lower branches</li><li>• facial nerve</li><li>• platysma muscle</li><li>• marginal mandibular branch</li><li>• lowest branch</li><li>• muscles affecting</li><li>• lips</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The facial artery can cross superficial to the marginal mandibular branch of the facial nerve . This anatomical relationship is significant, especially during surgical procedures in the neck and lower face , as it poses a risk for nerve damage if not properly identified.</li><li>➤ facial artery</li><li>➤ superficial</li><li>➤ marginal mandibular branch</li><li>➤ facial nerve</li><li>➤ anatomical relationship</li><li>➤ surgical procedures</li><li>➤ neck</li><li>➤ lower face</li><li>➤ nerve damage</li><li>➤ Facial vein also crosses superficial to it.</li><li>➤ Facial vein</li><li>➤ superficial</li><li>➤ Ref: IB Singh Textbook of Anatomy Glossopharyngeal Vol.3 Head and Neck, Neuroanatomy 7th Edition Pg 397</li><li>➤ Ref: IB Singh Textbook of Anatomy Glossopharyngeal Vol.3 Head and Neck, Neuroanatomy 7th Edition Pg 397</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The convicts of a gang rape case currently locked up in jail will be soon executed their death sentence as per the judgement. As per Indian laws hanging is the only mode of executing a death sentence for civilians. Which of the following statements is true in relation to the pointed structure?", "options": [{"label": "A", "text": "The median atlantoaxial joint is a hinge synovial joint", "correct": false}, {"label": "B", "text": "The lateral atlantoaxial joint is a plane synovial joint", "correct": false}, {"label": "C", "text": "The alar ligaments rupture in death due to judicial hanging", "correct": true}, {"label": "D", "text": "Apical ligament extends from dens to the posterior margin of foramen magnum", "correct": false}], "correct_answer": "C. The alar ligaments rupture in death due to judicial hanging", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture73_hoFiBMr.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture7_JhfxCjz.jpg"], "explanation": "<p><strong>Ans. C) The alar ligaments rupture in death due to judicial hanging</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . There are 3 synovial joints between the atlas and axis-one median &amp; two lateral joints . The median atlantoaxial joint is a pivot joint .</li><li>• Option A</li><li>• 3 synovial joints</li><li>• atlas</li><li>• axis-one median</li><li>• two lateral joints</li><li>• median atlantoaxial</li><li>• pivot joint</li><li>• Option B. lateral atlantoaxial joints participate in rotation of the head and also transmit the weight of the skull through atlanto occipital joints .</li><li>• Option B.</li><li>• lateral atlantoaxial joints</li><li>• rotation</li><li>• head</li><li>• transmit</li><li>• weight</li><li>• skull</li><li>• atlanto occipital joints</li><li>• Option D . Apical ligament of dens extends from tip of dens to basilar part of occipital bone close to anterior margin of foramen magnum .</li><li>• Option D</li><li>• Apical ligament</li><li>• dens</li><li>• tip</li><li>• dens</li><li>• basilar part</li><li>• occipital bone</li><li>• anterior margin</li><li>• foramen magnum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In death due to judicial hanging there is either rupture of transverse ligament or fracture of dens , as a result the atlas is dislocated from axis and compress spinal cord with fatal outcome</li><li>➤ In death due to judicial hanging there is either rupture of transverse ligament or fracture of dens , as a result the atlas is dislocated from axis and compress spinal cord with fatal outcome</li><li>➤ death</li><li>➤ judicial hanging</li><li>➤ rupture</li><li>➤ transverse ligament</li><li>➤ fracture of dens</li><li>➤ atlas is dislocated</li><li>➤ axis</li><li>➤ compress spinal cord</li><li>➤ fatal outcome</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 58</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 58</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not correct in relation to the above image?", "options": [{"label": "A", "text": "The vertebral level of B is C3", "correct": false}, {"label": "B", "text": "The posterior border of C receives the insertion longitudinal muscles of pharynx", "correct": false}, {"label": "C", "text": "The body of B receives the insertion of middle constrictor muscle", "correct": true}, {"label": "D", "text": "The vertebral level of C corresponds to the C4 &amp; C5 vertebra", "correct": false}], "correct_answer": "C. The body of B receives the insertion of middle constrictor muscle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-123.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The body of B receives the insertion of middle constrictor muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The vertebral level of hyoid bone is at C3 level .</li><li>• Option A.</li><li>• vertebral level</li><li>• hyoid bone</li><li>• C3 level</li><li>• Option B. Posterior border of thyroid cartilage receives the insertion of stylopharyngeus, palatopharyngeus &amp; salpingopharyngeus .</li><li>• Option B.</li><li>• Posterior border</li><li>• thyroid cartilage</li><li>• insertion</li><li>• stylopharyngeus, palatopharyngeus</li><li>• salpingopharyngeus</li><li>• Option D. Thyroid cartilage lies opposite C4 &amp; C5 vertebra and thyroid gland lies opposite C5 C6 C7 &amp; T1 vertebra .</li><li>• Option D.</li><li>• Thyroid cartilage</li><li>• opposite</li><li>• C4</li><li>• C5</li><li>• vertebra</li><li>• thyroid gland</li><li>• opposite</li><li>• C5 C6</li><li>• C7</li><li>• T1 vertebra</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The greater cornu of hyoid bone gives attachment to middle constrictor muscle . Body of hyoid gives origin to some fibres of hyoglossus genioglossus and insertion to geniohyoid, mylohyoid, sternohyoid &amp; superior belly of omohyoid .</li><li>➤ The greater cornu of hyoid bone gives attachment to middle constrictor muscle . Body of hyoid gives origin to some fibres of hyoglossus genioglossus and insertion to geniohyoid, mylohyoid, sternohyoid &amp; superior belly of omohyoid .</li><li>➤ greater cornu</li><li>➤ hyoid bone</li><li>➤ attachment</li><li>➤ middle constrictor muscle</li><li>➤ Body of hyoid</li><li>➤ hyoglossus genioglossus</li><li>➤ insertion</li><li>➤ geniohyoid, mylohyoid, sternohyoid</li><li>➤ superior belly of omohyoid</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 238</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 238</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pointed structure?", "options": [{"label": "A", "text": "Styloglossus arises from anterior surface of the tip", "correct": false}, {"label": "B", "text": "Laterally it is related to Parotid gland", "correct": false}, {"label": "C", "text": "Medially related to internal Carotid Artery", "correct": false}, {"label": "D", "text": "Stylopharyngeus arises from the Posterior surface", "correct": true}], "correct_answer": "D. Stylopharyngeus arises from the Posterior surface", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture2_NmIEMlN.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stylopharyngeus arises from the Posterior surface</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The stylopharyngeus arises from the medial surface of styloid process from temporal bone</li><li>• Option A</li><li>• stylopharyngeus</li><li>• medial surface</li><li>• styloid process</li><li>• temporal bone</li><li>• Option B. Lateral surface of styloid process is overlapped by parotid gland . And crossed by facial nerve .</li><li>• Option B.</li><li>• Lateral surface</li><li>• styloid process</li><li>• parotid gland</li><li>• facial nerve</li><li>• Option C . Medially in front related to internal carotid artery , internal jugular vein behind and last four cranial nerves between them.</li><li>• Option C</li><li>• Medially</li><li>• internal carotid artery</li><li>• internal jugular vein</li><li>• last four cranial nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Stylopharyngeus arises from the medial surface of base &amp; supplied by glossopharyngeal nerve .</li><li>➤ Stylopharyngeus arises from the medial surface of base &amp; supplied by glossopharyngeal nerve .</li><li>➤ Stylopharyngeus</li><li>➤ medial surface</li><li>➤ base</li><li>➤ glossopharyngeal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg27</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg27</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is true about the pointed structure?", "options": [{"label": "A", "text": "It connects the upper border of thyroid cartilage to lower border of hyoid bone", "correct": false}, {"label": "B", "text": "It is separated from the lamina of thyroid cartilage by a bursa", "correct": false}, {"label": "C", "text": "The nerve piercing it is a branch of recurrent laryngeal nerve", "correct": false}, {"label": "D", "text": "The artery piercing it is a branch of superior thyroid artery", "correct": true}], "correct_answer": "D. The artery piercing it is a branch of superior thyroid artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/fads.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture8_5HyZWP5.jpg"], "explanation": "<p><strong>Ans. D) The artery piercing it is a branch of superior thyroid artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The pointed structure is the thyrohyoid membrane. it connects the upper border of thyroid cartilage to upper border of hyoid bone .</li><li>• Option A</li><li>• upper border</li><li>• thyroid cartilage</li><li>• upper border</li><li>• hyoid bone</li><li>• Option B . It is separated from the hyoid bone by a subhyoid bursa .</li><li>• Option B</li><li>• separated</li><li>• hyoid bone</li><li>• subhyoid bursa</li><li>• Option C . The thyrohyoid membrane is pierced by the internal laryngeal nerve which is a branch of the superior laryngeal nerve . Internal laryngeal nerve supplies the mucosa of the larynx above the level of vocal folds .</li><li>• Option C</li><li>• internal laryngeal nerve</li><li>• superior laryngeal nerve</li><li>• mucosa</li><li>• larynx</li><li>• level</li><li>• vocal folds</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thyrohyoid membrane is pierced by superior laryngeal artery which is a branch of superior thyroid artery .</li><li>➤ superior laryngeal artery</li><li>➤ superior thyroid artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 240</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 240</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "W hich of the following statement is not true about the pointed structure in the below image?", "options": [{"label": "A", "text": "It arises from the lesser wing of sphenoid", "correct": false}, {"label": "B", "text": "It is inserted into the eyeball behind the equator", "correct": false}, {"label": "C", "text": "It is supplied by trochlear nerve", "correct": false}, {"label": "D", "text": "It causes extorsion of eyeball", "correct": true}], "correct_answer": "D. It causes extorsion of eyeball", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture4_sQ3qTHe.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture9_7PARVlj.jpg"], "explanation": "<p><strong>Ans. D) It causes extorsion of eyeball</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. T he pointed structure is superior oblique muscle of eyeball. It arises from the undersurface of lesser wing of sphenoid above and medial to the common tendinous ring .</li><li>• Option A. T</li><li>• superior oblique muscle</li><li>• undersurface</li><li>• lesser wing</li><li>• sphenoid</li><li>• above</li><li>• medial</li><li>• common tendinous ring</li><li>• Option B . It is inserted into the posterosuperior quadrant of the eyeball behind the equator .</li><li>• Option B</li><li>• posterosuperior quadrant</li><li>• eyeball</li><li>• behind</li><li>• equator</li><li>• Option C . All extraocular muscles of eyeball are supplied by oculomotor nerve except lateral rectus (abducens nerve) &amp; superior oblique (trochlear nerve).</li><li>• Option C</li><li>• extraocular muscles</li><li>• oculomotor nerve</li><li>• except</li><li>• lateral rectus</li><li>• superior oblique</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Superior oblique causes, abduction , depression and intorsion of eyeball .</li><li>• Superior oblique</li><li>• abduction</li><li>• depression</li><li>• intorsion</li><li>• eyeball</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following two marked structures share the same nerve supply:", "options": [{"label": "A", "text": "A &amp; B", "correct": false}, {"label": "B", "text": "B &amp; D", "correct": true}, {"label": "C", "text": "C &amp; D", "correct": false}, {"label": "D", "text": "A &amp; C", "correct": false}], "correct_answer": "B. B & D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture9_xqfG3u4.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B &amp; D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A&amp;B (Vallecula &amp; Palatine Tonsil): These structures do not share the same primary nerve supply . The vallecula is mainly innervated by the vagus nerve (via the superior laryngeal nerve ), while the palatine tonsil is primarily innervated by the glossopharyngeal nerve ( CN IX ).</li><li>• Option A.</li><li>• same primary nerve supply</li><li>• vallecula</li><li>• vagus nerve</li><li>• superior laryngeal nerve</li><li>• palatine tonsil</li><li>• glossopharyngeal nerve</li><li>• CN IX</li><li>• Option C. C&amp;D (Palatoglossus Muscle &amp; Circumvallate Papillae): The palatoglossus muscle and the circumvallate papillae do not share the same nerve supply. The palatoglossus muscle is innervated by the pharyngeal plexus (mainly the vagus nerve , CN X ), while the circumvallate papillae are innervated for taste by the glossopharyngeal nerve ( CN IX ).</li><li>• Option C.</li><li>• palatoglossus muscle</li><li>• palatoglossus muscle</li><li>• pharyngeal plexus</li><li>• vagus nerve</li><li>• CN X</li><li>• circumvallate papillae</li><li>• taste</li><li>• glossopharyngeal nerve</li><li>• CN IX</li><li>• Option D. A&amp;C (Vallecula &amp; Palatoglossus Muscle): These structures do not share the same primary nerve supply. The vallecula is mainly innervated by the superior laryngeal nerve (a branch of the vagus nerve , CN X ), and the palatoglossus muscle is innervated by the pharyngeal plexus (also predominantly by the vagus nerve , CN X ), but their specific functions and innervation patterns do not overlap significantly.</li><li>• Option D.</li><li>• vallecula</li><li>• innervated</li><li>• superior laryngeal nerve</li><li>• vagus nerve</li><li>• CN X</li><li>• palatoglossus muscle</li><li>• pharyngeal plexus</li><li>• vagus nerve</li><li>• CN X</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ B &amp; D: Glossopharyngeal nerve carries general sensation from posterior 1/3 tongue , taste sensation from circumvallate papillae and also conveys general sensation from palatine tonsil .</li><li>➤ B &amp; D: Glossopharyngeal nerve</li><li>➤ general sensation</li><li>➤ posterior 1/3 tongue</li><li>➤ taste sensation</li><li>➤ circumvallate papillae</li><li>➤ general sensation</li><li>➤ palatine tonsil</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 147</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 147</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is pierced by the dorsal scapular nerve in the posterior triangle?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture74_9zr0SNh.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture14_aqRtokR.jpg"], "explanation": "<p><strong>Ans. A) A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Splenius capitis forms the floor of posterior triangle and is covered by prevertebral fascia .</li><li>• Option B.</li><li>• Splenius capitis</li><li>• floor</li><li>• posterior triangle</li><li>• prevertebral fascia</li><li>• Option C . Levator scapulae: Dorsal scapular nerve disappears beneath levator scapulae to supply it and then the rhomboids minor and major .</li><li>• Option C</li><li>• Dorsal scapular nerve</li><li>• beneath levator scapulae</li><li>• rhomboids minor</li><li>• major</li><li>• Option D . Inferior belly of omohyoid divides the posterior triangle into upper occipital triangle and lower subclavian / supraclavicular triangle .</li><li>• Option D</li><li>• posterior triangle</li><li>• upper occipital triangle</li><li>• lower subclavian</li><li>• supraclavicular triangle</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Scalenus medius: Dorsal scapular arises from C5 root and pierces scalenus medius muscle .</li><li>• Dorsal scapular</li><li>• C5 root</li><li>• scalenus medius muscle</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 197</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 197</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following features will not be present in the paralysis of the pointed structure?", "options": [{"label": "A", "text": "Epiphora", "correct": false}, {"label": "B", "text": "Corneal Ulceration", "correct": false}, {"label": "C", "text": "Ptosis", "correct": true}, {"label": "D", "text": "Absent Corneal Reflex", "correct": false}], "correct_answer": "C. Ptosis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/screenshot-2024-02-21-101959.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture15_yOwqnpN.jpg"], "explanation": "<p><strong>Ans. C) Ptosis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Lacrimal part of orbicularis oculi aids in drainage of lacrimal fluid via lacrimal sac into nasolacrimal duct . Paralysis of which might result in spillage of tears / epiphora</li><li>• Option A</li><li>• Lacrimal</li><li>• orbicularis oculi</li><li>• drainage</li><li>• lacrimal fluid</li><li>• lacrimal sac</li><li>• nasolacrimal duct</li><li>• Paralysis</li><li>• spillage of tears</li><li>• epiphora</li><li>• Option B . Orbital part of orbicularis oculi will cause tight closure of eyelids , palpebral part gentle closure of eyelids . Paralysis will lead to inability to close eyes and thereby corneal ulceration .</li><li>• Option B</li><li>• Orbital</li><li>• tight closure</li><li>• eyelids</li><li>• palpebral</li><li>• gentle closure</li><li>• eyelids</li><li>• Paralysis</li><li>• inability</li><li>• close eyes</li><li>• corneal ulceration</li><li>• Option D. The afferent limb of corneal reflex - ophthalmic division of trigeminal nerve , the efferent limb includes facial nerve that innervates orbicularis oculi .</li><li>• Option D.</li><li>• afferent limb</li><li>• corneal reflex</li><li>• ophthalmic division</li><li>• trigeminal nerve</li><li>• efferent limb</li><li>• facial nerve</li><li>• orbicularis oculi</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• paralysis of orbicularis oculi cause inability to close the eye . Paralysis of levator palpebrae superioris only will cause ptosis</li><li>• paralysis of orbicularis oculi cause inability to close the eye .</li><li>• paralysis</li><li>• inability</li><li>• close the eye</li><li>• Paralysis of levator palpebrae superioris only will cause ptosis</li><li>• Paralysis</li><li>• levator palpebrae</li><li>• superioris</li><li>• ptosis</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck,Neuroanatomy 7 th Edition Pg 80</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck,Neuroanatomy 7 th Edition Pg 80</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a tributary of the pointed structure?", "options": [{"label": "A", "text": "Inferior Thyroid Vein", "correct": false}, {"label": "B", "text": "Common Facial Vein", "correct": false}, {"label": "C", "text": "Dorsal Scapular Vein", "correct": true}, {"label": "D", "text": "Axillary Vein", "correct": false}], "correct_answer": "C. Dorsal Scapular Vein", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture12_Cqk35BF.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture16_wNMFhc8.jpg"], "explanation": "<p><strong>Ans. C) Dorsal Scapular Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Inferior thyroid vein opens into left brachiocephalic vein .</li><li>• Option A.</li><li>• left brachiocephalic vein</li><li>• Option B. Common facial vein opens into internal jugular vein .</li><li>• Option B.</li><li>• internal jugular vein</li><li>• Option D . Axillary vein continues as subclavian vein at outer border of first rib</li><li>• Option D</li><li>• subclavian vein</li><li>• outer border</li><li>• first rib</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It receives dorsal scapular vein , external jugular vein . The subclavian vein is a major vein that plays a key role in draining blood from the upper extremities back to the heart . It has several important tributaries, which include:</li><li>➤ It receives dorsal scapular vein , external jugular vein .</li><li>➤ dorsal scapular vein</li><li>➤ external jugular vein</li><li>➤ The subclavian vein is a major vein that plays a key role in draining blood from the upper extremities back to the heart . It has several important tributaries, which include:</li><li>➤ subclavian vein</li><li>➤ major vein</li><li>➤ draining blood</li><li>➤ upper extremities</li><li>➤ back</li><li>➤ heart</li><li>➤ External Jugular Vein : This vein drains blood from the scalp and deep parts of the face . It is formed by the union of the posterior division of the retromandibular vein and the posterior auricular vein . Anterior Jugular Vein : This vein collects blood from the front of the neck . The left and right anterior jugular veins often connect via a jugular venous arch at the base of the neck before draining into the subclavian vein . Vertebral Vein : This vein drains the cervical spinal cord and posterior part of the skull . It travels with the vertebral artery within the transverse foramina of the cervical vertebrae before emptying into the subclavian vein . Internal Thoracic (Mammary) Vein : This vein runs along the inner side of the front of the chest wall and drains the breasts , anterior thoracic wall , and parts of the abdominal wall . It is a companion to the internal thoracic artery . Dorsal Scapular Vein : This vein drains the region around the scapula and the muscles attached to it . It may drain directly into the subclavian vein or into the transverse cervical vein . Transverse Cervical Vein : This vein drains the muscles and skin of the anterior neck region . It can drain either into the external jugular vein or directly into the subclavian vein . Suprascapular Vein : This vein drains the supraspinatus and infraspinatus muscles of the shoulder region . It typically empties into the external jugular or directly into the subclavian vein . Costocervical Trunk (Vein): This vein drains the deep parts of the neck and the upper intercostal spaces . It is formed by the union of the supreme intercostal vein and the deep cervical vein .</li><li>➤ External Jugular Vein : This vein drains blood from the scalp and deep parts of the face . It is formed by the union of the posterior division of the retromandibular vein and the posterior auricular vein .</li><li>➤ External Jugular Vein</li><li>➤ vein drains blood</li><li>➤ scalp</li><li>➤ deep parts</li><li>➤ face</li><li>➤ union</li><li>➤ posterior division</li><li>➤ retromandibular vein</li><li>➤ posterior auricular vein</li><li>➤ Anterior Jugular Vein : This vein collects blood from the front of the neck . The left and right anterior jugular veins often connect via a jugular venous arch at the base of the neck before draining into the subclavian vein .</li><li>➤ Anterior Jugular Vein</li><li>➤ collects blood</li><li>➤ front</li><li>➤ neck</li><li>➤ left</li><li>➤ right anterior jugular veins</li><li>➤ jugular venous arch</li><li>➤ base</li><li>➤ neck</li><li>➤ draining</li><li>➤ subclavian vein</li><li>➤ Vertebral Vein : This vein drains the cervical spinal cord and posterior part of the skull . It travels with the vertebral artery within the transverse foramina of the cervical vertebrae before emptying into the subclavian vein .</li><li>➤ Vertebral Vein</li><li>➤ cervical spinal cord</li><li>➤ posterior</li><li>➤ skull</li><li>➤ vertebral artery</li><li>➤ transverse foramina</li><li>➤ cervical vertebrae</li><li>➤ subclavian vein</li><li>➤ Internal Thoracic (Mammary) Vein : This vein runs along the inner side of the front of the chest wall and drains the breasts , anterior thoracic wall , and parts of the abdominal wall . It is a companion to the internal thoracic artery .</li><li>➤ Internal Thoracic</li><li>➤ Vein</li><li>➤ inner side</li><li>➤ front</li><li>➤ chest wall</li><li>➤ breasts</li><li>➤ anterior thoracic wall</li><li>➤ parts</li><li>➤ abdominal wall</li><li>➤ internal thoracic artery</li><li>➤ Dorsal Scapular Vein : This vein drains the region around the scapula and the muscles attached to it . It may drain directly into the subclavian vein or into the transverse cervical vein .</li><li>➤ Dorsal Scapular Vein</li><li>➤ scapula</li><li>➤ muscles attached to it</li><li>➤ directly</li><li>➤ subclavian vein</li><li>➤ transverse cervical vein</li><li>➤ Transverse Cervical Vein : This vein drains the muscles and skin of the anterior neck region . It can drain either into the external jugular vein or directly into the subclavian vein .</li><li>➤ Transverse Cervical Vein</li><li>➤ muscles</li><li>➤ skin</li><li>➤ anterior neck region</li><li>➤ external jugular vein</li><li>➤ subclavian vein</li><li>➤ Suprascapular Vein : This vein drains the supraspinatus and infraspinatus muscles of the shoulder region . It typically empties into the external jugular or directly into the subclavian vein .</li><li>➤ Suprascapular Vein</li><li>➤ supraspinatus</li><li>➤ infraspinatus muscles</li><li>➤ shoulder region</li><li>➤ external jugular</li><li>➤ directly</li><li>➤ subclavian vein</li><li>➤ Costocervical Trunk (Vein): This vein drains the deep parts of the neck and the upper intercostal spaces . It is formed by the union of the supreme intercostal vein and the deep cervical vein .</li><li>➤ Costocervical Trunk</li><li>➤ deep parts</li><li>➤ neck</li><li>➤ upper intercostal spaces</li><li>➤ supreme intercostal vein</li><li>➤ deep cervical vein</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 342</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 342</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a branch from the pointed structure?", "options": [{"label": "A", "text": "Suprahyoid artery", "correct": false}, {"label": "B", "text": "Stylomastoid artery", "correct": false}, {"label": "C", "text": "Sternomastoid artery", "correct": false}, {"label": "D", "text": "Submental artery", "correct": true}], "correct_answer": "D. Submental artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-192216.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture20.jpg"], "explanation": "<p><strong>Ans. D) Submental artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Suprahyoid artery is a branch from lingual artery</li><li>• Option A. Suprahyoid artery</li><li>• lingual artery</li><li>• Option B. Stylomastoid artery arises from posterior auricular artery</li><li>• Option B. Stylomastoid artery</li><li>• posterior auricular artery</li><li>• Option C. Sternomastoid branches arise from superior thyroid artery , occipital artery</li><li>• Option C. Sternomastoid</li><li>• superior thyroid artery</li><li>• occipital artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Facial artery in its cervical part gives rise to ascending palatine arteries , glandular branches , submental artery, and tonsillar branches .</li><li>➤ Facial artery</li><li>➤ cervical part</li><li>➤ ascending palatine arteries</li><li>➤ glandular branches</li><li>➤ submental artery,</li><li>➤ tonsillar branches</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 321</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 321</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is correct about the pointed structure?", "options": [{"label": "A", "text": "It is formed by the union of posterior division of Retromandibular Vein and Superficial Temporal Vein", "correct": false}, {"label": "B", "text": "It lies in the lateral wall of Tonsillar Sinus", "correct": false}, {"label": "C", "text": "It receives the Dorsal Scapular Vein", "correct": false}, {"label": "D", "text": "Suprascapular vein opens into it", "correct": true}], "correct_answer": "D. Suprascapular vein opens into it", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture21_gD5yVlY.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture21.jpg"], "explanation": "<p><strong>Ans. D) Suprascapular vein opens into it</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It is formed by the union of posterior division of retromandibular vein and superficial temporal vein . The external jugular vein is primarily formed by the union of the posterior division of the retromandibular vein and the posterior auricular vein , not the superficial temporal vein . The superficial temporal vein is more commonly associated with the formation of the retromandibular vein itself.</li><li>• Option A</li><li>• union</li><li>• posterior division</li><li>• retromandibular vein</li><li>• superficial temporal vein</li><li>• posterior division</li><li>• retromandibular vein</li><li>• posterior auricular vein</li><li>• superficial temporal vein</li><li>• superficial temporal vein</li><li>• formation</li><li>• retromandibular vein</li><li>• Option B . It lies in the lateral wall of tonsillar sinus . The external jugular vein runs superficially down the side of the neck . It is not associated with the tonsillar sinus , which is related to the palatine tonsil located in the oropharynx , far from the course of the external jugular vein . IJV lies in the lateral wall of tonsillar sinus</li><li>• Option B</li><li>• lateral wall</li><li>• tonsillar sinus</li><li>• external jugular vein</li><li>• superficially down</li><li>• side</li><li>• neck</li><li>• tonsillar sinus</li><li>• palatine tonsil</li><li>• oropharynx</li><li>• external jugular vein</li><li>• lateral wall</li><li>• tonsillar sinus</li><li>• Option C. Dorsal scapular vein opens into subclavian vein . The dorsal scapular vein usually drains into the subclavian vein or the transverse cervical vein , not the external jugular vein . The external jugular vein's tributaries can vary but typically include veins like the posterior external jugular , transverse cervical , and supraclavicular veins .</li><li>• Option C. Dorsal scapular vein</li><li>• subclavian vein</li><li>• subclavian vein</li><li>• transverse cervical vein</li><li>• external jugular vein</li><li>• posterior external jugular</li><li>• transverse cervical</li><li>• supraclavicular veins</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Suprascapular vein opens into it: The suprascapular vein , which drains the suprascapular region of the shoulder , can drain into the external jugular vein , although there is variability in venous anatomy among individuals. Transverse cervical vein , anterior jugular veins and suprascapular veins open into the external jugular vein .</li><li>➤ Suprascapular vein opens into it: The suprascapular vein , which drains the suprascapular region of the shoulder , can drain into the external jugular vein , although there is variability in venous anatomy among individuals.</li><li>➤ Suprascapular vein opens into it:</li><li>➤ suprascapular vein</li><li>➤ suprascapular region</li><li>➤ shoulder</li><li>➤ external jugular vein</li><li>➤ variability</li><li>➤ venous anatomy</li><li>➤ Transverse cervical vein , anterior jugular veins and suprascapular veins open into the external jugular vein .</li><li>➤ Transverse cervical vein</li><li>➤ anterior jugular veins</li><li>➤ suprascapular veins</li><li>➤ external jugular vein</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 346</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 346</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to his primary care physician complaining of an unusual problem. He notices that every time he eats or even thinks about sour foods, he experiences sweating and flushing on the right side of his face. He reports that this has been happening for the past six months. His medical history is significant for a right parotid gland tumor for which he underwent surgical resection one year ago. On physical examination, localized sweating and flushing are observed as shown in image on the cheek when he is given a lemon slice to smell. Which nerve is involved in the above clinical condition?", "options": [{"label": "A", "text": "Nerve of Pterygoid Canal", "correct": false}, {"label": "B", "text": "Chorda Tympani", "correct": false}, {"label": "C", "text": "Auriculo Temporal Nerve", "correct": true}, {"label": "D", "text": "Nerve to Inferior Oblique", "correct": false}], "correct_answer": "C. Auriculo Temporal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-104930.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Auricula Temporal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Nerve of pterygoid canal carries preganglionic parasympathetic secretomotor fibres for lacrimal gland .</li><li>• Option A:</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• lacrimal gland</li><li>• Option B: Chorda tympani carry preganglionic parasympathetic secretomotor fibres for submandibular and sublingual salivary gland .</li><li>• Option B:</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• submandibular</li><li>• sublingual salivary gland</li><li>• Option D: Nerve to inferior oblique carries the preganglionic parasympathetic fibres for sphincter pupillae and ciliaris muscle .</li><li>• Option D:</li><li>• preganglionic parasympathetic fibres</li><li>• sphincter pupillae</li><li>• ciliaris muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Frey’s syndrome - The regenerating secretomotor fibers of auriculotemporal nerve for the parotid gland gets misdirected into the sensory fibres of great auricular nerve that supplies the skin and sweat glands over the parotid gland resulting in gustatory sweating .</li><li>➤ Frey’s syndrome - The regenerating secretomotor fibers of auriculotemporal nerve for the parotid gland gets misdirected into the sensory fibres of great auricular nerve that supplies the skin and sweat glands over the parotid gland resulting in gustatory sweating .</li><li>➤ Frey’s syndrome - The regenerating secretomotor fibers of auriculotemporal nerve for the parotid gland gets misdirected into the sensory fibres of great auricular nerve that supplies the skin and sweat glands over the parotid gland resulting in gustatory sweating .</li><li>➤ Frey’s syndrome</li><li>➤ regenerating secretomotor fibers</li><li>➤ parotid gland</li><li>➤ misdirected</li><li>➤ sensory fibres</li><li>➤ great auricular nerve</li><li>➤ supplies</li><li>➤ skin</li><li>➤ sweat glands</li><li>➤ parotid gland</li><li>➤ gustatory sweating</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 95,96</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 95,96</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the pointed structure drain into?", "options": [{"label": "A", "text": "Mastoid Nodes", "correct": false}, {"label": "B", "text": "Preauricular Nodes", "correct": false}, {"label": "C", "text": "Superficial Cervical Nodes", "correct": false}, {"label": "D", "text": "Submandibular Nodes", "correct": true}], "correct_answer": "D. Submandibular Nodes", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-105221.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Submandibular Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Retro auricular nodes/Mastoid nodes drain part of auricle , scalp and posterior wall of External Acoustic Meatus .</li><li>• Option A:</li><li>• auricle</li><li>• scalp</li><li>• posterior wall</li><li>• External Acoustic Meatus</li><li>• Option B: Preauricular lymph nodes belong to superficial group of parotid nodes and lie in front of tragus .</li><li>• Option B:</li><li>• superficial group</li><li>• parotid nodes</li><li>• front of tragus</li><li>• Option C: Superficial cervical nodes receive lymph from the floor of external acoustic meatus , lobule of ear , angle of mandible and lower part of parotid region .</li><li>• Option C:</li><li>• lymph</li><li>• floor</li><li>• external acoustic meatus</li><li>• lobule of ear</li><li>• angle of mandible</li><li>• lower part</li><li>• parotid region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Frontal sinus , most of the ethmoidal sinus and maxillary sinus drain into submandibular lymph nodes .</li><li>➤ Frontal sinus , most of the ethmoidal sinus and maxillary sinus drain into submandibular lymph nodes .</li><li>➤ Frontal sinus</li><li>➤ ethmoidal sinus</li><li>➤ maxillary sinus</li><li>➤ submandibular lymph nodes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the pointed structure open into?", "options": [{"label": "A", "text": "Superior Meatus", "correct": false}, {"label": "B", "text": "Middle Meatus", "correct": false}, {"label": "C", "text": "Inferior Meatus", "correct": false}, {"label": "D", "text": "Sphenoethmoidal Recess", "correct": true}], "correct_answer": "D. Sphenoethmoidal Recess", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture24_fkN0JL2.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-105420.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-105432.jpg"], "explanation": "<p><strong>Ans. D) Sphenoethmoidal Recess</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior meatus receives the posterior ethmoidal sinus .</li><li>• Option A:</li><li>• posterior ethmoidal sinus</li><li>• Option B: Middle meatus receives maxillary sinus, frontal sinus, anterior ethmoidal and middle ethmoidal sinus .</li><li>• Option B:</li><li>• maxillary sinus, frontal sinus, anterior ethmoidal</li><li>• middle ethmoidal sinus</li><li>• Option C: Inferior meatus receives the nasolacrimal duct.</li><li>• Option C:</li><li>• nasolacrimal duct.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sphenoethmoidal recess: It opens into sphenoethmoidal recess .</li><li>➤ Sphenoethmoidal recess: It opens into sphenoethmoidal recess .</li><li>➤ Sphenoethmoidal recess:</li><li>➤ opens</li><li>➤ sphenoethmoidal recess</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 217</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 217</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure in the given image:", "options": [{"label": "A", "text": "Chorda Tympani", "correct": false}, {"label": "B", "text": "Lesser Petrosal Nerve", "correct": false}, {"label": "C", "text": "Greater Petrosal Nerve", "correct": true}, {"label": "D", "text": "Deep Petrosal Nerve", "correct": false}], "correct_answer": "C. Greater Petrosal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115035.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115055.jpg"], "explanation": "<p><strong>Ans. C) Greater Petrosal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Chorda tympani nerve arises from facial nerves 6mm above stylomastoid foramen . It conveys preganglionic parasympathetic secretomotor fibres to the submandibular and sublingual salivary gland . It also conveys taste sensation from anterior 2/3 tongue .</li><li>• Option A: Chorda tympani</li><li>• arises</li><li>• facial nerves</li><li>• 6mm above</li><li>• stylomastoid foramen</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• submandibular</li><li>• sublingual salivary gland</li><li>• taste</li><li>• sensation</li><li>• anterior 2/3 tongue</li><li>• Option B: Lesser petrosal nerve arises from the tympanic plexus formed by the tympanic branch of Glossopharyngeal nerve and carries preganglionic parasympathetic secretomotor fibres for parotid gland .</li><li>• Option B: Lesser petrosal nerve</li><li>• tympanic plexus</li><li>• tympanic branch</li><li>• Glossopharyngeal nerve</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• parotid gland</li><li>• Option D: Deep petrosal nerve is formed by the sympathetic plexus that surrounds the internal carotid artery .</li><li>• Option D:</li><li>• Deep petrosal nerve</li><li>• sympathetic plexus</li><li>• surrounds</li><li>• internal carotid artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Greater petrosal nerve arises from the geniculate ganglion of the facial nerve . It conveys preganglionic secretomotor fibres to the lacrimal glands , glands of nasal mucosa and soft palate . It also conveys a taste sensation from the soft palate .</li><li>➤ Greater petrosal nerve arises from the geniculate ganglion of the facial nerve .</li><li>➤ geniculate ganglion</li><li>➤ facial nerve</li><li>➤ It conveys preganglionic secretomotor fibres to the lacrimal glands , glands of nasal mucosa and soft palate .</li><li>➤ preganglionic secretomotor fibres</li><li>➤ lacrimal glands</li><li>➤ glands</li><li>➤ nasal mucosa</li><li>➤ soft palate</li><li>➤ It also conveys a taste sensation from the soft palate .</li><li>➤ taste sensation</li><li>➤ soft palate</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 398</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 398</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Incorrect statement about the Layer of Deep Cervical Fascia pointed out in the given image:", "options": [{"label": "A", "text": "Encloses Sternocleidomastoid", "correct": false}, {"label": "B", "text": "Forms Sphenomandibular Ligament", "correct": true}, {"label": "C", "text": "Forms Roof for Posterior Triangle", "correct": false}, {"label": "D", "text": "Encloses Submandibular Gland", "correct": false}], "correct_answer": "B. Forms Sphenomandibular Ligament", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115106.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Forms Sphenomandibular Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: It splits to enclose sternocleidomastoid and trapezius muscles ; both are innervated by spinal accessory nerve .</li><li>• Option A:</li><li>• enclose sternocleidomastoid</li><li>• trapezius muscles</li><li>• spinal accessory nerve</li><li>• Option C: Investing layer of deep cervical fascia forms the roof of anterior and posterior triangle . The prevertebral layer of deep cervical fascia forms the floor of posterior triangle .</li><li>• Option C: Investing layer</li><li>• deep cervical fascia</li><li>• roof</li><li>• anterior</li><li>• posterior triangle</li><li>• prevertebral layer</li><li>• floor</li><li>• posterior triangle</li><li>• Option D: Investing layer of deep cervical fascia splits to enclose submandibular and parotid salivary glands .</li><li>• Option D: Investing layer</li><li>• deep cervical fascia</li><li>• splits</li><li>• enclose submandibular</li><li>• parotid salivary glands</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Investing layer of deep cervical fascia: The deep lamellar that splits to enclose the parotid gland thickens to form the stylomandibular ligament which separates the parotid gland from submandibular gland . Sphenomandibular ligament is remnant of meckel’s cartilage .</li><li>➤ Investing layer of deep cervical fascia: The deep lamellar that splits to enclose the parotid gland thickens to form the stylomandibular ligament which separates the parotid gland from submandibular gland .</li><li>➤ Investing layer of deep cervical fascia:</li><li>➤ deep lamellar</li><li>➤ splits</li><li>➤ enclose</li><li>➤ parotid gland</li><li>➤ thickens</li><li>➤ stylomandibular ligament</li><li>➤ separates</li><li>➤ parotid gland</li><li>➤ submandibular gland</li><li>➤ Sphenomandibular ligament is remnant of meckel’s cartilage .</li><li>➤ Sphenomandibular ligament</li><li>➤ remnant</li><li>➤ meckel’s cartilage</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the Nerve that provides innervation to the structure indicated by the Arrow?", "options": [{"label": "A", "text": "Hypoglossal Nerve", "correct": false}, {"label": "B", "text": "Vagus Nerve", "correct": true}, {"label": "C", "text": "Facial Nerve", "correct": false}, {"label": "D", "text": "Accessory Nerve", "correct": false}], "correct_answer": "B. Vagus Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115121.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115134_sGlTWTG.jpg"], "explanation": "<p><strong>Ans. B) Vagus Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Hypoglossal nerve supplies all muscles of tongue except palatoglossus . It’s injury will cause tongue deviation on same side of lesion and larynx deviation to active side of lesion</li><li>• Option A:</li><li>• all muscles</li><li>• except palatoglossus</li><li>• tongue deviation</li><li>• same side</li><li>• lesion</li><li>• larynx deviation</li><li>• active side</li><li>• lesion</li><li>• Option C: Facial nerve innervates muscles of face , provides preganglionic secretomotor fibres for lacrimal gland , submandibular , sublingual salivary gland , glands of nasal mucosa and soft palate .</li><li>• Option C:</li><li>• muscles of face</li><li>• preganglionic secretomotor fibres</li><li>• lacrimal gland</li><li>• submandibular</li><li>• sublingual salivary gland</li><li>• glands</li><li>• nasal mucosa</li><li>• soft palate</li><li>• Option D: Spinal accessory nerve innervates sternocleidomastoid and trapezius muscle .</li><li>• Option D:</li><li>• sternocleidomastoid</li><li>• trapezius muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Carotid sinus: It lies at the bifurcation of the common carotid artery and also extends to the proximal part of the internal carotid artery . The carotid body lies in the posterior wall of carotid sinus . The carotid sinus is a baroreceptor and carotid body is a chemoreceptor . Both are innervated by IX, X cranial nerves .</li><li>➤ Carotid sinus: It lies at the bifurcation of the common carotid artery and also extends to the proximal part of the internal carotid artery .</li><li>➤ Carotid sinus:</li><li>➤ bifurcation</li><li>➤ common carotid artery</li><li>➤ extends</li><li>➤ proximal part</li><li>➤ internal carotid artery</li><li>➤ The carotid body lies in the posterior wall of carotid sinus .</li><li>➤ posterior wall</li><li>➤ carotid sinus</li><li>➤ The carotid sinus is a baroreceptor and carotid body is a chemoreceptor . Both are innervated by IX, X cranial nerves .</li><li>➤ baroreceptor</li><li>➤ chemoreceptor</li><li>➤ IX, X cranial nerves</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 405, 408</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 405, 408</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Arrangement of structures within the Parotid Gland from Superficial to Deep:", "options": [{"label": "A", "text": "RMV, ECA, VII Nerve", "correct": false}, {"label": "B", "text": "ECA, RMV, VII Nerve", "correct": false}, {"label": "C", "text": "VII Nerve, ECA, RMV", "correct": false}, {"label": "D", "text": "VII Nerve, RMV, ECA", "correct": true}], "correct_answer": "D. VII Nerve, RMV, ECA", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115150.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115217.jpg"], "explanation": "<p><strong>Ans. D) VII Nerve, RMV, ECA</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Facial nerve lies in the superficial plane and enters the parotid gland through its posteromedial surface divides into cervical and temporo facial trunks , branches of which exit through anterior border .</li><li>• Option A:</li><li>• Facial nerve</li><li>• superficial plane</li><li>• enters</li><li>• parotid gland</li><li>• posteromedial surface</li><li>• cervical</li><li>• temporo facial trunks</li><li>• branches</li><li>• exit</li><li>• anterior border</li><li>• Option B: RMV lies in the intermediate zone and divides into anterior and posterior division . Anterior division joins with common facial vein . The posterior division joins with the posterior auricular vein .</li><li>• Option B:</li><li>• RMV</li><li>• intermediate zone</li><li>• anterior</li><li>• posterior division</li><li>• Anterior division</li><li>• common facial vein</li><li>• posterior division</li><li>• posterior auricular vein</li><li>• Option C: ECA lies in the deep zone and divides into its terminal branches’ superficial temporal artery and maxillary artery .</li><li>• Option C:</li><li>• ECA</li><li>• deep zone</li><li>• terminal branches’</li><li>• superficial temporal artery</li><li>• maxillary artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The parotid gland is one of the major salivary glands located in the face, and it contains various structures arranged from superficial to deep as follows:</li><li>➤ major salivary glands</li><li>➤ superficial to deep</li><li>➤ Skin and Subcutaneous Tissue (Superficial): The most superficial layer includes the skin and subcutaneous tissue that covers the external surface of the parotid gland . Superficial Musculoaponeurotic System (SMAS): Beneath the subcutaneous tissue, there is a layer known as the SMAS, which is a fibrous layer of connective tissue that surrounds the muscles of the face . Parotid Duct (Stensen's Duct): The parotid duct, also known as Stensen's duct, runs through the gland and carries saliva from the parotid gland to the oral cavity. It is usually located superficially within the gland and can be seen on the buccal mucosa near the upper second molar . Parotid Gland Parenchyma: The parenchyma of the parotid gland is the glandular tissue itself. It is the main functional part of the gland responsible for producing saliva . This glandular tissue is located deep within the gland . Facial Nerve (Cranial Nerve VII): The facial nerve passes through the parotid gland. It is situated deep within the gland and gives rise to its branches, known as the intraparotid branches of the facial nerve , which innervate the muscles of facial expression .</li><li>➤ Skin and Subcutaneous Tissue (Superficial): The most superficial layer includes the skin and subcutaneous tissue that covers the external surface of the parotid gland .</li><li>➤ Skin and Subcutaneous Tissue (Superficial):</li><li>➤ covers</li><li>➤ external surface</li><li>➤ parotid gland</li><li>➤ Superficial Musculoaponeurotic System (SMAS): Beneath the subcutaneous tissue, there is a layer known as the SMAS, which is a fibrous layer of connective tissue that surrounds the muscles of the face .</li><li>➤ Superficial Musculoaponeurotic System (SMAS):</li><li>➤ fibrous layer</li><li>➤ connective tissue</li><li>➤ muscles</li><li>➤ face</li><li>➤ Parotid Duct (Stensen's Duct): The parotid duct, also known as Stensen's duct, runs through the gland and carries saliva from the parotid gland to the oral cavity. It is usually located superficially within the gland and can be seen on the buccal mucosa near the upper second molar .</li><li>➤ Parotid Duct (Stensen's Duct):</li><li>➤ gland</li><li>➤ carries saliva</li><li>➤ superficially</li><li>➤ gland</li><li>➤ buccal mucosa</li><li>➤ upper second molar</li><li>➤ Parotid Gland Parenchyma: The parenchyma of the parotid gland is the glandular tissue itself. It is the main functional part of the gland responsible for producing saliva . This glandular tissue is located deep within the gland .</li><li>➤ Parotid Gland Parenchyma:</li><li>➤ glandular tissue</li><li>➤ producing saliva</li><li>➤ deep</li><li>➤ gland</li><li>➤ Facial Nerve (Cranial Nerve VII): The facial nerve passes through the parotid gland. It is situated deep within the gland and gives rise to its branches, known as the intraparotid branches of the facial nerve , which innervate the muscles of facial expression .</li><li>➤ Facial Nerve (Cranial Nerve VII):</li><li>➤ deep</li><li>➤ intraparotid branches</li><li>➤ facial nerve</li><li>➤ innervate</li><li>➤ muscles</li><li>➤ facial expression</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 88</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 88</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The pointed structure is accompanied by?", "options": [{"label": "A", "text": "Recurrent Laryngeal Nerve", "correct": false}, {"label": "B", "text": "External Laryngeal Nerve", "correct": true}, {"label": "C", "text": "Internal Laryngeal Nerve", "correct": false}, {"label": "D", "text": "Superior Laryngeal Nerve", "correct": false}], "correct_answer": "B. External Laryngeal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115231.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115248.jpg"], "explanation": "<p><strong>Ans. B) External Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Recurrent laryngeal nerve accompanies inferior thyroid artery and present variable relation close to the gland therefore inferior thyroid artery is ligated away from the gland , also it forms the principal source of blood supply to the parathyroids .</li><li>• Option A:</li><li>• inferior thyroid artery</li><li>• gland</li><li>• inferior thyroid artery</li><li>• ligated away</li><li>• gland</li><li>• principal source</li><li>• blood supply</li><li>• parathyroids</li><li>• Option C: Internal laryngeal nerve pierces thyrohyoid membrane accompanied by superior laryngeal vessel and traverses the piriform fossa to supply the mucosa of larynx below vocal cords .</li><li>• Option C:</li><li>• thyrohyoid membrane</li><li>• superior laryngeal vessel</li><li>• piriform fossa</li><li>• mucosa</li><li>• larynx</li><li>• below vocal cords</li><li>• Option D: Superior laryngeal nerve is a branch of vagus in the neck . It divides into external and internal laryngeal nerve .</li><li>• Option D:</li><li>• branch</li><li>• vagus</li><li>• neck</li><li>• external</li><li>• internal laryngeal nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superior thyroid artery, first branch of external carotid artery is accompanied on its posteromedial aspect by external laryngeal nerve but close to the gland they separate and the best place to litigate the artery is close to the gland .</li><li>➤ Superior thyroid artery, first branch of external carotid artery is accompanied on its posteromedial aspect by external laryngeal nerve but close to the gland they separate and the best place to litigate the artery is close to the gland .</li><li>➤ first branch</li><li>➤ external carotid artery</li><li>➤ posteromedial aspect</li><li>➤ external laryngeal nerve</li><li>➤ separate</li><li>➤ best place</li><li>➤ litigate</li><li>➤ artery</li><li>➤ close</li><li>➤ gland</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What would be the consequence of damaging the nerve located medial to the structure indicated by the blue arrow?", "options": [{"label": "A", "text": "Loss of Lacrimation", "correct": false}, {"label": "B", "text": "Parotid Gland Fysfunction", "correct": false}, {"label": "C", "text": "Hyperacusis", "correct": false}, {"label": "D", "text": "Loss of Taste Sensation from Anterior 2/3 of Tongue", "correct": true}], "correct_answer": "D. Loss of Taste Sensation from Anterior 2/3 of Tongue", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115512.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Loss of Taste Sensation from Anterior 2/3 of Tongue</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Injury to facial nerve proximal to geniculate ganglion will result in loss of lacrimation .</li><li>• Option A: Injury</li><li>• facial nerve</li><li>• geniculate ganglion</li><li>• loss of lacrimation</li><li>• Option B: Injury to glossopharyngeal nerve / auriculotemporal branch of mandibular nerve will result in parotid gland dysfunction.</li><li>• Option B: Injury</li><li>• glossopharyngeal nerve</li><li>• auriculotemporal branch</li><li>• mandibular nerve</li><li>• Option C: Injury to nerve to stapedius , a branch from facial nerve will result in hyperacusis .</li><li>• Option C: Injury</li><li>• nerve</li><li>• stapedius</li><li>• facial nerve</li><li>• hyperacusis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The spine of sphenoid is situated close to foramen spinosum . It is medially related to the cartilaginous part of auditory tube and chorda tympani nerve and laterally auriculotemporal nerve . Chorda tympani carries a taste sensation from anterior 2/3 tongue .</li><li>➤ The spine of sphenoid is situated close to foramen spinosum . It is medially related to the cartilaginous part of auditory tube and chorda tympani nerve and laterally auriculotemporal nerve .</li><li>➤ spine of sphenoid</li><li>➤ foramen spinosum</li><li>➤ medially</li><li>➤ cartilaginous part</li><li>➤ auditory tube</li><li>➤ chorda tympani nerve</li><li>➤ laterally</li><li>➤ auriculotemporal nerve</li><li>➤ Chorda tympani carries a taste sensation from anterior 2/3 tongue .</li><li>➤ taste sensation</li><li>➤ anterior 2/3 tongue</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 396</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 396</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Structure passing through probed opening:", "options": [{"label": "A", "text": "Maxillary Nerve", "correct": true}, {"label": "B", "text": "Mandibular Nerve", "correct": false}, {"label": "C", "text": "Facial Nerve", "correct": false}, {"label": "D", "text": "Abducens Nerve", "correct": false}], "correct_answer": "A. Maxillary Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115530.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Maxillary Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The mandibular division of the trigeminal nerve ( V3 ) passes through the foramen ovale . This nerve carries sensory and motor fibers to the face and jaw .</li><li>• Option B:</li><li>• trigeminal nerve</li><li>• V3</li><li>• foramen ovale</li><li>• sensory</li><li>• motor fibers</li><li>• face</li><li>• jaw</li><li>• Option C: Several cranial nerves and blood vessels pass through the internal acoustic meatus :</li><li>• Option C:</li><li>• internal acoustic meatus</li><li>• Facial Nerve (VII): The facial nerve enters the internal acoustic meatus before exiting the skull. Vestibulocochlear Nerve (VIII): This nerve is responsible for hearing and balance. It also passes through the internal acoustic meatus. Internal Auditory Artery and Vein: These blood vessels accompany the cranial nerves through the internal acoustic meatus.</li><li>• Facial Nerve (VII): The facial nerve enters the internal acoustic meatus before exiting the skull.</li><li>• Facial Nerve (VII): The facial nerve enters the internal acoustic meatus before exiting the skull.</li><li>• Facial Nerve (VII):</li><li>• Vestibulocochlear Nerve (VIII): This nerve is responsible for hearing and balance. It also passes through the internal acoustic meatus.</li><li>• Vestibulocochlear Nerve (VIII): This nerve is responsible for hearing and balance. It also passes through the internal acoustic meatus.</li><li>• Vestibulocochlear Nerve (VIII):</li><li>• Internal Auditory Artery and Vein: These blood vessels accompany the cranial nerves through the internal acoustic meatus.</li><li>• Internal Auditory Artery and Vein: These blood vessels accompany the cranial nerves through the internal acoustic meatus.</li><li>• Internal Auditory Artery and Vein:</li><li>• Option D: Abducens nerve enters orbit through intermediate compartment of superior orbital fissure . The superior orbital fissure is a complex opening in the skull that allows various structures to pass through, including Oculomotor Nerve (III), Trochlear Nerve (IV), Ophthalmic Division of the Trigeminal Nerve (V1), Abducens Nerve (VI) Superior Ophthalmic Vein and Branches of the ophthalmic artery and sympathetic nerves .</li><li>• Option D:</li><li>• Abducens nerve</li><li>• intermediate compartment</li><li>• superior orbital fissure</li><li>• skull</li><li>• allows</li><li>• Oculomotor Nerve</li><li>• Trochlear Nerve</li><li>• Ophthalmic Division</li><li>• Trigeminal Nerve</li><li>• Abducens Nerve</li><li>• Superior Ophthalmic Vein</li><li>• ophthalmic artery</li><li>• sympathetic nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Foramen rotundum which connects the middle cranial fossa with pterygopalatine fossa and traversed by maxillary nerve .</li><li>➤ Foramen rotundum which connects the middle cranial fossa with pterygopalatine fossa and traversed by maxillary nerve .</li><li>➤ Foramen rotundum which connects the middle cranial fossa with pterygopalatine fossa and traversed by maxillary nerve .</li><li>➤ Foramen rotundum</li><li>➤ connects</li><li>➤ middle cranial fossa</li><li>➤ pterygopalatine fossa</li><li>➤ maxillary nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 41</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 41</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Paralysis of the pointed structure will result in:", "options": [{"label": "A", "text": "Hoarseness of Voice, Aspiration", "correct": false}, {"label": "B", "text": "Weak Voice", "correct": true}, {"label": "C", "text": "Aspiration", "correct": false}, {"label": "D", "text": "Difficulty in Breathing", "correct": false}], "correct_answer": "B. Weak Voice", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115548.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Weak Voice</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Recurrent laryngeal nerve supplies all muscles of the larynx except cricothyroid and is sensory to the mucosa of the larynx below the level of vocal cords . Its injury will result in hoarseness and aspiration .</li><li>• Option A: Recurrent laryngeal nerve</li><li>• all muscles</li><li>• except</li><li>• cricothyroid</li><li>• sensory</li><li>• mucosa</li><li>• larynx below</li><li>• vocal cords</li><li>• hoarseness</li><li>• aspiration</li><li>• Option C: Injury to internal laryngeal nerve also will result in aspiration , it is sensory to mucosa of larynx above the level of vocal cords .</li><li>• Option C:</li><li>• internal laryngeal nerve</li><li>• aspiration</li><li>• sensory</li><li>• mucosa of larynx</li><li>• above</li><li>• vocal cords</li><li>• Option D: Recurrent laryngeal nerve innervates posterior cricoarytenoid muscle which is an abductor of vocal cord . Its paralysis vocal cord will lie in cadaveric position and cause dyspnoea .</li><li>• Option D: Recurrent laryngeal nerve</li><li>• posterior cricoarytenoid muscle</li><li>• abductor</li><li>• vocal cord</li><li>• paralysis vocal cord</li><li>• cadaveric position</li><li>• dyspnoea</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ Cricothyroid muscle , innervated by external laryngeal nerves and is a tensor of the vocal cord . Its paralysis will result in weak voice .</li><li>➤ Cricothyroid muscle , innervated by external laryngeal nerves and is a tensor of the vocal cord . Its paralysis will result in weak voice .</li><li>➤ Cricothyroid muscle</li><li>➤ external laryngeal nerves</li><li>➤ tensor</li><li>➤ vocal cord</li><li>➤ weak voice</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Branches from Second Part of Maxillary Artery are: Middle Meningeal Artery Masseteric Artery Sphenopalatine Artery Buccal Artery Accessory Meningeal Artery Anterior Tympanic Artery Deep Temporal Artery", "options": [{"label": "A", "text": "1, 3, 5", "correct": false}, {"label": "B", "text": "2, 4, 7", "correct": true}, {"label": "C", "text": "4, 5, 6", "correct": false}, {"label": "D", "text": "2, 3, 7", "correct": false}], "correct_answer": "B. 2, 4, 7", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115603.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115615.jpg"], "explanation": "<p><strong>Ans. B) 2, 4, 7</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Maxillary artery is the larger terminal branch of the external carotid artery . It is divided into three parts by lateral pterygoid muscle .</li><li>➤ Maxillary artery is the larger terminal branch of the external carotid artery . It is divided into three parts by lateral pterygoid muscle .</li><li>➤ Maxillary artery</li><li>➤ larger terminal branch</li><li>➤ external carotid artery</li><li>➤ three parts</li><li>➤ lateral pterygoid muscle</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 328-331</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 328-331</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sequential arrangement of secretomotor pathway to lacrimal gland: Pons Nerve of pterygoid canal Geniculate ganglion Nervus intermedius Lacrimal nerve Greater petrosal nerve Pterygopalatine ganglion Zygomaticotemporal nerve", "options": [{"label": "A", "text": "1, 4, 3, 2, 6, 7, 8, 5", "correct": false}, {"label": "B", "text": "1, 4, 3, 6, 2, 7, 8, 5", "correct": true}, {"label": "C", "text": "1, 3, 2, 7, 4, 6, 8, 5", "correct": false}, {"label": "D", "text": "1, 3, 7, 4, 2, 6, 8, 5", "correct": false}], "correct_answer": "B. 1, 4, 3, 6, 2, 7, 8, 5", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115631.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115658.jpg"], "explanation": "<p><strong>Ans. B) 1, 4, 3, 6, 2, 7,</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Secretomotor pathway of lacrimal gland</li><li>• Secretomotor pathway</li><li>• lacrimal gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The secretomotor pathway of the lacrimal gland , which controls tear production , is a complex neural pathway involving both autonomic and sensory nerves .</li><li>➤ secretomotor pathway</li><li>➤ lacrimal gland</li><li>➤ controls tear production</li><li>➤ both autonomic</li><li>➤ sensory nerves</li><li>➤ Origin: The secretomotor pathway for the lacrimal gland originates in the lacrimatory nucleus located in the pontine tegmentum of the brainstem . Parasympathetic Pathway: Preganglionic Neurons, the pathway begins with the preganglionic parasympathetic neurons in the superior salivatory nucleus . These neurons send their axons via the facial nerve . Greater Petrosal Nerve: The fibers then branch off from the facial nerve to form the greater petrosal nerve, which carries these parasympathetic fibers . Pterygopalatine Ganglion: The fibers from the greater petrosal nerve synapse in the pterygopalatine ganglion, located in the pterygopalatine fossa . Postganglionic Neurons: From the pterygopalatine ganglion, the postganglionic parasympathetic fibers join the branches of the maxillary nerve and reach the lacrimal gland . Sympathetic Pathway: Though the primary control of lacrimal secretion is parasympathetic , there is also a sympathetic innervation. Sympathetic fibers originate in the superior cervical ganglion and follow a pathway along the internal carotid artery , eventually joining the parasympathetic pathway to the lacrimal gland . Sympathetic innervation primarily modulates the blood flow to the gland rather than directly stimulating secretion . Sensory Pathway: Sensory innervation to the lacrimal gland is provided by the lacrimal nerve , a branch of the ophthalmic nerve . This is not directly involved in tear secretion but can influence it reflexively in response to sensory stimuli. Reflex Arc: The lacrimal reflex arc is important in tear production . Sensory input from the cornea and conjunctiva can trigger a reflex increase in tear production via the parasympathetic pathway . Emotional stimuli can also influence this pathway, leading to increased tear production during emotional states .</li><li>➤ Origin: The secretomotor pathway for the lacrimal gland originates in the lacrimatory nucleus located in the pontine tegmentum of the brainstem .</li><li>➤ Origin:</li><li>➤ lacrimatory nucleus</li><li>➤ pontine tegmentum</li><li>➤ brainstem</li><li>➤ Parasympathetic Pathway: Preganglionic Neurons, the pathway begins with the preganglionic parasympathetic neurons in the superior salivatory nucleus . These neurons send their axons via the facial nerve .</li><li>➤ Parasympathetic Pathway:</li><li>➤ superior salivatory nucleus</li><li>➤ axons</li><li>➤ facial nerve</li><li>➤ Greater Petrosal Nerve: The fibers then branch off from the facial nerve to form the greater petrosal nerve, which carries these parasympathetic fibers .</li><li>➤ Greater Petrosal Nerve:</li><li>➤ facial nerve</li><li>➤ parasympathetic fibers</li><li>➤ Pterygopalatine Ganglion: The fibers from the greater petrosal nerve synapse in the pterygopalatine ganglion, located in the pterygopalatine fossa .</li><li>➤ Pterygopalatine Ganglion:</li><li>➤ greater petrosal nerve</li><li>➤ pterygopalatine fossa</li><li>➤ Postganglionic Neurons: From the pterygopalatine ganglion, the postganglionic parasympathetic fibers join the branches of the maxillary nerve and reach the lacrimal gland .</li><li>➤ Postganglionic Neurons:</li><li>➤ maxillary</li><li>➤ nerve</li><li>➤ reach</li><li>➤ lacrimal gland</li><li>➤ Sympathetic Pathway: Though the primary control of lacrimal secretion is parasympathetic , there is also a sympathetic innervation. Sympathetic fibers originate in the superior cervical ganglion and follow a pathway along the internal carotid artery , eventually joining the parasympathetic pathway to the lacrimal gland . Sympathetic innervation primarily modulates the blood flow to the gland rather than directly stimulating secretion .</li><li>➤ Sympathetic Pathway:</li><li>➤ parasympathetic</li><li>➤ superior cervical ganglion</li><li>➤ pathway</li><li>➤ internal carotid artery</li><li>➤ parasympathetic pathway</li><li>➤ lacrimal gland</li><li>➤ modulates</li><li>➤ blood flow</li><li>➤ gland</li><li>➤ directly stimulating secretion</li><li>➤ Sensory Pathway: Sensory innervation to the lacrimal gland is provided by the lacrimal nerve , a branch of the ophthalmic nerve . This is not directly involved in tear secretion but can influence it reflexively in response to sensory stimuli.</li><li>➤ Sensory Pathway:</li><li>➤ lacrimal gland</li><li>➤ lacrimal nerve</li><li>➤ ophthalmic nerve</li><li>➤ Reflex Arc: The lacrimal reflex arc is important in tear production . Sensory input from the cornea and conjunctiva can trigger a reflex increase in tear production via the parasympathetic pathway . Emotional stimuli can also influence this pathway, leading to increased tear production during emotional states .</li><li>➤ Reflex Arc:</li><li>➤ tear production</li><li>➤ cornea</li><li>➤ conjunctiva</li><li>➤ trigger</li><li>➤ reflex</li><li>➤ increase</li><li>➤ tear production</li><li>➤ parasympathetic pathway</li><li>➤ increased tear production</li><li>➤ emotional states</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 76</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 76</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a Branch of Facial Nerve?", "options": [{"label": "A", "text": "Deep Petrosal Nerve", "correct": false}, {"label": "B", "text": "Lesser Petrosal Nerve", "correct": false}, {"label": "C", "text": "Greater Petrosal Nerve", "correct": true}, {"label": "D", "text": "External Petrosal Nerve", "correct": false}], "correct_answer": "C. Greater Petrosal Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Greater Petrosal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Deep petrosal nerve arises from the sympathetic plexus around the internal carotid artery , it joins with the greater petrosal nerve to form the nerve of the pterygoid canal .</li><li>• Option A:</li><li>• sympathetic plexus</li><li>• internal carotid artery</li><li>• greater petrosal nerve</li><li>• nerve</li><li>• pterygoid canal</li><li>• Option B: Lesser petrosal nerve – the tympanic branch of glossopharyngeal nerve forms a plexus beneath the promontory and some of the fibres of the plexus conveying preganglionic secretomotor fibres for parotid gland leave tympanic cavity as lesser petrosal nerve .</li><li>• Option B:</li><li>• tympanic branch</li><li>• glossopharyngeal nerve</li><li>• plexus</li><li>• promontory</li><li>• fibres</li><li>• plexus</li><li>• preganglionic secretomotor</li><li>• fibres</li><li>• parotid gland</li><li>• leave</li><li>• tympanic cavity</li><li>• lesser petrosal nerve</li><li>• Option D: External petrosal nerve carries sympathetic fibres from the sympathetic plexus around middle meningeal artery coursing extradurally laterally to the greater and lesser petrosal nerves on the petrous ridge’s anterior surface .</li><li>• Option D:</li><li>• sympathetic fibres</li><li>• sympathetic plexus</li><li>• middle meningeal artery</li><li>• extradurally laterally</li><li>• greater</li><li>• lesser petrosal nerves</li><li>• petrous ridge’s</li><li>• anterior surface</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The greater petrosal nerve is indeed related to the facial nerve ( cranial nerve VII ). The greater petrosal nerve carries parasympathetic preganglionic fibers that originate in the superior salivatory nucleus of the brainstem. These fibers travel through the facial nerve and exit via the geniculate ganglion . From there, they join the greater petrosal nerve , which then synapses in the pterygopalatine ganglion. The postganglionic fibers from the pterygopalatine ganglion go on to innervate several structures in the head , including the lacrimal gland (for tear production), the nasal glands (for mucus production), and the palatal and pharyngeal glands (for secretion). This parasympathetic pathway is involved in controlling various secretory functions in the head and is associated with the facial nerve through the greater petrosal nerve .</li><li>➤ facial nerve</li><li>➤ cranial nerve VII</li><li>➤ greater petrosal nerve</li><li>➤ parasympathetic preganglionic fibers</li><li>➤ originate</li><li>➤ superior salivatory nucleus</li><li>➤ brainstem.</li><li>➤ facial nerve</li><li>➤ exit</li><li>➤ geniculate ganglion</li><li>➤ greater petrosal nerve</li><li>➤ synapses</li><li>➤ pterygopalatine ganglion.</li><li>➤ postganglionic fibers</li><li>➤ pterygopalatine ganglion</li><li>➤ head</li><li>➤ lacrimal gland</li><li>➤ nasal glands</li><li>➤ palatal</li><li>➤ pharyngeal glands</li><li>➤ head</li><li>➤ facial nerve</li><li>➤ greater petrosal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 395</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 395</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a feature of Facial Nerve Injury?", "options": [{"label": "A", "text": "Loss of Transverse wrinkles of Forehead", "correct": false}, {"label": "B", "text": "Corneal Reflex Disturbed", "correct": false}, {"label": "C", "text": "Inability to Open the Eyes", "correct": true}, {"label": "D", "text": "Decreased Lacrimation", "correct": false}], "correct_answer": "C. Inability to Open the Eyes", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Inability to Open the Eyes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Loss of transverse wrinkles of the forehead is a feature of facial nerve injury . The facial nerve controls the frontalis muscle , which is responsible for raising the eyebrows and creating transverse wrinkles on the forehead . In facial nerve injury, the ability to raise the eyebrows on the affected side is lost .</li><li>• Option A:</li><li>• facial nerve injury</li><li>• frontalis muscle</li><li>• raising</li><li>• eyebrows</li><li>• transverse wrinkles</li><li>• forehead</li><li>• ability</li><li>• raise</li><li>• eyebrows</li><li>• affected side</li><li>• lost</li><li>• Option B: Corneal reflex disturbed is a feature of facial nerve injury . The facial nerve plays a role in the corneal reflex , which involves the blink reflex in response to corneal stimulation . Damage to the facial nerve can lead to a disturbed or absent corneal reflex on the affected side. The afferent limb of corneal reflex is via ophthalmic division of trigeminal nerve and efferent limb is via facial nerve .</li><li>• Option B:</li><li>• facial nerve injury</li><li>• corneal reflex</li><li>• blink reflex</li><li>• corneal stimulation</li><li>• Damage</li><li>• facial nerve</li><li>• disturbed</li><li>• absent corneal reflex</li><li>• affected side.</li><li>• afferent limb</li><li>• corneal reflex</li><li>• ophthalmic division</li><li>• trigeminal nerve</li><li>• efferent limb</li><li>• facial nerve</li><li>• Option D: Decreased lacrimation is a feature of facial nerve injury . The facial nerve also controls the lacrimal glands responsible for tear production . Facial nerve injury can lead to decreased or absent tear production on the affected side , resulting in dryness of the eye . The preganglionic parasympathetic fibre for lacrimal gland passes via nervus intermedius component of facial nerve .</li><li>• Option D:</li><li>• facial nerve injury</li><li>• lacrimal glands</li><li>• tear production</li><li>• decreased</li><li>• absent tear production</li><li>• affected side</li><li>• dryness</li><li>• eye</li><li>• preganglionic parasympathetic fibre</li><li>• lacrimal gland passes</li><li>• nervus intermedius component</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inability to open eyes is not typically associated with facial nerve injury. Facial nerve injury primarily affects the muscles of facial expression , including the orbicularis oculi muscle responsible for closing the eyes . While facial nerve injury can lead to difficulty in closing the eye ( lagophthalmos ), it does not usually result in an inability to open the eyes. Levator palpebrae superioris elevates the upper eyelid to open the palpebral fissure and is innervated by upper division of oculomotor nerve .</li><li>➤ not typically</li><li>➤ muscles</li><li>➤ facial expression</li><li>➤ orbicularis oculi muscle</li><li>➤ closing</li><li>➤ eyes</li><li>➤ difficulty</li><li>➤ closing</li><li>➤ eye</li><li>➤ lagophthalmos</li><li>➤ Levator palpebrae superioris</li><li>➤ elevates</li><li>➤ upper eyelid</li><li>➤ open</li><li>➤ palpebral fissure</li><li>➤ upper division</li><li>➤ oculomotor nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury to Chorda Tympani leads to all the following Except:", "options": [{"label": "A", "text": "Decreased Salivation from Submandibular Salivary Gland", "correct": false}, {"label": "B", "text": "Loss of Taste Sensation from Anterior 2/3 of Tongue", "correct": false}, {"label": "C", "text": "Decreased Saliva Secretion from Sublingual Gland", "correct": false}, {"label": "D", "text": "Decreased Taste Sensation from Soft Palate", "correct": true}], "correct_answer": "D. Decreased Taste Sensation from Soft Palate", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Decreased Taste Sensation from Soft Palate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Chorda tympani nerve carries preganglionic parasympathetic secretomotor fibres for submandibular salivary gland and joins the lingual nerve in infratemporal fossa and is distributed through it. It is in the submandibular ganglion . The postganglionic fibres pass directly to the submandibular gland .</li><li>• Option A: Chorda tympani nerve</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• submandibular salivary gland</li><li>• lingual nerve</li><li>• infratemporal fossa</li><li>• submandibular ganglion</li><li>• postganglionic fibres</li><li>• submandibular gland</li><li>• Option B: Chorda tympani nerve represents the pretrematic branch of first branchial arch and conveys taste sensation from anterior 2/3 of tongue .</li><li>• Option B:</li><li>• pretrematic branch</li><li>• first branchial arch</li><li>• taste sensation</li><li>• anterior 2/3</li><li>• tongue</li><li>• Option C: Chorda tympani nerve carries preganglionic parasympathetic secretomotor fibres for sublingual salivary gland and relays in submandibular ganglion . The postganglionic fibres enter back into lingual nerve and distributed to sublingual salivary gland .</li><li>• Option C:</li><li>• preganglionic parasympathetic secretomotor fibres</li><li>• sublingual salivary gland</li><li>• submandibular ganglion</li><li>• lingual nerve</li><li>• sublingual salivary gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Taste fibres from soft palate pass via lesser palatine nerves , pterygopalatine ganglion without interruption, nerve of pterygoid canal and greater petrosal nerve and terminate as peripheral process of pseudounipolar neurons in geniculate ganglion .</li><li>➤ Taste fibres</li><li>➤ soft palate</li><li>➤ lesser palatine nerves</li><li>➤ nerve of pterygoid canal</li><li>➤ greater petrosal nerve</li><li>➤ pseudounipolar neurons</li><li>➤ geniculate ganglion</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 398</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 398</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with complaints of double vision and difficulty walking, especially when descending stairs or walking on uneven ground. He notes that his symptoms seem to worsen throughout the day. Physical examination reveals a limitation in downward gaze and adduction in the right eye, along with a head tilt towards the left shoulder. There are no other neurological deficits noted. Based on the patient's symptoms, which of the following cranial nerves is most likely not involved in carrying parasympathetic fibers and is associated with his condition?", "options": [{"label": "A", "text": "IV", "correct": true}, {"label": "B", "text": "VII", "correct": false}, {"label": "C", "text": "III", "correct": false}, {"label": "D", "text": "IX", "correct": false}], "correct_answer": "A. IV", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-131634.jpg"], "explanation": "<p><strong>Ans. A) IV</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The preganglionic parasympathetic secretomotor fibres passing through facial nerve innervates submandibular , sublingual salivary gland , lacrimal gland and glands of soft palate and nasal mucosa .</li><li>• Option B:</li><li>• facial nerve</li><li>• submandibular</li><li>• sublingual salivary gland</li><li>• lacrimal</li><li>• gland</li><li>• glands</li><li>• soft palate</li><li>• nasal mucosa</li><li>• Option C: The preganglionic parasympathetic secretomotor fibres passing through Oculomotor nerve innervates ciliary , sphincter pupillae muscles .</li><li>• Option C:</li><li>• Oculomotor nerve</li><li>• ciliary</li><li>• sphincter pupillae muscles</li><li>• Option D: The preganglionic parasympathetic secretomotor fibres passing through Glossopharyngeal nerve innervates parotid gland .</li><li>• Option D:</li><li>• Glossopharyngeal nerve</li><li>• parotid gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trochlear nerve is purely motor and innervates superior oblique muscle . The trochlear nerve, also known as cranial nerve IV (CN IV), does not carry parasympathetic fibers. It is a motor nerve that innervates a single muscle : the superior oblique muscle of the eye . This muscle is responsible for downward and outward movements of the eyeball . The trochlear nerve is unique among cranial nerves for several reasons: It is the smallest cranial nerve in terms of the number of axons it contains. It has the longest intracranial course . It is the only cranial nerve that exits the brainstem dorsally . It crosses (decussates) within the brainstem before exiting , meaning that each nerve innervates the superior oblique muscle on the opposite side of the body from where it originated.</li><li>➤ Trochlear nerve is purely motor and innervates superior oblique muscle .</li><li>➤ Trochlear nerve</li><li>➤ motor</li><li>➤ superior oblique muscle</li><li>➤ The trochlear nerve, also known as cranial nerve IV (CN IV), does not carry parasympathetic fibers. It is a motor nerve that innervates a single muscle : the superior oblique muscle of the eye . This muscle is responsible for downward and outward movements of the eyeball .</li><li>➤ cranial nerve IV</li><li>➤ motor nerve</li><li>➤ single muscle</li><li>➤ superior oblique muscle</li><li>➤ eye</li><li>➤ downward</li><li>➤ outward movements</li><li>➤ eyeball</li><li>➤ The trochlear nerve is unique among cranial nerves for several reasons: It is the smallest cranial nerve in terms of the number of axons it contains. It has the longest intracranial course . It is the only cranial nerve that exits the brainstem dorsally . It crosses (decussates) within the brainstem before exiting , meaning that each nerve innervates the superior oblique muscle on the opposite side of the body from where it originated.</li><li>➤ trochlear nerve</li><li>➤ cranial nerves</li><li>➤ It is the smallest cranial nerve in terms of the number of axons it contains. It has the longest intracranial course . It is the only cranial nerve that exits the brainstem dorsally . It crosses (decussates) within the brainstem before exiting , meaning that each nerve innervates the superior oblique muscle on the opposite side of the body from where it originated.</li><li>➤ It is the smallest cranial nerve in terms of the number of axons it contains.</li><li>➤ smallest cranial nerve</li><li>➤ number</li><li>➤ axons</li><li>➤ It has the longest intracranial course .</li><li>➤ longest intracranial course</li><li>➤ It is the only cranial nerve that exits the brainstem dorsally .</li><li>➤ only cranial nerve</li><li>➤ exits</li><li>➤ brainstem dorsally</li><li>➤ It crosses (decussates) within the brainstem before exiting , meaning that each nerve innervates the superior oblique muscle on the opposite side of the body from where it originated.</li><li>➤ crosses</li><li>➤ before exiting</li><li>➤ innervates</li><li>➤ superior oblique muscle</li><li>➤ opposite side</li><li>➤ body</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old construction worker was present to the emergency department with severe pain and swelling in his right arm after falling from a ladder and landing on his shoulder. On examination, the right arm appears edematous with decreased sensation and weakened pulse when compared to the left arm. Imaging studies are ordered to assess for vascular and nerve damage, particularly around the axillary region, where the injury seems most severe.", "options": [{"label": "A", "text": "Pretracheal Fascia", "correct": false}, {"label": "B", "text": "Prevertebral Fascia", "correct": true}, {"label": "C", "text": "Investing Layer", "correct": false}, {"label": "D", "text": "Pharyngobasilar Fascia", "correct": false}], "correct_answer": "B. Prevertebral Fascia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132224.jpg"], "explanation": "<p><strong>Ans. B) Prevertebral Fascia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Pretracheal fascia thickens to form the ligament of Berry between the medial surface of thyroid gland and cricoid cartilage .</li><li>• Option A:</li><li>• thickens</li><li>• ligament</li><li>• Berry</li><li>• medial surface</li><li>• thyroid gland</li><li>• cricoid cartilage</li><li>• Option C: Investing layer of deep cervical fascia thickens to form parotidomasseteric fascia and stylomandibular ligament .</li><li>• Option C:</li><li>• deep cervical fascia</li><li>• thickens</li><li>• parotidomasseteric fascia</li><li>• stylomandibular ligament</li><li>• Option D: Pharyngobasilar fascia – is the thickened submucosa in the upper part of pharynx and closes sinus of Morgagni to attach to base of skull .</li><li>• Option D:</li><li>• thickened submucosa</li><li>• upper part</li><li>• pharynx</li><li>• closes sinus</li><li>• Morgagni</li><li>• base of skull</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Axillary sheath that surrounds the subclavian artery and cords of brachial plexus is derived from prevertebral layer of deep cervical fascia .</li><li>➤ Axillary sheath that surrounds the subclavian artery and cords of brachial plexus is derived from prevertebral layer of deep cervical fascia .</li><li>➤ Axillary sheath</li><li>➤ subclavian artery</li><li>➤ cords</li><li>➤ brachial plexus</li><li>➤ prevertebral layer</li><li>➤ deep cervical fascia</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Content of Space of Burns:", "options": [{"label": "A", "text": "Clavicular Head of Sternocleidomastoid", "correct": false}, {"label": "B", "text": "Sternal Head of Sternocleidomastoid", "correct": true}, {"label": "C", "text": "External Jugular Vein", "correct": false}, {"label": "D", "text": "Supraclavicular Nerves", "correct": false}], "correct_answer": "B. Sternal Head of Sternocleidomastoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132256.jpg"], "explanation": "<p><strong>Ans. B) Sternal Head of Sternocleidomastoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The clavicular head of the sternocleidomastoid muscle is not a content of the space of Burns.</li><li>• Option A:</li><li>• not</li><li>• Option C: The external jugular vein typically runs superficially across the sternocleidomastoid muscle , especially as it traverses the area en route to draining into the subclavian vein .</li><li>• Option C:</li><li>• superficially</li><li>• sternocleidomastoid muscle</li><li>• subclavian vein</li><li>• Option D: The supraclavicular nerves, branches of the cervical plexus , emerge from behind the sternocleidomastoid muscle and descend into the space of Burns to provide sensory innervation to the skin over the shoulder area . These nerves are not the contents of the space of Burns.</li><li>• Option D:</li><li>• cervical plexus</li><li>• emerge</li><li>• behind</li><li>• sternocleidomastoid muscle</li><li>• descend</li><li>• space of Burns</li><li>• sensory innervation</li><li>• skin</li><li>• shoulder area</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sternal head of the sternocleidomastoid muscle helps form the boundary of the space of Burns and is not considered content within the space. It defines the medial border of this area. Suprasternal space of Burns contains - sternal head of sternocleidomastoid , jugular venous arch , interclavicular ligament , occasionally lymph node</li><li>➤ The sternal head of the sternocleidomastoid muscle helps form the boundary of the space of Burns and is not considered content within the space. It defines the medial border of this area.</li><li>➤ boundary</li><li>➤ space of Burns</li><li>➤ medial border</li><li>➤ Suprasternal space of Burns contains - sternal head of sternocleidomastoid , jugular venous arch , interclavicular ligament , occasionally lymph node</li><li>➤ Suprasternal space</li><li>➤ Burns</li><li>➤ sternal head of sternocleidomastoid</li><li>➤ jugular venous arch</li><li>➤ interclavicular ligament</li><li>➤ lymph node</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 177</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 177</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle which divide Subclavian Artery into 3 parts:", "options": [{"label": "A", "text": "Scalenus Minimus", "correct": false}, {"label": "B", "text": "Scalenus Medius", "correct": false}, {"label": "C", "text": "Scalenus Posterior", "correct": false}, {"label": "D", "text": "Scalenus Anterior", "correct": true}], "correct_answer": "D. Scalenus Anterior", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132315.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132331.jpg"], "explanation": "<p><strong>Ans. D) Scalenus Anterior</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Scalenus minimus contributes to the suprapleural membrane / Sibson’s fascia .</li><li>• Option A:</li><li>• suprapleural membrane</li><li>• Sibson’s fascia</li><li>• Option B: The trunks of brachial plexus lie between scalenus medius and scalenus anterior .</li><li>• Option B:</li><li>• scalenus medius</li><li>• scalenus anterior</li><li>• Option C: Scalenus posterior is inserted into outer surface of second rib .</li><li>• Option C:</li><li>• outer surface</li><li>• second rib</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The subclavian artery is divided into 3 parts by scalenus anterior muscle . The phrenic nerve seen on anterior surface of scalenus anterior .</li><li>➤ scalenus anterior muscle</li><li>➤ phrenic nerve</li><li>➤ anterior surface</li><li>➤ scalenus anterior</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 332</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 332</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The First Branch of External Carotid Artery", "options": [{"label": "A", "text": "Ascending Pharyngeal Artery", "correct": true}, {"label": "B", "text": "Facial Artery", "correct": false}, {"label": "C", "text": "Superior Thyroid Artery", "correct": false}, {"label": "D", "text": "Lingual Artery", "correct": false}], "correct_answer": "A. Ascending Pharyngeal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132423.jpg"], "explanation": "<p><strong>Ans. A) Ascending Pharyngeal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B : Facial artery arises just above the tip of the greater cornu of hyoid bone in the carotid triangle.</li><li>• Option B</li><li>• Option C: Superior thyroid artery often arises from the external carotid artery near its origin, but it may also originate from the common carotid bifurcation in many cases. It is not consistently the first branch.</li><li>• Option C:</li><li>• Option D : Lingual artery arises just opposite the tip of greater cornu of hyoid bone and its course is divided into 3 parts by hyoglossus muscle.</li><li>• Option D</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ascending pharyngeal artery is the first branch of the external carotid artery and is its only medial branch.</li><li>➤ It is a long, slender vessel that runs superiorly along the lateral wall of the pharynx to the base of the skull.</li><li>➤ The ascending pharyngeal artery supplies:</li><li>➤ The pharynx Middle ear Meninges Prevertebral muscles Parts of the soft palate</li><li>➤ The pharynx</li><li>➤ Middle ear</li><li>➤ Meninges</li><li>➤ Prevertebral muscles</li><li>➤ Parts of the soft palate</li><li>➤ While the superior thyroid artery is often described as the first branch in some texts, more detailed anatomical studies indicate that the ascending pharyngeal artery typically originates first from the external carotid artery.</li><li>➤ Ref : Recent anatomical studies and advanced imaging research on the external carotid arterial system</li><li>➤ Ref</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Lateral Atlanto Axial Joint is an example of:", "options": [{"label": "A", "text": "Pivot Joint", "correct": false}, {"label": "B", "text": "Ellipsoidal Joint", "correct": false}, {"label": "C", "text": "Plane Joint", "correct": true}, {"label": "D", "text": "Saddle Joint", "correct": false}], "correct_answer": "C. Plane Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-133214.jpg"], "explanation": "<p><strong>Ans. C) Plane Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Median atlantoaxial joints are pivot synovial joints which permit rotational movements and are also called as joints of No</li><li>• Option A:</li><li>• Median atlantoaxial joints</li><li>• pivot synovial joints</li><li>• rotational movements</li><li>• joints</li><li>• No</li><li>• Option B: The Atlanto Occipital Joints are ellipsoidal synovial joints and permit flexion , extension , lateral flexion and are called joints of yes .</li><li>• Option B:</li><li>• ellipsoidal synovial joints</li><li>• flexion</li><li>• extension</li><li>• lateral flexion</li><li>• joints</li><li>• yes</li><li>• Option D: Saddle synovial joint in head and neck region includes the incudomalleal joint .</li><li>• Option D:</li><li>• synovial joint</li><li>• head</li><li>• neck</li><li>• incudomalleal joint</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lateral atlanto-axial joint is an example of a plane joint . This type of synovial joint allows for rotation around a single axis . In the case of the lateral atlanto-axial joint, it permits the rotation of the head , as seen when shaking the head \" no .\" The joint is formed between the C1 vertebra (also known as the atlas ) and the C2 vertebra (also known as the axis ). The defining feature of this pivot joint is the odontoid process (or dens ) of the axis , around which the atlas rotates . This specific structure and function allow for a significant range of rotational movement , which is crucial for head and neck mobility .</li><li>➤ The lateral atlanto-axial joint is an example of a plane joint . This type of synovial joint allows for rotation around a single axis . In the case of the lateral atlanto-axial joint, it permits the rotation of the head , as seen when shaking the head \" no .\"</li><li>➤ The lateral atlanto-axial joint is an example of a plane joint . This type of synovial joint allows for rotation around a single axis . In the case of the lateral atlanto-axial joint, it permits the rotation of the head , as seen when shaking the head \" no .\"</li><li>➤ lateral atlanto-axial joint</li><li>➤ plane joint</li><li>➤ rotation</li><li>➤ single axis</li><li>➤ rotation</li><li>➤ head</li><li>➤ shaking</li><li>➤ head</li><li>➤ no</li><li>➤ The joint is formed between the C1 vertebra (also known as the atlas ) and the C2 vertebra (also known as the axis ). The defining feature of this pivot joint is the odontoid process (or dens ) of the axis , around which the atlas rotates .</li><li>➤ The joint is formed between the C1 vertebra (also known as the atlas ) and the C2 vertebra (also known as the axis ). The defining feature of this pivot joint is the odontoid process (or dens ) of the axis , around which the atlas rotates .</li><li>➤ between</li><li>➤ C1 vertebra</li><li>➤ atlas</li><li>➤ C2 vertebra</li><li>➤ axis</li><li>➤ pivot joint</li><li>➤ odontoid process</li><li>➤ dens</li><li>➤ axis</li><li>➤ atlas rotates</li><li>➤ This specific structure and function allow for a significant range of rotational movement , which is crucial for head and neck mobility .</li><li>➤ This specific structure and function allow for a significant range of rotational movement , which is crucial for head and neck mobility .</li><li>➤ specific structure</li><li>➤ function</li><li>➤ allow</li><li>➤ significant range</li><li>➤ rotational movement</li><li>➤ crucial</li><li>➤ head</li><li>➤ neck mobility</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 59</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 59</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a Forensic Medicine Conference, a detailed discussion is held on the mechanisms of death in cases of judicial hanging. One of the topics focuses on the anatomical structures involved in the upper cervical spine and their role in the cause of death when subjected to the forces involved in hanging. A case is presented where an individual subjected to judicial hanging was found to have significant cervical spine injuries during the autopsy. Based on the anatomical and forensic analysis, which of the following structures is most likely to be involved in causing death due to rupture in cases of judicial hanging?", "options": [{"label": "A", "text": "Upper Band of Cruciate Ligament", "correct": false}, {"label": "B", "text": "Apical Ligament of Dens", "correct": false}, {"label": "C", "text": "Transverse Ligament of Dens", "correct": true}, {"label": "D", "text": "Membranatectoria", "correct": false}], "correct_answer": "C. Transverse Ligament of Dens", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200147.jpg"], "explanation": "<p><strong>Ans. C) Transverse Ligament of Dens</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The upper band of cruciate ligament extends from upper margin of transverse ligament to the basilar part of occipital bone .</li><li>• Option A:</li><li>• extends</li><li>• upper margin</li><li>• transverse ligament</li><li>• basilar part</li><li>• occipital bone</li><li>• Option B: Apical ligament of dens extends from tip of dens to basilar part of occipital bone close to anterior margin of foramen magnum .</li><li>• Option B:</li><li>• tip</li><li>• dens</li><li>• basilar part</li><li>• occipital bone</li><li>• close</li><li>• anterior margin</li><li>• foramen magnum</li><li>• Option D: Membranatectoria is upward continuation of posterior longitudinal ligament and lies within the vertebral canal and is intimately adherent to spinal dura mater .</li><li>• Option D:</li><li>• Membranatectoria</li><li>• upward continuation</li><li>• posterior longitudinal ligament</li><li>• vertebral canal</li><li>• adherent</li><li>• spinal dura mater</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In judicial hanging , death is most commonly attributed to fracture-dislocation of the cervical vertebrae , specifically at the level of C2 (the axis ), which can lead to transection or damage to the spinal cord . This injury results in immediate cessation of vital functions , including respiration and cardiac activity , leading to death . While the transverse ligament of the atlas ( C1 ) holds the dens ( odontoid process ) of the axis ( C2 ) in place and its rupture could potentially contribute to instability between C1 and C2 , the primary cause of death in judicial hangings is typically the high-energy trauma to the neck that causes a fracture-dislocation of the cervical vertebrae rather than isolated injury to the ligaments .</li><li>➤ In judicial hanging , death is most commonly attributed to fracture-dislocation of the cervical vertebrae , specifically at the level of C2 (the axis ), which can lead to transection or damage to the spinal cord .</li><li>➤ judicial hanging</li><li>➤ death</li><li>➤ fracture-dislocation</li><li>➤ cervical vertebrae</li><li>➤ level</li><li>➤ C2</li><li>➤ axis</li><li>➤ lead</li><li>➤ transection</li><li>➤ damage</li><li>➤ spinal cord</li><li>➤ This injury results in immediate cessation of vital functions , including respiration and cardiac activity , leading to death .</li><li>➤ immediate cessation</li><li>➤ vital functions</li><li>➤ respiration</li><li>➤ cardiac activity</li><li>➤ leading</li><li>➤ death</li><li>➤ While the transverse ligament of the atlas ( C1 ) holds the dens ( odontoid process ) of the axis ( C2 ) in place and its rupture could potentially contribute to instability between C1 and C2 , the primary cause of death in judicial hangings is typically the high-energy trauma to the neck that causes a fracture-dislocation of the cervical vertebrae rather than isolated injury to the ligaments .</li><li>➤ transverse ligament</li><li>➤ atlas</li><li>➤ C1</li><li>➤ dens</li><li>➤ odontoid process</li><li>➤ axis</li><li>➤ C2</li><li>➤ place</li><li>➤ rupture</li><li>➤ potentially</li><li>➤ instability between</li><li>➤ C1</li><li>➤ C2</li><li>➤ death</li><li>➤ judicial hangings</li><li>➤ high-energy trauma</li><li>➤ neck</li><li>➤ fracture-dislocation</li><li>➤ cervical vertebrae</li><li>➤ isolated</li><li>➤ injury</li><li>➤ ligaments</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 60</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 60</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following are Branches of External Carotid Artery supplying Nasal Septum except:", "options": [{"label": "A", "text": "Anterior Ethmoidal Artery", "correct": true}, {"label": "B", "text": "Sphenopalatine Artery", "correct": false}, {"label": "C", "text": "Greater Palatine Artery", "correct": false}, {"label": "D", "text": "Superior Labial Artery", "correct": false}], "correct_answer": "A. Anterior Ethmoidal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200206.jpg"], "explanation": "<p><strong>Ans. A) Anterior Ethmoidal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Sphenopalatine artery arises from the maxillary artery ( external carotid artery ) and is also called the artery of epistaxis .</li><li>• Option B:</li><li>• maxillary artery</li><li>• external carotid artery</li><li>• artery</li><li>• epistaxis</li><li>• Option C: Greater palatine artery arises from maxillary artery ( external carotid artery ) and supplies the posteroinferior portion of nasal septum .</li><li>• Option C:</li><li>• maxillary artery</li><li>• external carotid artery</li><li>• supplies</li><li>• posteroinferior portion</li><li>• nasal septum</li><li>• Option D: Septal branches of superior labial artery from facial artery ( external carotid artery ) supplies the mobile part of nasal septum .</li><li>• Option D:</li><li>• Septal branches</li><li>• facial artery</li><li>• external carotid artery</li><li>• mobile part</li><li>• nasal septum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anterior ethmoidal artery that supplies the anterosuperior portion of the nasal septum is a branch of ophthalmic artery which arises from the cerebral part of internal carotid artery .</li><li>➤ supplies</li><li>➤ anterosuperior portion</li><li>➤ nasal septum</li><li>➤ branch</li><li>➤ ophthalmic artery</li><li>➤ arises</li><li>➤ cerebral part</li><li>➤ internal carotid artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 212</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 212</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is true regarding Carotid Sheath?", "options": [{"label": "A", "text": "Ansa Cervicalis lies on the Posterior Wall", "correct": false}, {"label": "B", "text": "It is formed by Investing Layer of Deep Cervical Fascia", "correct": false}, {"label": "C", "text": "It contains IX, X, XI Cranial Nerves", "correct": false}, {"label": "D", "text": "The Arterial Stem is Medial", "correct": true}], "correct_answer": "D. The Arterial Stem is Medial", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200227.jpg"], "explanation": "<p><strong>Ans. D) The Arterial Stem is Medial</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The ansa cervicalis , a loop of nerves formed from the cervical plexus that supplies motor innervation to some infrahyoid muscles , does not lie on the posterior wall of the carotid sheath. It is actually located more superficially within the neck , typically on the surface of the carotid sheath or embedded in the fascia covering the sternocleidomastoid muscle .</li><li>• Option A:</li><li>• ansa cervicalis</li><li>• loop</li><li>• nerves</li><li>• cervical plexus</li><li>• supplies</li><li>• motor innervation</li><li>• infrahyoid muscles</li><li>• superficially</li><li>• within</li><li>• neck</li><li>• surface</li><li>• carotid sheath</li><li>• embedded</li><li>• fascia</li><li>• sternocleidomastoid muscle</li><li>• Option B: It is formed by investing layer of deep cervical fascia: The carotid sheath is formed by contributions from all three layers of the deep cervical fascia: the investing, pretracheal, and prevertebral layers. However, it is not formed by the investing layer alone. The investing layer contributes to the superficial aspect of the sheath, the pretracheal fascia contributes to the anterior part, and the prevertebral fascia contributes to the posterior part.</li><li>• Option B: It is formed by investing layer of deep cervical fascia:</li><li>• Option C: The Vagus nerve is the only Cranial Nerve that lies inside the Carotid Sheath.</li><li>• Option C:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Within the carotid sheath , the common carotid artery (or the internal carotid artery, higher in the neck) is located medially , the internal jugular vein is located laterally , and the vagus nerve is situated posteriorly between and slightly lateral to the artery and vein .</li><li>➤ Within the carotid sheath , the common carotid artery (or the internal carotid artery, higher in the neck) is located medially , the internal jugular vein is located laterally , and the vagus nerve is situated posteriorly between and slightly lateral to the artery and vein .</li><li>➤ carotid sheath</li><li>➤ common carotid artery</li><li>➤ medially</li><li>➤ laterally</li><li>➤ posteriorly</li><li>➤ slightly lateral</li><li>➤ artery</li><li>➤ vein</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Sequential Arrangement of Auditory Pathway from Periphery to Centre: Cochlear Nerve Superior Olivary Nucleus Medial Geniculate Body Cochlear Nuclei Lateral Lemniscus Inferior Colliculus", "options": [{"label": "A", "text": "1-3-2-4-5-6", "correct": false}, {"label": "B", "text": "1-4-2-5-6-3", "correct": true}, {"label": "C", "text": "1-3-4-2-6-5", "correct": false}, {"label": "D", "text": "1-4-2-3-6-5", "correct": false}], "correct_answer": "B. 1-4-2-5-6-3", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200254.jpg"], "explanation": "<p><strong>Ans. B) 1-4-2-5-6-3</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• The sequence of structures involved in this pathway is as follows:</li><li>• sequence</li><li>• structures</li><li>• Cochlear nerve: Sound information is initially converted into electrical signals by hair cells in the cochlea . These signals are then carried by the cochlear nerve, a part of the vestibulocochlear nerve (cranial nerve VIII ), from the cochlea to the brainstem . Cochlear nuclei: Upon reaching the brainstem, the fibers of the cochlear nerve synapse in the cochlear nuclei ( dorsal and ventral cochlear nuclei ), which are located at the junction of the pons and medulla . Superior olivary nucleus: After the cochlear nuclei, some fibers cross to the other side ( decussate ) and along with uncrossed fibers , project to the superior olivary nucleus in the pons . The superior olivary nucleus is involved in sound localization . Lateral lemniscus: Axons from the superior olivary nucleus and other nuclei ascend to the midbrain through a tract called the lateral lemniscus . Inferior colliculus: The lateral lemniscus fibers synapse in the inferior colliculus , which is an important auditory relay station in the midbrain and is involved in the reflexive responses to sound . Medial geniculate body: From the inferior colliculus , the pathway continues to the medial geniculate body of the thalamus , which acts as a relay station , further processing auditory information before sending it to the cortex .</li><li>• Cochlear nerve: Sound information is initially converted into electrical signals by hair cells in the cochlea . These signals are then carried by the cochlear nerve, a part of the vestibulocochlear nerve (cranial nerve VIII ), from the cochlea to the brainstem .</li><li>• Cochlear nerve:</li><li>• electrical signals</li><li>• hair cells</li><li>• cochlea</li><li>• vestibulocochlear nerve</li><li>• VIII</li><li>• cochlea</li><li>• brainstem</li><li>• Cochlear nuclei: Upon reaching the brainstem, the fibers of the cochlear nerve synapse in the cochlear nuclei ( dorsal and ventral cochlear nuclei ), which are located at the junction of the pons and medulla .</li><li>• Cochlear nuclei:</li><li>• cochlear nerve synapse</li><li>• cochlear nuclei</li><li>• dorsal</li><li>• ventral cochlear nuclei</li><li>• junction</li><li>• pons</li><li>• medulla</li><li>• Superior olivary nucleus: After the cochlear nuclei, some fibers cross to the other side ( decussate ) and along with uncrossed fibers , project to the superior olivary nucleus in the pons . The superior olivary nucleus is involved in sound localization .</li><li>• Superior olivary nucleus:</li><li>• decussate</li><li>• uncrossed fibers</li><li>• project</li><li>• superior olivary nucleus</li><li>• pons</li><li>• sound localization</li><li>• Lateral lemniscus: Axons from the superior olivary nucleus and other nuclei ascend to the midbrain through a tract called the lateral lemniscus .</li><li>• Lateral lemniscus:</li><li>• Axons</li><li>• superior olivary nucleus</li><li>• ascend</li><li>• midbrain</li><li>• tract</li><li>• lateral lemniscus</li><li>• Inferior colliculus: The lateral lemniscus fibers synapse in the inferior colliculus , which is an important auditory relay station in the midbrain and is involved in the reflexive responses to sound .</li><li>• Inferior colliculus:</li><li>• lateral lemniscus fibers</li><li>• synapse</li><li>• inferior colliculus</li><li>• auditory relay station</li><li>• midbrain</li><li>• reflexive responses</li><li>• sound</li><li>• Medial geniculate body: From the inferior colliculus , the pathway continues to the medial geniculate body of the thalamus , which acts as a relay station , further processing auditory information before sending it to the cortex .</li><li>• Medial geniculate body:</li><li>• inferior colliculus</li><li>• medial geniculate body</li><li>• thalamus</li><li>• relay station</li><li>• auditory information</li><li>• before</li><li>• cortex</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sequence of Auditory Pathway Cochlear Nerve Cochlear Nucleus Superior Olivary Nucleus Lateral Lemniscus Medial Geniculate Body Auditory Cortex First Order Neuron – Spiral Ganglion Second Order Neuron – Cochlear Nucleus Third Order Neuron – Superior Olivary Nucleus Fourth Order Neuron – Medial Geniculate Body</li><li>➤ Sequence of Auditory Pathway</li><li>➤ Cochlear Nerve</li><li>➤ Cochlear Nucleus</li><li>➤ Superior Olivary Nucleus</li><li>➤ Lateral Lemniscus</li><li>➤ Medial Geniculate Body</li><li>➤ Auditory Cortex First Order Neuron – Spiral Ganglion Second Order Neuron – Cochlear Nucleus Third Order Neuron – Superior Olivary Nucleus Fourth Order Neuron – Medial Geniculate Body</li><li>➤ First Order Neuron – Spiral Ganglion Second Order Neuron – Cochlear Nucleus Third Order Neuron – Superior Olivary Nucleus Fourth Order Neuron – Medial Geniculate Body</li><li>➤ First Order Neuron – Spiral Ganglion</li><li>➤ Second Order Neuron – Cochlear Nucleus</li><li>➤ Third Order Neuron – Superior Olivary Nucleus</li><li>➤ Fourth Order Neuron – Medial Geniculate Body</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 273</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 273</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following sites is anastomosis between External and Internal Carotid Arteries?", "options": [{"label": "A", "text": "Angle of Mandible", "correct": false}, {"label": "B", "text": "Angle of Mouth", "correct": false}, {"label": "C", "text": "Medial canthus of eye", "correct": true}, {"label": "D", "text": "Condyle of Mandible", "correct": false}], "correct_answer": "C. Medial canthus of eye", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200334.jpg"], "explanation": "<p><strong>Ans. C) Medial Canthus of Eye</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Skin over of angle of mandible innervated by great auricular nerve from cervical plexus.</li><li>• Option A:</li><li>• Skin</li><li>• great auricular nerve</li><li>• cervical plexus.</li><li>• Option B: The modiolus is situated 1.2cm lateral to angle of mouth , injury to which can lead to facial asymmetry .</li><li>• Option B:</li><li>• modiolus</li><li>• 1.2cm lateral</li><li>• angle of mouth</li><li>• facial asymmetry</li><li>• Option D: Condylar process of mandible articulates with mandibular fossa of temporal bone to form the bicondylar synovial joint .</li><li>• Option D:</li><li>• Condylar process</li><li>• articulates</li><li>• mandibular fossa</li><li>• temporal bone</li><li>• bicondylar synovial joint</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The site of anastomosis between the external and internal carotid arteries around the medial canthus of the eye involves branches of both arterial systems . The anastomosis here is primarily between:</li><li>➤ external</li><li>➤ internal carotid arteries</li><li>➤ medial canthus</li><li>➤ eye</li><li>➤ branches</li><li>➤ both arterial systems</li><li>➤ The angular artery , which is a terminal branch of the facial artery (a branch of the external carotid artery ), and Branches of the ophthalmic artery , which is a branch of the internal carotid artery .</li><li>➤ The angular artery , which is a terminal branch of the facial artery (a branch of the external carotid artery ), and</li><li>➤ angular artery</li><li>➤ terminal branch</li><li>➤ facial artery</li><li>➤ branch</li><li>➤ external carotid artery</li><li>➤ Branches of the ophthalmic artery , which is a branch of the internal carotid artery .</li><li>➤ Branches</li><li>➤ ophthalmic artery</li><li>➤ branch</li><li>➤ internal carotid artery</li><li>➤ The ophthalmic artery sends out several branches that supply structures within the orbit and around the eye , including the medial canthus . One of these branches, the dorsal nasal artery (a continuation of the ophthalmic artery after it gives off the supraorbital artery ), can anastomose with the angular artery near the medial canthus . This anastomosis provides a potential collateral circulation pathway between the external and internal carotid arterial systems .</li><li>➤ orbit</li><li>➤ around</li><li>➤ eye</li><li>➤ medial canthus</li><li>➤ dorsal nasal artery</li><li>➤ ophthalmic artery</li><li>➤ gives off</li><li>➤ supraorbital artery</li><li>➤ angular artery</li><li>➤ medial canthus</li><li>➤ potential collateral circulation pathway</li><li>➤ external</li><li>➤ internal carotid arterial systems</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 82</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 82</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tympanic Membrane is supplied by ALL except:", "options": [{"label": "A", "text": "Vagus Nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "C", "text": "Trigeminal Nerve", "correct": false}, {"label": "D", "text": "Facial Nerve", "correct": true}], "correct_answer": "D. Facial Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200353.jpg"], "explanation": "<p><strong>Ans. D) Facial Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The lower and posterior part of the cuticular layer of tympanic membrane is supplied by auricular branch of vagus.</li><li>• Option A:</li><li>• lower</li><li>• posterior part</li><li>• cuticular layer</li><li>• tympanic membrane</li><li>• auricular branch</li><li>• vagus.</li><li>• Option B: The mucous layer of tympanic membrane is supplied by IX nerve via tympanic plexus .</li><li>• Option B:</li><li>• mucous layer</li><li>• IX nerve</li><li>• tympanic plexus</li><li>• Option C: The upper and anterior part of the cuticular layer of the tympanic membrane is supplied by the auriculotemporal nerve , a branch of the mandibular division of the trigeminal nerve .</li><li>• Option C:</li><li>• upper</li><li>• anterior part</li><li>• cuticular layer</li><li>• tympanic membrane</li><li>• auriculotemporal nerve</li><li>• mandibular division</li><li>• trigeminal nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The tympanic membrane , or eardrum , receives its sensory innervation from several cranial nerves due to its complex embryological development . The nerves supplying the tympanic membrane include:</li><li>➤ tympanic membrane</li><li>➤ eardrum</li><li>➤ sensory innervation</li><li>➤ several cranial nerves</li><li>➤ complex embryological development</li><li>➤ tympanic membrane</li><li>➤ Auriculotemporal Nerve: A branch of the mandibular nerve ( V3 ), which is the third division of the trigeminal nerve ( CN V ), supplies the anterior and superior portions of the tympanic membrane . Auricular Branch of the Vagus Nerve (Arnold's Nerve): This branch of the vagus nerve ( CN X ) supplies the posterior and inferior parts of the tympanic membrane . It can be involved in the cough reflex elicited by ear manipulations . Tympanic Branch of the Glossopharyngeal Nerve (Jacobson's Nerve): This branch provides innervation to the middle ear cavity , including the medial surface of the tympanic membrane . These nerves together ensure that the tympanic membrane is well-innervated , allowing it to transmit vibrations caused by sound waves effectively to the ossicles of the middle ear , and also making it sensitive to pain , touch , and temperature .</li><li>➤ Auriculotemporal Nerve: A branch of the mandibular nerve ( V3 ), which is the third division of the trigeminal nerve ( CN V ), supplies the anterior and superior portions of the tympanic membrane .</li><li>➤ Auriculotemporal Nerve:</li><li>➤ mandibular nerve</li><li>➤ V3</li><li>➤ third division</li><li>➤ trigeminal nerve</li><li>➤ CN V</li><li>➤ anterior</li><li>➤ superior portions</li><li>➤ tympanic membrane</li><li>➤ Auricular Branch of the Vagus Nerve (Arnold's Nerve): This branch of the vagus nerve ( CN X ) supplies the posterior and inferior parts of the tympanic membrane . It can be involved in the cough reflex elicited by ear manipulations .</li><li>➤ Auricular Branch of the Vagus Nerve (Arnold's Nerve):</li><li>➤ vagus nerve</li><li>➤ CN X</li><li>➤ posterior</li><li>➤ inferior parts</li><li>➤ tympanic membrane</li><li>➤ cough reflex</li><li>➤ ear manipulations</li><li>➤ Tympanic Branch of the Glossopharyngeal Nerve (Jacobson's Nerve): This branch provides innervation to the middle ear cavity , including the medial surface of the tympanic membrane .</li><li>➤ Tympanic Branch of the Glossopharyngeal Nerve (Jacobson's Nerve):</li><li>➤ innervation</li><li>➤ middle ear cavity</li><li>➤ medial surface</li><li>➤ tympanic membrane</li><li>➤ These nerves together ensure that the tympanic membrane is well-innervated , allowing it to transmit vibrations caused by sound waves effectively to the ossicles of the middle ear , and also making it sensitive to pain , touch , and temperature .</li><li>➤ tympanic membrane</li><li>➤ well-innervated</li><li>➤ allowing</li><li>➤ transmit</li><li>➤ sound waves effectively</li><li>➤ ossicles</li><li>➤ middle ear</li><li>➤ sensitive</li><li>➤ pain</li><li>➤ touch</li><li>➤ temperature</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 280</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 280</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following Structure does not pass through the Gap between Superior and Middle Constrictor of Pharynx?", "options": [{"label": "A", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "B", "text": "Stylopharyngeus Muscle", "correct": false}, {"label": "C", "text": "Internal Laryngeal Nerve", "correct": true}, {"label": "D", "text": "Stylohyoid Ligament", "correct": false}], "correct_answer": "C. Internal Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-152652.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-152705.jpg"], "explanation": "<p><strong>Ans. C) Internal Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Glossopharyngeal nerve is the nerve of the third pharyngeal arch that innervates stylopharyngeus muscle and passes between the superior and middle constrictor of pharynx .</li><li>• Option A:</li><li>• nerve</li><li>• third pharyngeal</li><li>• arch</li><li>• stylopharyngeus muscle</li><li>• superior</li><li>• middle constrictor</li><li>• pharynx</li><li>• Option B: Stylopharyngeus, Salpingopharyngeus and Palatopharyngeus are the longitudinal muscles of pharynx . All muscles of pharynx are innervated by pharyngeal plexus contributed by IX, X and XI cranial nerve . Stylopharygeus muscle is present between the superior and middle constrictor pharynx .</li><li>• Option B:</li><li>• Stylopharyngeus,</li><li>• Salpingopharyngeus</li><li>• Palatopharyngeus</li><li>• longitudinal muscles</li><li>• pharynx</li><li>• pharyngeal plexus</li><li>• IX, X</li><li>• XI cranial nerve</li><li>• superior</li><li>• middle constrictor pharynx</li><li>• Option D: Stylohyoid ligament is derived from reichert's cartilage of 2 nd pharyngeal arch . It is also present between the superior and middle constrictor of pharynx muscle .</li><li>• Option D:</li><li>• Stylohyoid ligament</li><li>• reichert's cartilage</li><li>• 2 nd pharyngeal arch</li><li>• between</li><li>• superior</li><li>• middle constrictor</li><li>• pharynx muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The gap between the superior and middle constrictor muscles of the pharynx , also known as the Sinus of Morgagni , allows passage for several structures, including: The stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve (CN IX). The glossopharyngeal nerve (CN IX) itself. The pharyngeal branch of the vagus nerve (CN X) along with some pharyngeal vessels. A structure that does not pass through this gap is the internal laryngeal nerve, a branch of the vagus nerve (CN X). The internal laryngeal nerve , along with the superior laryngeal artery (a branch of the superior thyroid artery), actually passes through the thyrohyoid membrane , which is located more inferiorly , between the hyoid bone and the thyroid cartilage , and not through the gap between the superior and middle constrictor muscles.</li><li>➤ The gap between the superior and middle constrictor muscles of the pharynx , also known as the Sinus of Morgagni , allows passage for several structures, including: The stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve (CN IX). The glossopharyngeal nerve (CN IX) itself. The pharyngeal branch of the vagus nerve (CN X) along with some pharyngeal vessels.</li><li>➤ gap</li><li>➤ superior</li><li>➤ middle constrictor muscles</li><li>➤ pharynx</li><li>➤ Sinus</li><li>➤ Morgagni</li><li>➤ The stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve (CN IX). The glossopharyngeal nerve (CN IX) itself. The pharyngeal branch of the vagus nerve (CN X) along with some pharyngeal vessels.</li><li>➤ The stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve (CN IX).</li><li>➤ stylopharyngeus muscle</li><li>➤ glossopharyngeal nerve</li><li>➤ The glossopharyngeal nerve (CN IX) itself.</li><li>➤ glossopharyngeal nerve</li><li>➤ The pharyngeal branch of the vagus nerve (CN X) along with some pharyngeal vessels.</li><li>➤ pharyngeal branch</li><li>➤ vagus nerve</li><li>➤ A structure that does not pass through this gap is the internal laryngeal nerve, a branch of the vagus nerve (CN X).</li><li>➤ The internal laryngeal nerve , along with the superior laryngeal artery (a branch of the superior thyroid artery), actually passes through the thyrohyoid membrane , which is located more inferiorly , between the hyoid bone and the thyroid cartilage , and not through the gap between the superior and middle constrictor muscles.</li><li>➤ internal laryngeal</li><li>➤ nerve</li><li>➤ superior laryngeal artery</li><li>➤ thyrohyoid membrane</li><li>➤ inferiorly</li><li>➤ hyoid bone</li><li>➤ thyroid cartilage</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 231</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 231</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "True about Superior Oblique Muscle:", "options": [{"label": "A", "text": "It originates from Lesser Wing of Sphenoid and inserts into Sclera in front of Equator", "correct": false}, {"label": "B", "text": "It is innervated by Oculomotor Nerve", "correct": false}, {"label": "C", "text": "It lies along the Medial Wall of Orbit above Superior Rectus Muscle", "correct": true}, {"label": "D", "text": "It causes Depression and Extorsion of the Eyeball", "correct": false}], "correct_answer": "C. It lies along the Medial Wall of Orbit above Superior Rectus Muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-144801.jpg"], "explanation": "<p><strong>Ans. C) It lies along the Medial Wall of Orbit above Superior Rectus Muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior oblique muscle arises from lesser wing of sphenoid and inserts into the sclera behind the equator in the posterosuperior quadrant of the eyeball.</li><li>• Option A:</li><li>• behind the equator</li><li>• posterosuperior quadrant</li><li>• Option B: Superior oblique is innervated by trochlear nerve .</li><li>• Option B:</li><li>• trochlear nerve</li><li>• Option D: Actions of superior oblique causes depression, abduction and intorsion of the eyeball.</li><li>• Option D:</li><li>• intorsion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superior Oblique Muscle originates from the sphenoid bone , just above the nasal cavity and behind the medial wall of the orbit . It runs along the medial wall of the orbit towards the front . Then, it passes through a fibrocartilaginous structure called the trochlea , which acts like a pulley , located near the frontoethmoidal suture at the superomedial aspect of the orbit . After passing through the trochlea , the tendon of the superior oblique muscle turns posteriorly , laterally , and downwards to insert onto the sclera (the white part of the eye ) on the posterior , lateral , and inferior aspect of the eyeball , beneath the superior rectus muscle . The primary action of the superior oblique muscle is to intort (rotate inward towards the nose ), depress , and abduct the eyeball , particularly when it is in an adducted position . Its unique path allows it to perform these specific movements, which are important for the coordination and vertical alignment of the eyes .</li><li>➤ Superior Oblique Muscle originates from the sphenoid bone , just above the nasal cavity and behind the medial wall of the orbit .</li><li>➤ sphenoid bone</li><li>➤ above</li><li>➤ nasal cavity</li><li>➤ behind</li><li>➤ medial wall</li><li>➤ orbit</li><li>➤ It runs along the medial wall of the orbit towards the front .</li><li>➤ medial wall</li><li>➤ orbit</li><li>➤ front</li><li>➤ Then, it passes through a fibrocartilaginous structure called the trochlea , which acts like a pulley , located near the frontoethmoidal suture at the superomedial aspect of the orbit .</li><li>➤ fibrocartilaginous structure</li><li>➤ trochlea</li><li>➤ pulley</li><li>➤ frontoethmoidal suture</li><li>➤ superomedial aspect</li><li>➤ orbit</li><li>➤ After passing through the trochlea , the tendon of the superior oblique muscle turns posteriorly , laterally , and downwards to insert onto the sclera (the white part of the eye ) on the posterior , lateral , and inferior aspect of the eyeball , beneath the superior rectus muscle .</li><li>➤ trochlea</li><li>➤ tendon</li><li>➤ superior oblique muscle</li><li>➤ posteriorly</li><li>➤ laterally</li><li>➤ downwards</li><li>➤ insert</li><li>➤ sclera</li><li>➤ white part</li><li>➤ eye</li><li>➤ posterior</li><li>➤ lateral</li><li>➤ inferior aspect</li><li>➤ eyeball</li><li>➤ superior rectus muscle</li><li>➤ The primary action of the superior oblique muscle is to intort (rotate inward towards the nose ), depress , and abduct the eyeball , particularly when it is in an adducted position . Its unique path allows it to perform these specific movements, which are important for the coordination and vertical alignment of the eyes .</li><li>➤ superior oblique muscle</li><li>➤ intort</li><li>➤ nose</li><li>➤ depress</li><li>➤ abduct</li><li>➤ eyeball</li><li>➤ adducted position</li><li>➤ unique path</li><li>➤ perform</li><li>➤ coordination</li><li>➤ vertical alignment</li><li>➤ eyes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 255</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 255</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old woman presents to the ENT clinic with a chronic stuffy nose, facial pain, and a reduced sense of smell. She reports that these symptoms have persisted for several months and are not relieved by over-the-counter allergy medications. A CT scan of the sinuses reveals opacification of the ethmoid air cells, suggestive of chronic ethmoid sinusitis. The ENT specialist explains that understanding the anatomy of the ethmoid sinuses and their drainage pathways is crucial for planning her treatment, which may include endoscopic sinus surgery. Given the focus on the ethmoid sinuses, which of the following ethmoidal sinuses is correctly matched with its drainage site into the bulla ethmoidalis?", "options": [{"label": "A", "text": "Anterior Ethmoidal Sinus", "correct": false}, {"label": "B", "text": "Posterior Ethmoidal Sinus", "correct": false}, {"label": "C", "text": "Middle Ethmoidal Sinus", "correct": true}, {"label": "D", "text": "Maxillary Sinus", "correct": false}], "correct_answer": "C. Middle Ethmoidal Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-144817.jpg"], "explanation": "<p><strong>Ans. C) Middle Ethmoidal Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Anterior ethmoidal sinus opens into the wall of the ethmoidal infundibulum in middle meatus .</li><li>• Option A:</li><li>• wall</li><li>• ethmoidal infundibulum</li><li>• middle meatus</li><li>• Option B: Posterior ethmoidal sinus opens into superior meatus .</li><li>• Option B:</li><li>• superior meatus</li><li>• Option D: Maxillary sinus, largest of the paranasal sinus opens into the floor of hiatus semilunaris in middle meatus .</li><li>• Option D:</li><li>• largest</li><li>• paranasal sinus</li><li>• floor</li><li>• hiatus</li><li>• semilunaris</li><li>• middle meatus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle ethmoidal air cells open into the bulla ethmoidalis . The bulla ethmoidalis is a bony prominence located within the middle meatus of the nasal cavity , and it is part of the ethmoid bone . The ethmoid sinus is divided into anterior , middle , and posterior air cells , and the middle ethmoidal air cells specifically drain into the semilunar hiatus , which lies adjacent to the bulla ethmoidalis . This drainage pattern is an important aspect of the anatomy and physiology of the nasal cavity and paranasal sinuses , particularly in relation to sinus ventilation and drainage .</li><li>➤ The middle ethmoidal air cells open into the bulla ethmoidalis .</li><li>➤ bulla ethmoidalis</li><li>➤ The bulla ethmoidalis is a bony prominence located within the middle meatus of the nasal cavity , and it is part of the ethmoid bone .</li><li>➤ bony prominence</li><li>➤ within</li><li>➤ middle meatus</li><li>➤ nasal cavity</li><li>➤ ethmoid bone</li><li>➤ The ethmoid sinus is divided into anterior , middle , and posterior air cells , and the middle ethmoidal air cells specifically drain into the semilunar hiatus , which lies adjacent to the bulla ethmoidalis .</li><li>➤ anterior</li><li>➤ middle</li><li>➤ posterior air</li><li>➤ cells</li><li>➤ middle ethmoidal air cells</li><li>➤ semilunar hiatus</li><li>➤ adjacent</li><li>➤ bulla ethmoidalis</li><li>➤ This drainage pattern is an important aspect of the anatomy and physiology of the nasal cavity and paranasal sinuses , particularly in relation to sinus ventilation and drainage .</li><li>➤ important aspect</li><li>➤ anatomy</li><li>➤ physiology</li><li>➤ nasal cavity</li><li>➤ paranasal sinuses</li><li>➤ sinus ventilation</li><li>➤ drainage</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 215</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 215</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old man presents to the clinic with a laceration on the lateral aspect of his neck following a minor car accident. The wound is superficial, but there is noticeable bleeding. Upon examination, the bleeding is identified as coming from a vein that appears to be running superficially across the sternocleidomastoid muscle. The patient's neurological examination is normal, and there are no signs of deeper neck structure involvement. The clinic's medical team proceeds to control the bleeding and suture the laceration, taking care to avoid any underlying structures. In the context of this patient's injury and the anatomy of the neck, which of the following structures is most likely to have been involved in the superficial laceration and is known to pierce the fascia over the posterior triangle of the neck?", "options": [{"label": "A", "text": "Spinal Accessory Nerve", "correct": false}, {"label": "B", "text": "Supraclavicular Nerve", "correct": false}, {"label": "C", "text": "External Jugular Vein", "correct": true}, {"label": "D", "text": "Internal Jugular Vein", "correct": false}], "correct_answer": "C. External Jugular Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture67.jpg"], "explanation": "<p><strong>Ans. C) External Jugular Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Spinal accessory nerve lies between the fascial roof formed by the investing layer of deep cervical fascia and fascial floor formed by prevertebral layer of deep cervical fascia resting on levator scapulae .</li><li>• Option A:</li><li>• fascial roof</li><li>• investing layer</li><li>• deep cervical fascia</li><li>• fascial floor</li><li>• prevertebral layer</li><li>• deep cervical fascia</li><li>• levator scapulae</li><li>• Option B: Supraclavicular nerves from cervical plexus lie beneath prevertebral fascia and pierce the fascial floor and finally fascia roof for final distribution .</li><li>• Option B:</li><li>• Supraclavicular nerves</li><li>• beneath prevertebral fascia</li><li>• pierce</li><li>• fascial floor</li><li>• fascia roof</li><li>• final distribution</li><li>• Option D: Internal jugular vein is found within the carotid sheath in the anterior triangle of the neck .</li><li>• Option D:</li><li>• carotid sheath</li><li>• anterior triangle</li><li>• neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The fascia over the posterior triangle of the neck is pierced by the external jugular vein as it drains into the subclavian vein . The external jugular vein is formed near the angle of the mandible by the union of the posterior branch of the retromandibular vein and the posterior auricular vein . It descends across the sternocleidomastoid muscle superficially and then pierces the investing layer of the deep cervical fascia (which covers the posterior triangle ) to drain into the subclavian vein . This anatomical feature is important for the drainage of blood from the head and neck back to the heart .</li><li>➤ The fascia over the posterior triangle of the neck is pierced by the external jugular vein as it drains into the subclavian vein .</li><li>➤ posterior triangle</li><li>➤ neck</li><li>➤ external jugular vein</li><li>➤ drains</li><li>➤ subclavian vein</li><li>➤ The external jugular vein is formed near the angle of the mandible by the union of the posterior branch of the retromandibular vein and the posterior auricular vein .</li><li>➤ near</li><li>➤ angle</li><li>➤ mandible</li><li>➤ union</li><li>➤ posterior branch</li><li>➤ retromandibular vein</li><li>➤ posterior auricular vein</li><li>➤ It descends across the sternocleidomastoid muscle superficially and then pierces the investing layer of the deep cervical fascia (which covers the posterior triangle ) to drain into the subclavian vein . This anatomical feature is important for the drainage of blood from the head and neck back to the heart .</li><li>➤ descends</li><li>➤ sternocleidomastoid muscle</li><li>➤ superficially</li><li>➤ pierces</li><li>➤ investing layer</li><li>➤ deep cervical fascia</li><li>➤ covers</li><li>➤ posterior triangle</li><li>➤ drain</li><li>➤ subclavian vein</li><li>➤ drainage</li><li>➤ blood</li><li>➤ head</li><li>➤ neck back</li><li>➤ heart</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 197</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 197</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Middle Cervical Ganglion location corresponds to:", "options": [{"label": "A", "text": "Upper Border of Lamina of Thyroid Cartilage", "correct": false}, {"label": "B", "text": "Anterior Tubercle of Transverse Process of C6 Vertebra", "correct": true}, {"label": "C", "text": "Base of Scaleno Vertebral Triangle", "correct": false}, {"label": "D", "text": "Location of Inferior Parathyroid Gland", "correct": false}], "correct_answer": "B. Anterior Tubercle of Transverse Process of C6 Vertebra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture65.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture66.jpg"], "explanation": "<p><strong>Ans. B) Anterior Tubercle of Transverse Process of C6 Vertebra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The upper border of the lamina of the thyroid cartilage is an important landmark in the neck , but it is not typically where the middle cervical ganglion is located. This area corresponds more to the laryngeal region.</li><li>• Option A:</li><li>• neck</li><li>• more</li><li>• laryngeal region.</li><li>• Option C: The scaleno vertebral triangle , formed by the scalene muscles and the first rib , is an important anatomical region, especially concerning the brachial plexus and subclavian artery. However, the middle cervical ganglion is not typically located at the base of this triangle.</li><li>• Option C:</li><li>• scaleno vertebral triangle</li><li>• scalene muscles</li><li>• first rib</li><li>• brachial plexus</li><li>• subclavian artery.</li><li>• Option D: The inferior parathyroid glands are located on the posterior aspect of the thyroid gland , typically near the lower poles of the thyroid lobes . The location of these glands is not directly related to the typical position of the middle cervical ganglion.</li><li>• Option D:</li><li>• posterior aspect</li><li>• thyroid gland</li><li>• lower poles</li><li>• thyroid lobes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle cervical ganglion, which is the smallest of the three principal cervical ganglia of the sympathetic trunk , is typically located near the level of the sixth cervical vertebra (C6). However, its position can be variable, and it may not always be present in all individuals. When it is present, it is usually found anterior to the transverse process of C6 , near the inferior thyroid artery, which it often accompanies. The description that it corresponds to the anterior tubercle of the transverse process of the C6 vertebra is a general guideline for its location but given the variability in the anatomy of the sympathetic ganglia , the middle cervical ganglion's exact position can vary from person to person . It's also worth noting that the C6 vertebra is notable for its long anterior tubercle , known as the carotid tubercle or Chassaignac's tubercle , which serves as a landmark for the carotid artery pulse and can be used as a guide during surgical procedures in the neck.</li><li>➤ The middle cervical ganglion, which is the smallest of the three principal cervical ganglia of the sympathetic trunk , is typically located near the level of the sixth cervical vertebra (C6). However, its position can be variable, and it may not always be present in all individuals. When it is present, it is usually found anterior to the transverse process of C6 , near the inferior thyroid artery, which it often accompanies.</li><li>➤ smallest</li><li>➤ three principal cervical ganglia</li><li>➤ sympathetic trunk</li><li>➤ sixth cervical vertebra</li><li>➤ anterior</li><li>➤ transverse process</li><li>➤ C6</li><li>➤ near</li><li>➤ inferior thyroid artery,</li><li>➤ The description that it corresponds to the anterior tubercle of the transverse process of the C6 vertebra is a general guideline for its location but given the variability in the anatomy of the sympathetic ganglia , the middle cervical ganglion's exact position can vary from person to person . It's also worth noting that the C6 vertebra is notable for its long anterior tubercle , known as the carotid tubercle or Chassaignac's tubercle , which serves as a landmark for the carotid artery pulse and can be used as a guide during surgical procedures in the neck.</li><li>➤ anterior tubercle</li><li>➤ transverse process</li><li>➤ C6 vertebra</li><li>➤ general guideline</li><li>➤ location</li><li>➤ variability</li><li>➤ anatomy</li><li>➤ sympathetic ganglia</li><li>➤ middle cervical ganglion's exact position</li><li>➤ vary</li><li>➤ person</li><li>➤ person</li><li>➤ C6 vertebra</li><li>➤ notable</li><li>➤ long anterior tubercle</li><li>➤ carotid tubercle</li><li>➤ Chassaignac's tubercle</li><li>➤ landmark</li><li>➤ carotid artery pulse</li><li>➤ guide</li><li>➤ surgical procedures</li><li>➤ neck.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 420</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 420</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the gastroenterology clinic with complaints of progressive difficulty swallowing solid foods and a sensation of food sticking in his throat. He also reports occasional regurgitation of undigested food, especially when lying down, but denies any weight loss, heartburn, or respiratory symptoms. Barium swallow study shows a posterior protrusion in the pharyngoesophageal region, suggesting the presence of Zenker’s diverticulum. Given the location and presentation of the patient's symptoms, which anatomical area associated with the development of Zenker's diverticulum is most relevant to this case?", "options": [{"label": "A", "text": "Nasopharynx", "correct": false}, {"label": "B", "text": "Oropharynx", "correct": false}, {"label": "C", "text": "Cricopharyngeus", "correct": true}, {"label": "D", "text": "Thyropharyngeus", "correct": false}], "correct_answer": "C. Cricopharyngeus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture63.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture64.jpg"], "explanation": "<p><strong>Ans. C) Cricopharyngeus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The nasopharynx is the upper part of the pharynx , lying behind the nose and above the soft palate . Killian's dehiscence is not located in the nasopharynx; it is found much lower , near the transition from the pharynx to the esophagus .</li><li>• Option A:</li><li>• upper part</li><li>• pharynx</li><li>• behind</li><li>• nose</li><li>• above</li><li>• soft palate</li><li>• lower</li><li>• transition</li><li>• pharynx</li><li>• esophagus</li><li>• Option B: The oropharynx lies below the nasopharynx and extends from the soft palate to the upper edge of the epiglottis . While the oropharynx is involved in swallowing , Killian's dehiscence is not located here but rather in the lower pharyngeal region.</li><li>• Option B:</li><li>• below</li><li>• nasopharynx</li><li>• extends</li><li>• soft palate</li><li>• upper edge</li><li>• epiglottis</li><li>• oropharynx</li><li>• swallowing</li><li>• Option D: The thyropharyngeus is another part of the inferior pharyngeal constrictor muscle , positioned superior to the cricopharyngeus muscle . While it contributes to the structure of the pharyngeal wall , Killian's dehiscence is specifically related to the area near the cricopharyngeus muscle rather than the thyropharyngeus muscle .</li><li>• Option D:</li><li>• thyropharyngeus</li><li>• another part</li><li>• inferior pharyngeal constrictor muscle</li><li>• positioned superior</li><li>• cricopharyngeus muscle</li><li>• contributes</li><li>• structure</li><li>• pharyngeal wall</li><li>• area</li><li>• cricopharyngeus muscle</li><li>• thyropharyngeus muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cricopharyngeus muscle is part of the inferior pharyngeal constrictor muscle and acts as the upper esophageal sphincter . Killian's dehiscence is located in the area where the muscle fibers of the cricopharyngeus part slightly, creating a potential area of weakness between the thyropharyngeus portion of the inferior pharyngeal constrictor and the cricopharyngeus muscle itself.</li><li>➤ The cricopharyngeus muscle is part of the inferior pharyngeal constrictor muscle and acts as the upper esophageal sphincter .</li><li>➤ cricopharyngeus muscle</li><li>➤ inferior pharyngeal constrictor muscle</li><li>➤ upper esophageal sphincter</li><li>➤ Killian's dehiscence is located in the area where the muscle fibers of the cricopharyngeus part slightly, creating a potential area of weakness between the thyropharyngeus portion of the inferior pharyngeal constrictor and the cricopharyngeus muscle itself.</li><li>➤ muscle fibers</li><li>➤ cricopharyngeus part</li><li>➤ potential area</li><li>➤ weakness</li><li>➤ thyropharyngeus portion</li><li>➤ inferior pharyngeal constrictor</li><li>➤ cricopharyngeus muscle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 224.</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 224.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is the site of blocking of Superior Laryngeal Nerve?", "options": [{"label": "A", "text": "Angle of Mandible", "correct": false}, {"label": "B", "text": "Cricoid Cartilage", "correct": false}, {"label": "C", "text": "Transverse Process of C7", "correct": false}, {"label": "D", "text": "Great Cornu of Hyoid", "correct": true}], "correct_answer": "D. Great Cornu of Hyoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture61.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture62.jpg"], "explanation": "<p><strong>Ans. D) Great Cornu of Hyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior laryngeal divides into external and internal laryngeal nerves . ELN is entirely motor and supplies cricothyroid muscle . The angle of the mandible is too far anterior and superior to the course of the superior laryngeal nerve and is not an appropriate site for blocking this nerve.</li><li>• Option A:</li><li>• Superior laryngeal</li><li>• external</li><li>• internal laryngeal nerves</li><li>• motor</li><li>• supplies cricothyroid muscle</li><li>• too far</li><li>• anterior</li><li>• superior</li><li>• course</li><li>• superior laryngeal nerve</li><li>• Option B: Cricoid cartilage lies opposite C6 vertebral level . The cricoid cartilage is located inferior to the area where the superior laryngeal nerve branches off the vagus nerve , making it a less suitable location for blocking this specific nerve .</li><li>• Option B:</li><li>• opposite C6 vertebral level</li><li>• inferior</li><li>• area</li><li>• superior laryngeal nerve</li><li>• vagus nerve</li><li>• less suitable location</li><li>• blocking</li><li>• specific nerve</li><li>• Option C: Inferior cervical ganglion is located at C7 level . The transverse process of the C7 vertebra is too inferior and is not related to the course of the superior laryngeal nerve. This site is not used for blocking the superior laryngeal nerve.</li><li>• Option C:</li><li>• C7 level</li><li>• transverse process</li><li>• C7 vertebra</li><li>• too inferior</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior laryngeal nerve, a branch of the vagus nerve ( CN X ), can be blocked to provide anesthesia to the upper part of the larynx . The most suitable site for blocking the superior laryngeal nerve is near the great cornu of the hyoid bone .</li><li>➤ vagus nerve</li><li>➤ CN X</li><li>➤ blocked</li><li>➤ anesthesia</li><li>➤ upper part</li><li>➤ larynx</li><li>➤ blocking</li><li>➤ superior laryngeal nerve</li><li>➤ great cornu</li><li>➤ hyoid bone</li><li>➤ The superior laryngeal nerve divides into two branches : the internal and external laryngeal nerves . The internal laryngeal nerve, which provides sensory innervation to the mucosa above the vocal cords , passes medially to the thyrohyoid membrane , which is closely related to the greater horn ( cornu ) of the hyoid bone . Anesthetizing the superior laryngeal nerve at this point effectively blocks sensation to the upper larynx .</li><li>➤ two branches</li><li>➤ internal</li><li>➤ external laryngeal nerves</li><li>➤ sensory innervation</li><li>➤ mucosa above</li><li>➤ vocal cords</li><li>➤ medially</li><li>➤ thyrohyoid membrane</li><li>➤ greater horn</li><li>➤ cornu</li><li>➤ hyoid bone</li><li>➤ Anesthetizing</li><li>➤ superior laryngeal nerve</li><li>➤ effectively blocks</li><li>➤ sensation</li><li>➤ upper larynx</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Inferior Thyroid Artery is a Branch of:", "options": [{"label": "A", "text": "Thyrocervical Trunk", "correct": true}, {"label": "B", "text": "Costocervical Trunk", "correct": false}, {"label": "C", "text": "ICA", "correct": false}, {"label": "D", "text": "ECA", "correct": false}], "correct_answer": "A. Thyrocervical Trunk", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture54.jpg"], "explanation": "<p><strong>Ans. A) Thyrocervical Trunk</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Costo cervical trunk – arises from the 2nd part of subclavian artery and gives rise to superior intercostal and deep cervical artery .</li><li>• Option B:</li><li>• arises</li><li>• 2nd part</li><li>• subclavian artery</li><li>• superior intercostal</li><li>• deep cervical artery</li><li>• Option C: Internal carotid artery is one of terminal branch of common carotid artery at the level of C3-C4</li><li>• Option C:</li><li>• terminal branch</li><li>• common carotid artery</li><li>• C3-C4</li><li>• Option D: External carotid artery gives rise to eight branches in the neck . Its terminal branches are the superficial temporal artery and maxillary artery .</li><li>• Option D:</li><li>• eight branches</li><li>• neck</li><li>• terminal branches</li><li>• superficial temporal artery</li><li>• maxillary artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior thyroid artery is indeed a branch of the thyrocervical trunk . The thyrocervical trunk is a major branch of the subclavian artery , and it gives rise to several important arteries that supply the neck , upper chest , and shoulder area . The inferior thyroid artery specifically supplies blood to the thyroid gland , parathyroid glands , and surrounding structures in the neck .</li><li>➤ The inferior thyroid artery is indeed a branch of the thyrocervical trunk .</li><li>➤ The inferior thyroid artery is indeed a branch of the thyrocervical trunk .</li><li>➤ inferior thyroid artery</li><li>➤ branch</li><li>➤ thyrocervical trunk</li><li>➤ The thyrocervical trunk is a major branch of the subclavian artery , and it gives rise to several important arteries that supply the neck , upper chest , and shoulder area .</li><li>➤ The thyrocervical trunk is a major branch of the subclavian artery , and it gives rise to several important arteries that supply the neck , upper chest , and shoulder area .</li><li>➤ thyrocervical trunk</li><li>➤ major branch</li><li>➤ subclavian artery</li><li>➤ supply</li><li>➤ neck</li><li>➤ upper chest</li><li>➤ shoulder area</li><li>➤ The inferior thyroid artery specifically supplies blood to the thyroid gland , parathyroid glands , and surrounding structures in the neck .</li><li>➤ The inferior thyroid artery specifically supplies blood to the thyroid gland , parathyroid glands , and surrounding structures in the neck .</li><li>➤ supplies blood</li><li>➤ thyroid gland</li><li>➤ parathyroid glands</li><li>➤ surrounding</li><li>➤ structures</li><li>➤ neck</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 338</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 338</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 4-year-old boy is brought to the pediatrician by his parents due to recurrent middle ear infections and noticeable nasal regurgitation while drinking fluids. His speech development is slightly delayed, and his parents report that his voice has a nasal quality. Examination reveals a high-arched palate and bifid uvula. Which of the following structures, potentially affected by the underlying anatomical anomaly, is most likely contributing to this child's clinical presentation?", "options": [{"label": "A", "text": "Palatoglossus", "correct": false}, {"label": "B", "text": "Palatopharyngeus", "correct": false}, {"label": "C", "text": "Tensor Tympani", "correct": false}, {"label": "D", "text": "Levator Veli Palatini", "correct": true}], "correct_answer": "D. Levator Veli Palatini", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture55.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-132649.jpg"], "explanation": "<p><strong>Ans. D) Levator Veli Palatini</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Palatoglossus is innervated by pharyngeal plexus forms anterior pillar for tonsillar fossa .</li><li>• Option A:</li><li>• pharyngeal plexus</li><li>• anterior pillar</li><li>• tonsillar fossa</li><li>• Option B: Palatopharyngeus forms posterior pillar for tonsillar fossa and forms passavant's ridge .</li><li>• Option B:</li><li>• posterior pillar</li><li>• tonsillar fossa</li><li>• passavant's ridge</li><li>• Option C: Tensor tympani, muscle of middle ear , its contractions dampen sound vibrations .</li><li>• Option C:</li><li>• muscle of middle ear</li><li>• dampen</li><li>• sound vibrations</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sinus of Morgagni , also known as the gap or space between the superior and middle pharyngeal constrictor muscles , allows for the passage of several important structures into the pharynx . These include:</li><li>➤ sinus of Morgagni</li><li>➤ gap</li><li>➤ space</li><li>➤ superior</li><li>➤ middle pharyngeal constrictor muscles</li><li>➤ allows</li><li>➤ passage</li><li>➤ pharynx</li><li>➤ Glossopharyngeal nerve (CN IX) passes through this gap to provide sensory innervation to the posterior third of the tongue , the oropharynx , and the tonsils . It also carries taste sensation from the posterior third of the tongue . Stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve , passes through the sinus of Morgagni . It elevates the pharynx during swallowing and speech . While the lingual artery primarily supplies the tongue , some of its branches or the artery itself may pass near or through this region as it ascends to the tongue . Pharyngeal branches of the vagus nerve (CN X) may also pass through or in close proximity to this gap , contributing to the innervation of the pharynx .</li><li>➤ Glossopharyngeal nerve (CN IX) passes through this gap to provide sensory innervation to the posterior third of the tongue , the oropharynx , and the tonsils . It also carries taste sensation from the posterior third of the tongue .</li><li>➤ Glossopharyngeal nerve (CN IX)</li><li>➤ sensory innervation</li><li>➤ posterior third</li><li>➤ tongue</li><li>➤ oropharynx</li><li>➤ tonsils</li><li>➤ carries taste sensation</li><li>➤ posterior third</li><li>➤ tongue</li><li>➤ Stylopharyngeus muscle , which is innervated by the glossopharyngeal nerve , passes through the sinus of Morgagni . It elevates the pharynx during swallowing and speech .</li><li>➤ Stylopharyngeus muscle</li><li>➤ glossopharyngeal nerve</li><li>➤ sinus of Morgagni</li><li>➤ elevates</li><li>➤ pharynx</li><li>➤ swallowing</li><li>➤ speech</li><li>➤ While the lingual artery primarily supplies the tongue , some of its branches or the artery itself may pass near or through this region as it ascends to the tongue .</li><li>➤ supplies</li><li>➤ tongue</li><li>➤ branches</li><li>➤ artery</li><li>➤ pass near</li><li>➤ ascends</li><li>➤ tongue</li><li>➤ Pharyngeal branches of the vagus nerve (CN X) may also pass through or in close proximity to this gap , contributing to the innervation of the pharynx .</li><li>➤ Pharyngeal branches of the vagus nerve (CN X)</li><li>➤ proximity</li><li>➤ gap</li><li>➤ innervation</li><li>➤ pharynx</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 233</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 233</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient presented with a sagging face, asymmetrical smile, facial muscle tone with drooping of left angle of mouth, eyelid with drooping cornersand inability to blow properly. Which Nerve is involved in this case?", "options": [{"label": "A", "text": "Facial Nerve", "correct": true}, {"label": "B", "text": "Maxillary Nerve", "correct": false}, {"label": "C", "text": "Mandibular Nerve", "correct": false}, {"label": "D", "text": "Ophthalmic Nerve", "correct": false}], "correct_answer": "A. Facial Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-16-184247.jpg"], "explanation": "<p><strong>Ans. A) Facial Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Maxillary nerve is the second branch of the Trigeminal nerve (CN V). It is primarily a sensory nerve for the mid-facial region, including the lower eyelid , upper lip , and cheek . While this nerve is responsible for sensation in areas of the face, it does not control facial muscle movements. Therefore, its involvement would not lead to muscle weakness or paralysis, making it an unlikely cause of the patient's symptoms.</li><li>• Option B.</li><li>• second branch</li><li>• Trigeminal nerve (CN V).</li><li>• sensory nerve</li><li>• mid-facial region,</li><li>• lower eyelid</li><li>• upper lip</li><li>• cheek</li><li>• does not control facial muscle movements.</li><li>• Option C. The Mandibular nerve is the third branch of the Trigeminal nerve (CN V). It has both sensory and motor functions , the latter mainly for the muscles of mastication (chewing). Though this nerve has motor functions , these are largely restricted to the muscles of mastication . It does not control the muscles responsible for facial expressions, so it's unlikely to be the cause of the symptoms like drooping mouth and eyelid or asymmetrical smile.</li><li>• Option C.</li><li>• third branch of the Trigeminal nerve (CN V).</li><li>• sensory</li><li>• motor functions</li><li>• muscles of mastication (chewing).</li><li>• motor functions</li><li>• restricted</li><li>• muscles of mastication</li><li>• Option D. The Ophthalmic nerve is the first branch of the Trigeminal nerve (CN V) and is primarily a sensory nerve for the upper part of the face , including the forehead, scalp, and upper eyelid . This nerve provides sensation to the upper facial region but does not control muscle movements. Thus, its dysfunction would not result in the muscular symptoms described in the patient.</li><li>• Option D.</li><li>• first branch</li><li>• Trigeminal nerve (CN V)</li><li>• sensory nerve</li><li>• upper part of the face</li><li>• forehead, scalp,</li><li>• upper eyelid</li><li>• sensation</li><li>• upper facial</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Facial nerve (CN VII) is responsible for motor control of most of the facial muscles . It controls movements such as blinking , smiling , frowning , and other expressions . The symptoms described, such as asymmetrical smile, drooping of the mouth and eyelid, and difficulty in blowing, are classic signs of facial nerve palsy . This nerve's impairment leads to weakness or paralysis of the facial muscles on the affected side.</li><li>➤ The Facial nerve (CN VII) is responsible for motor control of most of the facial muscles . It controls movements such as blinking , smiling , frowning , and other expressions .</li><li>➤ The Facial nerve (CN VII) is responsible for motor control of most of the facial muscles . It controls movements such as blinking , smiling , frowning , and other expressions .</li><li>➤ Facial nerve (CN VII)</li><li>➤ motor control</li><li>➤ facial muscles</li><li>➤ movements</li><li>➤ blinking</li><li>➤ smiling</li><li>➤ frowning</li><li>➤ other expressions</li><li>➤ The symptoms described, such as asymmetrical smile, drooping of the mouth and eyelid, and difficulty in blowing, are classic signs of facial nerve palsy . This nerve's impairment leads to weakness or paralysis of the facial muscles on the affected side.</li><li>➤ The symptoms described, such as asymmetrical smile, drooping of the mouth and eyelid, and difficulty in blowing, are classic signs of facial nerve palsy . This nerve's impairment leads to weakness or paralysis of the facial muscles on the affected side.</li><li>➤ facial nerve palsy</li><li>➤ impairment</li><li>➤ weakness</li><li>➤ paralysis</li><li>➤ facial muscles</li><li>➤ Injury to facial nerve produces LMN Bell’s palsy which presents with</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 393</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 393</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Woodruff’s Plexus is located over:", "options": [{"label": "A", "text": "Posterior to Superior Turbinate", "correct": false}, {"label": "B", "text": "Posterior to Middle Turbinate", "correct": false}, {"label": "C", "text": "Posterior to Inferior Turbinate", "correct": true}, {"label": "D", "text": "Inferior to Superior Turbinate", "correct": false}], "correct_answer": "C. Posterior to Inferior Turbinate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture53.jpg"], "explanation": "<p><strong>Ans. C) Posterior to Inferior Turbinate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior and middle turbinate are parts of labyrinth of ethmoid bone .</li><li>• Option A:</li><li>• Superior</li><li>• middle turbinate</li><li>• labyrinth</li><li>• ethmoid bone</li><li>• Option B: Anterior epistaxis results from injury to kissel bach’s plexus located over anteroinferior portion of nasal septum .</li><li>• Option B:</li><li>• Anterior</li><li>• epistaxis</li><li>• kissel bach’s</li><li>• plexus</li><li>• anteroinferior portion</li><li>• nasal septum</li><li>• Option D: Inferior turbinate is the largest and is an independent bone .</li><li>• Option D:</li><li>• Inferior turbinate</li><li>• largest</li><li>• independent bone</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Woodruff's plexus , also known as Woodruff's area , is a venous plexus located in the posterior part of the nasal cavity , near the posterior end of the inferior nasal concha or turbinate . It is situated over the posterior nasal septum and the lateral nasal wall , particularly in the region of the sphenopalatine foramen . This plexus is known for being a potential source of posterior epistaxis due to its rich vascularization and location . The veins of Woodruff's plexus are connected to the sphenopalatine artery , which is a branch of the maxillary artery (itself a branch of the external carotid artery ).</li><li>➤ Woodruff's plexus , also known as Woodruff's area , is a venous plexus located in the posterior part of the nasal cavity , near the posterior end of the inferior nasal concha or turbinate .</li><li>➤ Woodruff's plexus</li><li>➤ Woodruff's area</li><li>➤ venous plexus</li><li>➤ posterior part</li><li>➤ nasal cavity</li><li>➤ posterior end</li><li>➤ inferior nasal concha</li><li>➤ turbinate</li><li>➤ It is situated over the posterior nasal septum and the lateral nasal wall , particularly in the region of the sphenopalatine foramen .</li><li>➤ posterior nasal septum</li><li>➤ lateral nasal wall</li><li>➤ region</li><li>➤ sphenopalatine foramen</li><li>➤ This plexus is known for being a potential source of posterior epistaxis due to its rich vascularization and location .</li><li>➤ potential source</li><li>➤ posterior epistaxis</li><li>➤ rich vascularization</li><li>➤ location</li><li>➤ The veins of Woodruff's plexus are connected to the sphenopalatine artery , which is a branch of the maxillary artery (itself a branch of the external carotid artery ).</li><li>➤ veins</li><li>➤ Woodruff's plexus</li><li>➤ connected</li><li>➤ sphenopalatine artery</li><li>➤ branch</li><li>➤ maxillary artery</li><li>➤ external carotid artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 219</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 219</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following Muscles of Face are innervated by Facial Nerve except:", "options": [{"label": "A", "text": "Levatorangulioris", "correct": false}, {"label": "B", "text": "Risorius", "correct": false}, {"label": "C", "text": "Masseter", "correct": true}, {"label": "D", "text": "Buccinator", "correct": false}], "correct_answer": "C. Masseter", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture50.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture51.jpg"], "explanation": "<p><strong>Ans. C) Masseter</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Levatorangulioris and other muscles of upper lip innervated by upper buccal branch of facial nerve .</li><li>• Option A:</li><li>• upper lip</li><li>• upper buccal branch</li><li>• facial nerve</li><li>• Option B: Risorius is an upward continuation of platysma .</li><li>• Option B:</li><li>• upward continuation</li><li>• platysma</li><li>• Option D: Buccinator is innervated by lower buccal branch of facial nerve .</li><li>• Option D:</li><li>• lower buccal branch</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Masseter present over the outer surface of ramus of mandible innervated by mandibular division of trigeminal nerve . It covers the lateral aspect of the mandibular ramus and extends to the zygomatic arch of the cheekbone . The primary function of the masseter muscle is to elevate the mandible , which closes the jaw during chewing . It also plays a minor role in protruding the mandible . The masseter is innervated by the masseteric nerve , a branch of the anterior division of the mandibular nerve ( V3 ), which is itself the third branch of the trigeminal nerve ( cranial nerve V ).</li><li>➤ Masseter present over the outer surface of ramus of mandible innervated by mandibular division of trigeminal nerve .</li><li>➤ Masseter present over the outer surface of ramus of mandible innervated by mandibular division of trigeminal nerve .</li><li>➤ outer surface</li><li>➤ ramus</li><li>➤ mandible</li><li>➤ mandibular division</li><li>➤ trigeminal nerve</li><li>➤ It covers the lateral aspect of the mandibular ramus and extends to the zygomatic arch of the cheekbone .</li><li>➤ It covers the lateral aspect of the mandibular ramus and extends to the zygomatic arch of the cheekbone .</li><li>➤ covers</li><li>➤ lateral aspect</li><li>➤ mandibular ramus</li><li>➤ extends</li><li>➤ zygomatic arch</li><li>➤ cheekbone</li><li>➤ The primary function of the masseter muscle is to elevate the mandible , which closes the jaw during chewing .</li><li>➤ The primary function of the masseter muscle is to elevate the mandible , which closes the jaw during chewing .</li><li>➤ primary function</li><li>➤ masseter muscle</li><li>➤ elevate</li><li>➤ mandible</li><li>➤ closes</li><li>➤ jaw</li><li>➤ chewing</li><li>➤ It also plays a minor role in protruding the mandible .</li><li>➤ It also plays a minor role in protruding the mandible .</li><li>➤ minor role</li><li>➤ protruding</li><li>➤ mandible</li><li>➤ The masseter is innervated by the masseteric nerve , a branch of the anterior division of the mandibular nerve ( V3 ), which is itself the third branch of the trigeminal nerve ( cranial nerve V ).</li><li>➤ The masseter is innervated by the masseteric nerve , a branch of the anterior division of the mandibular nerve ( V3 ), which is itself the third branch of the trigeminal nerve ( cranial nerve V ).</li><li>➤ masseter</li><li>➤ masseteric nerve</li><li>➤ anterior division</li><li>➤ mandibular nerve</li><li>➤ V3</li><li>➤ third branch</li><li>➤ trigeminal nerve</li><li>➤ cranial nerve V</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following does not Supply Palate?", "options": [{"label": "A", "text": "Tonsillar Branch of Facial Artery", "correct": true}, {"label": "B", "text": "Ascending Palatine Artery", "correct": false}, {"label": "C", "text": "Descending Palatine Artery", "correct": false}, {"label": "D", "text": "Ascending Pharyngeal Artery", "correct": false}], "correct_answer": "A. Tonsillar Branch of Facial Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture41.jpg"], "explanation": "<p><strong>Ans. A) Tonsillar Branch of Facial Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The ascending palatine artery, a branch of the facial artery , indeed supplies the palate . It ascends between the styloglossus and stylopharyngeus muscles and contributes to the blood supply of the soft palate and tonsils .</li><li>• Option B:</li><li>• branch</li><li>• facial artery</li><li>• supplies</li><li>• palate</li><li>• ascends</li><li>• styloglossus</li><li>• stylopharyngeus muscles</li><li>• contributes</li><li>• blood supply</li><li>• soft palate</li><li>• tonsils</li><li>• Option C: Descending palatine artery, which arises from the maxillary artery , is a major supplier of blood to the hard and soft palate . It typically divides into the greater and lesser palatine arteries , which supply the hard and soft palate , respectively.</li><li>• Option C:</li><li>• arises</li><li>• maxillary artery</li><li>• major supplier</li><li>• blood</li><li>• hard</li><li>• soft palate</li><li>• greater</li><li>• lesser palatine arteries</li><li>• supply</li><li>• hard</li><li>• soft palate</li><li>• Option D: The ascending pharyngeal artery, a branch of the external carotid artery , primarily supplies the pharynx . While it has branches that contribute to the blood supply of the pharynx and adjacent structures , it is not a primary supplier of the palate.</li><li>• Option D:</li><li>• external carotid artery</li><li>• supplies</li><li>• pharynx</li><li>• branches</li><li>• blood supply</li><li>• pharynx</li><li>• adjacent structures</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The blood supply of the palate is derived from several branches of the maxillary artery , which is one of the two terminal branches of the external carotid artery . The main arteries supplying the palate include:</li><li>➤ several branches</li><li>➤ maxillary artery</li><li>➤ one</li><li>➤ two terminal branches</li><li>➤ external carotid artery</li><li>➤ Greater Palatine Artery is the primary artery supplying the hard palate . It descends through the greater palatine canal , emerges from the greater palatine foramen , and supplies the mucosa and glands of the hard palate , except for a small area near the alveolar margin which is supplied by the nasopalatine artery . Lesser Palatine Arteries supply the soft palate . They descend through the lesser palatine canals and emerge through the lesser palatine foramina to supply the soft palate , uvula , and tonsils . A branch of the facial artery , the ascending palatine artery , contributes to the supply of the soft palate by ascending along the pharynx. Pharyngeal Branches of the Maxillary Artery branches may also contribute to the blood supply of the soft palate . Nasopalatine Artery runs forward on the nasal septum and supplies a small part of the anterior hard palate through the incisive canal .</li><li>➤ Greater Palatine Artery is the primary artery supplying the hard palate . It descends through the greater palatine canal , emerges from the greater palatine foramen , and supplies the mucosa and glands of the hard palate , except for a small area near the alveolar margin which is supplied by the nasopalatine artery .</li><li>➤ primary artery</li><li>➤ hard palate</li><li>➤ descends</li><li>➤ greater palatine canal</li><li>➤ emerges</li><li>➤ greater palatine foramen</li><li>➤ supplies</li><li>➤ mucosa</li><li>➤ glands</li><li>➤ hard palate</li><li>➤ small area</li><li>➤ alveolar margin</li><li>➤ supplied</li><li>➤ nasopalatine artery</li><li>➤ Lesser Palatine Arteries supply the soft palate . They descend through the lesser palatine canals and emerge through the lesser palatine foramina to supply the soft palate , uvula , and tonsils .</li><li>➤ soft palate</li><li>➤ descend</li><li>➤ lesser palatine canals</li><li>➤ emerge</li><li>➤ lesser palatine foramina</li><li>➤ supply</li><li>➤ soft palate</li><li>➤ uvula</li><li>➤ tonsils</li><li>➤ A branch of the facial artery , the ascending palatine artery , contributes to the supply of the soft palate by ascending along the pharynx.</li><li>➤ facial artery</li><li>➤ ascending palatine artery</li><li>➤ supply</li><li>➤ soft palate</li><li>➤ ascending</li><li>➤ pharynx.</li><li>➤ Pharyngeal Branches of the Maxillary Artery branches may also contribute to the blood supply of the soft palate .</li><li>➤ blood supply</li><li>➤ soft palate</li><li>➤ Nasopalatine Artery runs forward on the nasal septum and supplies a small part of the anterior hard palate through the incisive canal .</li><li>➤ forward</li><li>➤ nasal septum</li><li>➤ supplies</li><li>➤ small part</li><li>➤ anterior hard palate</li><li>➤ incisive canal</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 131</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Unilateral Injury to Hypoglossal Nerve leads to all except:", "options": [{"label": "A", "text": "Hemiatrophy of involved Side", "correct": false}, {"label": "B", "text": "Deviation of Tongue to Same Side", "correct": false}, {"label": "C", "text": "Loss of Taste Sensation in Same Side of Tongue", "correct": true}, {"label": "D", "text": "Fasciculations of Tongue", "correct": false}], "correct_answer": "C. Loss of Taste Sensation in Same Side of Tongue", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture40.jpg"], "explanation": "<p><strong>Ans. C) Loss of Taste Sensation in Same Side of Tongue</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: True . The hypoglossal nerve innervates the intrinsic and extrinsic muscles of the tongue ( except for the palatoglossus muscle , which is innervated by the vagus nerve ). Injury to the hypoglossal nerve can lead to weakness and atrophy of the tongue muscles on the affected side due to denervation . Over time, this can result in noticeable hemiatrophy of the tongue on the side of the injury .</li><li>• Option A: True</li><li>• intrinsic</li><li>• extrinsic muscles</li><li>• tongue</li><li>• except</li><li>• palatoglossus muscle</li><li>• vagus nerve</li><li>• hypoglossal nerve</li><li>• weakness</li><li>• atrophy</li><li>• tongue muscles</li><li>• affected side</li><li>• denervation</li><li>• hemiatrophy</li><li>• tongue</li><li>• side</li><li>• injury</li><li>• Option B: True . When the hypoglossal nerve is injured on one side, the tongue muscles on that side become weaker . When the patient attempts to protrude the tongue , it will deviate towards the weakened ( affected ) side . This is because the normal or unaffected side pushes the tongue towards the weakened side .</li><li>• Option B: True</li><li>• hypoglossal nerve</li><li>• tongue muscles</li><li>• side</li><li>• weaker</li><li>• attempts</li><li>• protrude</li><li>• tongue</li><li>• deviate</li><li>• weakened</li><li>• affected</li><li>• side</li><li>• normal</li><li>• unaffected</li><li>• side</li><li>• weakened side</li><li>• Option D: True . Fasciculations are involuntary , spontaneous muscle twitches that can occur as a result of nerve damage . When the hypoglossal nerve is injured , it can lead to fasciculations in the muscles of the tongue on the affected side . These fasciculations are often visible on the surface of the tongue and are a sign of lower motor neuron damage .</li><li>• Option D: True</li><li>• involuntary</li><li>• spontaneous muscle</li><li>• result</li><li>• nerve damage</li><li>• hypoglossal nerve</li><li>• injured</li><li>• fasciculations</li><li>• muscles</li><li>• tongue</li><li>• affected side</li><li>• fasciculations</li><li>• visible</li><li>• surface</li><li>• tongue</li><li>• sign</li><li>• lower motor neuron damage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Loss of Taste Sensation in Same Side of Tongue: False.</li><li>➤ The hypoglossal nerve is primarily a motor nerve and does not carry taste sensations. Taste sensation from the anterior two-thirds of the tongue is carried by the chorda tympani (a branch of the facial nerve , CN VII ), while the posterior one-third's taste sensation is carried by the glossopharyngeal nerve ( CN IX ). Therefore, a unilateral injury to the hypoglossal nerve would not affect taste sensation.</li><li>➤ The hypoglossal nerve is primarily a motor nerve and does not carry taste sensations.</li><li>➤ The hypoglossal nerve is primarily a motor nerve and does not carry taste sensations.</li><li>➤ motor nerve</li><li>➤ Taste sensation from the anterior two-thirds of the tongue is carried by the chorda tympani (a branch of the facial nerve , CN VII ), while the posterior one-third's taste sensation is carried by the glossopharyngeal nerve ( CN IX ).</li><li>➤ Taste sensation from the anterior two-thirds of the tongue is carried by the chorda tympani (a branch of the facial nerve , CN VII ), while the posterior one-third's taste sensation is carried by the glossopharyngeal nerve ( CN IX ).</li><li>➤ anterior two-thirds</li><li>➤ tongue</li><li>➤ chorda tympani</li><li>➤ branch</li><li>➤ facial nerve</li><li>➤ CN VII</li><li>➤ posterior one-third's taste sensation</li><li>➤ glossopharyngeal nerve</li><li>➤ CN IX</li><li>➤ Therefore, a unilateral injury to the hypoglossal nerve would not affect taste sensation.</li><li>➤ Therefore, a unilateral injury to the hypoglossal nerve would not affect taste sensation.</li><li>➤ unilateral injury</li><li>➤ hypoglossal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 138</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 138</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Tip of Tongue drains into:", "options": [{"label": "A", "text": "Occipital Lymph Node", "correct": false}, {"label": "B", "text": "Submental Lymph Node", "correct": true}, {"label": "C", "text": "Deep Cervical Nodes", "correct": false}, {"label": "D", "text": "Tonsillar Nodes", "correct": false}], "correct_answer": "B. Submental Lymph Node", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture38.jpg"], "explanation": "<p><strong>Ans. B) Submental Lymph Node</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Occipital nodes receive lymph from posterior part of scalp .</li><li>• Option A:</li><li>• posterior part</li><li>• scalp</li><li>• Option C: The lower deep cervical lymph nodes, especially jugulo omohyoid nodes are the principal lymph nodes of tongue .</li><li>• Option C:</li><li>• lower</li><li>• jugulo omohyoid nodes</li><li>• principal lymph nodes</li><li>• tongue</li><li>• Option D: Jugulodigastric nodes are the principal lymph nodes of palatine tonsil .</li><li>• Option D:</li><li>• Jugulodigastric nodes</li><li>• principal lymph nodes</li><li>• palatine tonsil</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lymphatic drainage of the tongue is complex and involves several groups of lymph nodes , primarily due to the tongue's role in oral functions and its exposure to various pathogens. The drainage patterns vary between the anterior and posterior parts of the tongue :</li><li>➤ lymphatic drainage</li><li>➤ tongue</li><li>➤ complex</li><li>➤ lymph nodes</li><li>➤ tongue's role</li><li>➤ oral functions</li><li>➤ exposure</li><li>➤ between</li><li>➤ anterior</li><li>➤ posterior parts</li><li>➤ tongue</li><li>➤ Anterior Two-Thirds of the Tongue</li><li>➤ Anterior Two-Thirds of the Tongue</li><li>➤ The lymph from the tip and the lateral margins of the anterior two-thirds of the tongue generally drains to the submental lymph nodes . The central part of the anterior two-thirds drains to the submandibular lymph nodes . Some lymph from the lateral parts of the anterior two-thirds may also drain directly to the deep cervical lymph nodes , bypassing the submandibular nodes .</li><li>➤ The lymph from the tip and the lateral margins of the anterior two-thirds of the tongue generally drains to the submental lymph nodes .</li><li>➤ lymph</li><li>➤ tip</li><li>➤ lateral margins</li><li>➤ anterior two-thirds</li><li>➤ submental lymph nodes</li><li>➤ The central part of the anterior two-thirds drains to the submandibular lymph nodes .</li><li>➤ central part</li><li>➤ anterior two-thirds drains</li><li>➤ submandibular lymph nodes</li><li>➤ Some lymph from the lateral parts of the anterior two-thirds may also drain directly to the deep cervical lymph nodes , bypassing the submandibular nodes .</li><li>➤ lateral parts</li><li>➤ anterior two-thirds</li><li>➤ drain directly</li><li>➤ deep cervical lymph nodes</li><li>➤ bypassing</li><li>➤ submandibular nodes</li><li>➤ Posterior One-Third of the Tongue</li><li>➤ Posterior One-Third of the Tongue</li><li>➤ The lymph from the posterior one-third of the tongue , which includes the area around the lingual tonsils , drains primarily to the deep cervical lymph nodes , especially the upper deep cervical nodes . This drainage can occur directly or via the jugulodigastric nodes (a subset of the deep cervical lymph nodes located around the junction of the posterior belly of the digastric muscle and the internal jugular vein ). There is also a potential for cross-drainage between the two sides of the tongue , meaning that lymph from one side of the tongue can drain to lymph nodes on the opposite side . Floor of the Mouth The lymphatics from the floor of the mouth , closely associated with the ventral surface of the tongue , primarily drain to the submandibular lymph nodes , with some drainage to the submental lymph nodes .</li><li>➤ The lymph from the posterior one-third of the tongue , which includes the area around the lingual tonsils , drains primarily to the deep cervical lymph nodes , especially the upper deep cervical nodes . This drainage can occur directly or via the jugulodigastric nodes (a subset of the deep cervical lymph nodes located around the junction of the posterior belly of the digastric muscle and the internal jugular vein ).</li><li>➤ posterior one-third</li><li>➤ tongue</li><li>➤ area</li><li>➤ lingual tonsils</li><li>➤ primarily</li><li>➤ deep cervical lymph nodes</li><li>➤ upper deep cervical nodes</li><li>➤ directly</li><li>➤ jugulodigastric nodes</li><li>➤ subset</li><li>➤ deep cervical lymph nodes</li><li>➤ junction</li><li>➤ posterior belly</li><li>➤ digastric muscle</li><li>➤ internal jugular vein</li><li>➤ There is also a potential for cross-drainage between the two sides of the tongue , meaning that lymph from one side of the tongue can drain to lymph nodes on the opposite side .</li><li>➤ potential</li><li>➤ cross-drainage</li><li>➤ two sides</li><li>➤ tongue</li><li>➤ lymph</li><li>➤ one side</li><li>➤ tongue</li><li>➤ lymph nodes</li><li>➤ opposite side</li><li>➤ Floor of the Mouth</li><li>➤ Floor of the Mouth</li><li>➤ The lymphatics from the floor of the mouth , closely associated with the ventral surface of the tongue , primarily drain to the submandibular lymph nodes , with some drainage to the submental lymph nodes .</li><li>➤ floor</li><li>➤ mouth</li><li>➤ ventral surface</li><li>➤ tongue</li><li>➤ drain</li><li>➤ submandibular lymph nodes</li><li>➤ drainage</li><li>➤ submental lymph nodes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 150</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 150</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Preganglionic Secretomotor Fibres for the Palatine Glands passes through:", "options": [{"label": "A", "text": "Lingual Nerve", "correct": false}, {"label": "B", "text": "Zygomatico Temporal Nerve", "correct": false}, {"label": "C", "text": "Jacobson’s Nerve", "correct": false}, {"label": "D", "text": "Nerve of Pterygoid Canal", "correct": true}], "correct_answer": "D. Nerve of Pterygoid Canal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture23.jpg"], "explanation": "<p><strong>Ans. D) Nerve of Pterygoid Canal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The lingual nerve is a branch of the mandibular nerve ( V3 , the third division of the trigeminal nerve ). While it carries general sensory fibers to the anterior two-thirds of the tongue , it does not carry secretomotor fibers to the palatine glands. The chorda tympani nerve , a branch of the facial nerve , does join the lingual nerve to provide secretomotor fibers to the submandibular and sublingual glands, but not to the palatine glands.</li><li>• Option A:</li><li>• mandibular nerve</li><li>• V3</li><li>• third division</li><li>• trigeminal nerve</li><li>• sensory fibers</li><li>• anterior two-thirds</li><li>• tongue</li><li>• chorda tympani nerve</li><li>• facial nerve</li><li>• join</li><li>• lingual nerve</li><li>• secretomotor fibers</li><li>• submandibular</li><li>• Option B: The zygomaticotemporal nerve is a branch of the zygomatic nerve , which itself is a branch of the maxillary nerve ( V2 , the second division of the trigeminal nerve ). This nerve primarily carries sensory fibers from the skin of the temporal region and is not involved in the innervation of the palatine glands.</li><li>• Option B:</li><li>• zygomatic nerve</li><li>• branch</li><li>• maxillary nerve</li><li>• V2</li><li>• second division</li><li>• trigeminal nerve</li><li>• carries sensory fibers</li><li>• skin</li><li>• temporal region</li><li>• Option C: Jacobson’s nerve , or the tympanic branch of the glossopharyngeal nerve ( CN IX ), is involved in the innervation of the middle ear . It contributes to the formation of the tympanic plexus but does not provide secretomotor fibers to the palatine glands.</li><li>• Option C: Jacobson’s nerve</li><li>• tympanic branch</li><li>• glossopharyngeal nerve</li><li>• CN IX</li><li>• innervation</li><li>• middle ear</li><li>• formation</li><li>• tympanic plexus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nerve of the Pterygoid Canal, also known as the Vidian nerve , the nerve of the pterygoid canal carries fibers from both the greater petrosal nerve (a branch of the facial nerve , CN VII , carrying preganglionic parasympathetic secretomotor fibers ) and the deep petrosal nerve (carrying sympathetic fibers ).</li><li>➤ Nerve of the Pterygoid Canal, also known as the Vidian nerve , the nerve of the pterygoid canal carries fibers from both the greater petrosal nerve (a branch of the facial nerve , CN VII , carrying preganglionic parasympathetic secretomotor fibers ) and the deep petrosal nerve (carrying sympathetic fibers ).</li><li>➤ Vidian nerve</li><li>➤ pterygoid canal</li><li>➤ fibers</li><li>➤ both</li><li>➤ greater petrosal nerve</li><li>➤ facial nerve</li><li>➤ CN VII</li><li>➤ preganglionic parasympathetic secretomotor fibers</li><li>➤ deep petrosal nerve</li><li>➤ sympathetic fibers</li><li>➤ These fibers pass through the pterygoid canal and reach the pterygopalatine ganglion . From the pterygopalatine ganglion , postganglionic parasympathetic fibers are distributed to the palatine glands , providing secretomotor innervation .</li><li>➤ These fibers pass through the pterygoid canal and reach the pterygopalatine ganglion .</li><li>➤ pterygoid canal</li><li>➤ reach</li><li>➤ pterygopalatine ganglion</li><li>➤ From the pterygopalatine ganglion , postganglionic parasympathetic fibers are distributed to the palatine glands , providing secretomotor innervation .</li><li>➤ pterygopalatine ganglion</li><li>➤ postganglionic parasympathetic fibers</li><li>➤ palatine glands</li><li>➤ secretomotor innervation</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 133</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 133</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Emergency Tracheostomy all the following structures are damaged Except:", "options": [{"label": "A", "text": "Isthmus of Thyroid", "correct": false}, {"label": "B", "text": "Arteria Thyroideaima", "correct": false}, {"label": "C", "text": "Inferior Thyroid Artery", "correct": true}, {"label": "D", "text": "Inferior Thyroid Vein", "correct": false}], "correct_answer": "C. Inferior Thyroid Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture27.jpg"], "explanation": "<p><strong>Ans. C) Inferior Thyroid Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The isthmus of the thyroid gland is a thin band of thyroid tissue that connects the two lobes of the gland across the midline , lying anterior to the second , third , and fourth tracheal rings . It is often encountered and may need to be divided or retracted during a tracheostomy , putting it at risk of damage .</li><li>• Option A:</li><li>• thin band</li><li>• thyroid tissue</li><li>• connects</li><li>• two lobes</li><li>• gland</li><li>• midline</li><li>• anterior</li><li>• second</li><li>• third</li><li>• fourth tracheal rings</li><li>• encountered</li><li>• divided</li><li>• retracted</li><li>• tracheostomy</li><li>• risk</li><li>• damage</li><li>• Option B: The arteria thyroidea ima is a small artery that is not present in all individuals; it is present in about 3-10% of the population . When it does exist , it arises directly from the brachiocephalic trunk or the aorta and ascends to supply the lower part of the thyroid gland , often reaching the isthmus . Due to its variable presence and location near the tracheostomy site , it could be damaged during the procedure , especially if the anatomy is not well visualized.</li><li>• Option B:</li><li>• small artery</li><li>• about 3-10%</li><li>• population</li><li>• exist</li><li>• arises directly</li><li>• brachiocephalic trunk</li><li>• aorta</li><li>• ascends</li><li>• supply</li><li>• lower part</li><li>• thyroid gland</li><li>• reaching</li><li>• isthmus</li><li>• tracheostomy</li><li>• site</li><li>• damaged</li><li>• procedure</li><li>• Option D: The inferior thyroid veins emerge from the lower part of the thyroid gland and drain into the brachiocephalic veins . These veins lie anterior to the trachea and can be encountered during a tracheostomy . They may be at risk of damage when accessing the trachea , especially if extensive dissection or an emergent approach is required .</li><li>• Option D:</li><li>• emerge</li><li>• lower part</li><li>• thyroid gland</li><li>• drain</li><li>• brachiocephalic veins</li><li>• anterior</li><li>• trachea</li><li>• encountered</li><li>• tracheostomy</li><li>• risk</li><li>• damage</li><li>• accessing</li><li>• trachea</li><li>• extensive dissection</li><li>• emergent approach</li><li>• required</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Emergency tracheostomy is a procedure performed to establish an airway during life-threatening situations . It involves making an incision through the neck into the trachea below the vocal cords . Due to the urgency and potential for complications , especially if performed in a less controlled environment , certain structures are at risk of being damaged .</li><li>➤ Emergency tracheostomy is a procedure performed to establish an airway during life-threatening situations . It involves making an incision through the neck into the trachea below the vocal cords .</li><li>➤ Emergency tracheostomy</li><li>➤ establish</li><li>➤ airway</li><li>➤ life-threatening situations</li><li>➤ making</li><li>➤ incision</li><li>➤ neck</li><li>➤ trachea</li><li>➤ below</li><li>➤ vocal cords</li><li>➤ Due to the urgency and potential for complications , especially if performed in a less controlled environment , certain structures are at risk of being damaged .</li><li>➤ urgency</li><li>➤ potential</li><li>➤ complications</li><li>➤ less controlled environment</li><li>➤ risk</li><li>➤ being damaged</li><li>➤ The inferior thyroid artery is a branch of the thyrocervical trunk , which arises from the subclavian artery . It primarily supplies the thyroid gland and the parathyroid glands . Given its course, the inferior thyroid artery is generally located more laterally and superiorly relative to the typical site of a tracheostomy and is less likely to be encountered and damaged during the procedure . Therefore, it is the correct answer as the structure least likely to be damaged during an emergency tracheostomy.</li><li>➤ branch</li><li>➤ thyrocervical trunk</li><li>➤ arises</li><li>➤ subclavian artery</li><li>➤ supplies</li><li>➤ thyroid gland</li><li>➤ parathyroid glands</li><li>➤ inferior thyroid artery</li><li>➤ laterally</li><li>➤ superiorly</li><li>➤ typical site</li><li>➤ tracheostomy</li><li>➤ damaged</li><li>➤ procedure</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In dislocation of temporomandibular joint, displacement of articular disc beyond tubercle of TMJ results from spasm of?", "options": [{"label": "A", "text": "Buccinator", "correct": false}, {"label": "B", "text": "Lateral Pterygoid", "correct": true}, {"label": "C", "text": "Masseter", "correct": false}, {"label": "D", "text": "Temporalis", "correct": false}], "correct_answer": "B. Lateral Pterygoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture26.jpg"], "explanation": "<p><strong>Ans. B) Lateral Pterygoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: The buccinator muscle is primarily involved in the movements of the cheeks , such as in blowing and chewing , and does not play a direct role in the movements of the TMJ.</li><li>• Option A:</li><li>• movements</li><li>• cheeks</li><li>• blowing</li><li>• chewing</li><li>• Option C: The masseter muscle is one of the primary muscles involved in elevation ( closing ) of the mandible and plays a critical role in chewing . While it is a powerful muscle of mastication , it does not typically cause displacement of the articular disc in TMJ dislocation.</li><li>• Option C:</li><li>• primary muscles</li><li>• elevation</li><li>• closing</li><li>• mandible</li><li>• critical role</li><li>• chewing</li><li>• powerful</li><li>• muscle</li><li>• mastication</li><li>• Option D: The temporalis muscle also primarily functions to elevate the mandible and assists in retracting the mandible . Like the masseter, it is involved in chewing but is not directly responsible for the displacement of the articular disc in TMJ dislocation.</li><li>• Option D:</li><li>• elevate</li><li>• mandible</li><li>• retracting</li><li>• mandible</li><li>• chewing</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lateral Pterygoid:</li><li>➤ Lateral Pterygoid:</li><li>➤ The lateral pterygoid muscle has two heads (upper and lower), and it is involved in the protrusion (forward movement) and depression (opening) of the mandible . When the lower head of the lateral pterygoid muscle contracts , it pulls the condyle of the mandible forward and downward . In cases of TMJ dislocation , excessive or uncontrolled activity of the lateral pterygoid muscle can lead to the condyle moving too far anteriorly , beyond the articular tubercle , resulting in dislocation . The lateral pterygoid is also involved in the anteromedial movement of the disc of the TMJ during opening of the mouth , and spasm of this muscle can contribute to the displacement of the articular disc .</li><li>➤ The lateral pterygoid muscle has two heads (upper and lower), and it is involved in the protrusion (forward movement) and depression (opening) of the mandible .</li><li>➤ two heads</li><li>➤ protrusion</li><li>➤ depression</li><li>➤ mandible</li><li>➤ When the lower head of the lateral pterygoid muscle contracts , it pulls the condyle of the mandible forward and downward .</li><li>➤ lower head</li><li>➤ contracts</li><li>➤ pulls</li><li>➤ condyle</li><li>➤ mandible</li><li>➤ forward</li><li>➤ downward</li><li>➤ In cases of TMJ dislocation , excessive or uncontrolled activity of the lateral pterygoid muscle can lead to the condyle moving too far anteriorly , beyond the articular tubercle , resulting in dislocation .</li><li>➤ TMJ dislocation</li><li>➤ excessive</li><li>➤ uncontrolled activity</li><li>➤ lateral pterygoid muscle</li><li>➤ condyle</li><li>➤ too far anteriorly</li><li>➤ beyond</li><li>➤ articular tubercle</li><li>➤ dislocation</li><li>➤ The lateral pterygoid is also involved in the anteromedial movement of the disc of the TMJ during opening of the mouth , and spasm of this muscle can contribute to the displacement of the articular disc .</li><li>➤ lateral pterygoid</li><li>➤ anteromedial movement</li><li>➤ disc</li><li>➤ TMJ</li><li>➤ opening</li><li>➤ mouth</li><li>➤ spasm</li><li>➤ displacement</li><li>➤ articular disc</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 111</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 111</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Floor of Digastric Triangle is formed by:", "options": [{"label": "A", "text": "Anterior Belly of Digastric", "correct": false}, {"label": "B", "text": "Posterior Belly of Digastric", "correct": false}, {"label": "C", "text": "Mylohyoid", "correct": true}, {"label": "D", "text": "Stylohyoid", "correct": false}], "correct_answer": "C. Mylohyoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture15.jpg"], "explanation": "<p><strong>Ans. C) Mylohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The anterior belly of the digastric muscle forms part of the anterior boundary of the digastric triangle but does not constitute the floor. It extends from the digastric fossa of the mandible to the hyoid bone .</li><li>• Option A:</li><li>• part</li><li>• anterior boundary</li><li>• digastric triangle</li><li>• extends</li><li>• digastric fossa</li><li>• mandible</li><li>• hyoid bone</li><li>• Option B: Similar to the anterior belly, the posterior belly of the digastric muscle forms part of the posterior boundary of the triangle and is not part of the floor. It runs from the mastoid notch of the temporal bone to the hyoid bone .</li><li>• Option B:</li><li>• part</li><li>• posterior boundary</li><li>• triangle</li><li>• mastoid notch</li><li>• temporal bone</li><li>• hyoid bone</li><li>• Option D: The stylohyoid muscle extends from the styloid process of the temporal bone to the hyoid bone and is located superior to the posterior belly of the digastric muscle . While it is associated with the digastric muscle and contributes to the formation of the posterior boundary of the triangle , it does not form the floor of the digastric triangle.</li><li>• Option D:</li><li>• extends</li><li>• styloid process</li><li>• temporal bone</li><li>• hyoid bone</li><li>• superior</li><li>• posterior belly</li><li>• digastric muscle</li><li>• digastric muscle</li><li>• formation</li><li>• posterior boundary</li><li>• triangle</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Mylohyoid:</li><li>• Mylohyoid:</li><li>• The mylohyoid muscle forms the primary floor of the digastric ( submandibular ) triangle . It is a broad , flat muscle that extends from the mylohyoid line of the mandible to the hyoid bone , creating a muscular floor for the mouth and contributing to the floor of the digastric triangle . The mylohyoid muscle elevates the floor of the mouth during swallowing .</li><li>• The mylohyoid muscle forms the primary floor of the digastric ( submandibular ) triangle .</li><li>• primary floor</li><li>• digastric</li><li>• submandibular</li><li>• triangle</li><li>• It is a broad , flat muscle that extends from the mylohyoid line of the mandible to the hyoid bone , creating a muscular floor for the mouth and contributing to the floor of the digastric triangle .</li><li>• broad</li><li>• flat muscle</li><li>• extends</li><li>• mylohyoid line</li><li>• mandible</li><li>• hyoid bone</li><li>• muscular floor</li><li>• mouth</li><li>• floor</li><li>• digastric triangle</li><li>• The mylohyoid muscle elevates the floor of the mouth during swallowing .</li><li>• elevates</li><li>• floor</li><li>• mouth</li><li>• swallowing</li><li>• Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 196</li><li>• Ref :</li><li>• IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 196</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Buccinator Muscle is pierced by:", "options": [{"label": "A", "text": "Facial Nerve", "correct": false}, {"label": "B", "text": "Wharton's Duct", "correct": false}, {"label": "C", "text": "Parotid Duct", "correct": true}, {"label": "D", "text": "Trigeminal Nerve", "correct": false}], "correct_answer": "C. Parotid Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture13_XoZJdaS.jpg"], "explanation": "<p><strong>Ans. C) Parotid Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. Facial nerve doesn't pierce the buccinator muscle. It is in deep relation with the parotid gland.</li><li>• Option A.</li><li>• Option B: Wharton's duct opens into the sublingual papillae on either side of frenulum linguae .</li><li>• Option B:</li><li>• sublingual papillae</li><li>• either side</li><li>• frenulum linguae</li><li>• Option D: Trigeminal ganglion lodges in Meckel's cave in middle cranial fossa .</li><li>• Option D:</li><li>• lodges</li><li>• Meckel's cave</li><li>• middle cranial fossa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The buccinator muscle is pierced by: Parotid Duct ( Stensen's Duct ). This is the duct of the parotid salivary gland , which travels forward through the cheek and pierces the buccinator muscle to open into the oral cavity opposite the second upper molar tooth . The parotid duct's opening through the buccinator allows saliva secreted by the parotid gland to enter the oral cavity , facilitating digestion and maintaining oral moisture .</li><li>➤ The buccinator muscle is pierced by: Parotid Duct ( Stensen's Duct ).</li><li>➤ buccinator muscle</li><li>➤ Parotid Duct</li><li>➤ Stensen's Duct</li><li>➤ This is the duct of the parotid salivary gland , which travels forward through the cheek and pierces the buccinator muscle to open into the oral cavity opposite the second upper molar tooth .</li><li>➤ duct</li><li>➤ parotid salivary gland</li><li>➤ forward</li><li>➤ cheek</li><li>➤ pierces</li><li>➤ buccinator muscle</li><li>➤ oral cavity</li><li>➤ opposite</li><li>➤ second upper molar tooth</li><li>➤ The parotid duct's opening through the buccinator allows saliva secreted by the parotid gland to enter the oral cavity , facilitating digestion and maintaining oral moisture .</li><li>➤ buccinator allows</li><li>➤ saliva</li><li>➤ parotid gland</li><li>➤ enter</li><li>➤ oral cavity</li><li>➤ facilitating digestion</li><li>➤ maintaining oral moisture</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 80</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 80</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Torticollis is due to Spasm of:", "options": [{"label": "A", "text": "Platysma", "correct": false}, {"label": "B", "text": "Trapezius", "correct": false}, {"label": "C", "text": "Sternocleidomastoid", "correct": true}, {"label": "D", "text": "Serratus Anterior", "correct": false}], "correct_answer": "C. Sternocleidomastoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/whatsapp-image-2024-02-20-at-110608-am.jpeg"], "explanation": "<p><strong>Ans. C) Sternocleidomastoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Platysma reduces the concavity of neck and relieves pressure over the veins .</li><li>• Option A:</li><li>• reduces</li><li>• concavity</li><li>• neck</li><li>• relieves pressure</li><li>• veins</li><li>• Option B: Trapezius innervated by spinal accessory nerve , injury to which patient unable to shrug his shoulders .</li><li>• Option B:</li><li>• spinal accessory nerve</li><li>• injury</li><li>• unable</li><li>• shrug</li><li>• shoulders</li><li>• Option D: Serratus anterior innervated by long thoracic nerve , injury to which produces winging of scapula .</li><li>• Option D:</li><li>• long thoracic nerve</li><li>• produces winging</li><li>• scapula</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Torticollis, also known as \" wry neck ,\" is characterized by an abnormal , asymmetrical head or neck position , which can be due to a variety of causes. When it occurs as a result of muscular spasm , it is most commonly associated with the sternocleidomastoid muscle. This muscle runs along each side of the neck , from the sternum and clavicle up to the mastoid process of the skull . In cases of torticollis involving the sternocleidomastoid muscle, the muscle on one side may contract involuntarily , tilting the head towards the affected side and rotating the chin upwards and towards the opposite side . This can be due to congenital factors , acquired muscle injury , inflammation , or other underlying conditions affecting the neuromuscular system .</li><li>➤ Torticollis, also known as \" wry neck ,\" is characterized by an abnormal , asymmetrical head or neck position , which can be due to a variety of causes. When it occurs as a result of muscular spasm , it is most commonly associated with the sternocleidomastoid muscle.</li><li>➤ Torticollis, also known as \" wry neck ,\" is characterized by an abnormal , asymmetrical head or neck position , which can be due to a variety of causes. When it occurs as a result of muscular spasm , it is most commonly associated with the sternocleidomastoid muscle.</li><li>➤ wry neck</li><li>➤ abnormal</li><li>➤ asymmetrical head</li><li>➤ neck position</li><li>➤ result</li><li>➤ muscular spasm</li><li>➤ sternocleidomastoid muscle.</li><li>➤ This muscle runs along each side of the neck , from the sternum and clavicle up to the mastoid process of the skull .</li><li>➤ This muscle runs along each side of the neck , from the sternum and clavicle up to the mastoid process of the skull .</li><li>➤ along each side</li><li>➤ neck</li><li>➤ sternum</li><li>➤ clavicle</li><li>➤ mastoid process</li><li>➤ skull</li><li>➤ In cases of torticollis involving the sternocleidomastoid muscle, the muscle on one side may contract involuntarily , tilting the head towards the affected side and rotating the chin upwards and towards the opposite side .</li><li>➤ In cases of torticollis involving the sternocleidomastoid muscle, the muscle on one side may contract involuntarily , tilting the head towards the affected side and rotating the chin upwards and towards the opposite side .</li><li>➤ sternocleidomastoid muscle,</li><li>➤ muscle</li><li>➤ one side</li><li>➤ involuntarily</li><li>➤ tilting</li><li>➤ head towards</li><li>➤ affected side</li><li>➤ rotating</li><li>➤ upwards</li><li>➤ towards</li><li>➤ opposite side</li><li>➤ This can be due to congenital factors , acquired muscle injury , inflammation , or other underlying conditions affecting the neuromuscular system .</li><li>➤ This can be due to congenital factors , acquired muscle injury , inflammation , or other underlying conditions affecting the neuromuscular system .</li><li>➤ congenital factors</li><li>➤ acquired muscle injury</li><li>➤ inflammation</li><li>➤ affecting</li><li>➤ neuromuscular system</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 185</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents to the emergency department with a severe headache, double vision, and recent onset of facial weakness on the right side. His mother mentions that he has had a persistent ear infection for several weeks, which was initially treated with antibiotics without significant improvement. On examination, the boy has difficulty abducting his right eye, and there is noticeable weakness in the muscles of facial expression on the same side. Based on the clinical presentation and the history of a chronic ear infection, which cranial nerves are most likely involved in this condition?", "options": [{"label": "A", "text": "V &amp; VI", "correct": false}, {"label": "B", "text": "VI &amp; VII", "correct": true}, {"label": "C", "text": "VII &amp; VIII", "correct": false}, {"label": "D", "text": "IX &amp; X", "correct": false}], "correct_answer": "B. VI & VII", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture12.jpg"], "explanation": "<p><strong>Ans. B) VI &amp; VII</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: V &amp; VI: This option includes the trigeminal nerve ( CN V ), which is involved in Gradenigo's syndrome through its ophthalmic division causing facial pain , and the abducens nerve (CN VI), which causes lateral rectus muscle palsy leading to double vision . This pairing partially matches the classic presentation of Gradenigo's syndrome .</li><li>• Option A: V &amp; VI:</li><li>• trigeminal nerve</li><li>• CN V</li><li>• Gradenigo's syndrome</li><li>• ophthalmic division</li><li>• facial pain</li><li>• abducens nerve</li><li>• lateral rectus</li><li>• muscle</li><li>• palsy</li><li>• double vision</li><li>• classic presentation</li><li>• Gradenigo's syndrome</li><li>• Option C: VII &amp; VIII: This option pairs the facial nerve ( CN VII ) and the vestibulocochlear nerve (CN VIII). Neither of these nerves is primarily involved in Gradenigo's syndrome. While middle ear infections can potentially affect the facial nerve due to its proximity , this is not a characteristic feature of Gradenigo's syndrome, and CN VIII involvement would be unrelated.</li><li>• Option C: VII &amp; VIII:</li><li>• facial nerve</li><li>• CN VII</li><li>• vestibulocochlear nerve</li><li>• middle ear</li><li>• infections</li><li>• potentially affect</li><li>• facial</li><li>• nerve</li><li>• proximity</li><li>• Option D: IX &amp; X: This option involves the glossopharyngeal nerve ( CN IX ) and the vagus nerve (CN X), neither of which is involved in Gradenigo's syndrome.</li><li>• Option D: IX &amp; X:</li><li>• glossopharyngeal nerve</li><li>• CN IX</li><li>• vagus nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ VI &amp; VII: This option includes the abducens nerve ( CN VI ) and the facial nerve ( CN VII ). While CN VI involvement is consistent with Gradenigo's syndrome , CN VII is not typically associated with this condition. Gradenigo's syndrome primarily involves the trigeminal nerve (for the facial pain component) rather than the facial nerve . Gradenigo syndrome is seen in infection of the petrous part of temporal bone . It presents a triad of symptoms which include - VII nerve palsy , VI nerve palsy and otitis media . The VI nerve passes through the dorello’s canal which lies below the petrosphenoid Ligament at the apex of the petrous part of temporal bone .</li><li>➤ VI &amp; VII: This option includes the abducens nerve ( CN VI ) and the facial nerve ( CN VII ). While CN VI involvement is consistent with Gradenigo's syndrome , CN VII is not typically associated with this condition. Gradenigo's syndrome primarily involves the trigeminal nerve (for the facial pain component) rather than the facial nerve .</li><li>➤ VI &amp; VII:</li><li>➤ abducens nerve</li><li>➤ CN VI</li><li>➤ facial nerve</li><li>➤ CN VII</li><li>➤ Gradenigo's syndrome</li><li>➤ involves</li><li>➤ trigeminal nerve</li><li>➤ facial pain</li><li>➤ facial nerve</li><li>➤ Gradenigo syndrome is seen in infection of the petrous part of temporal bone . It presents a triad of symptoms which include - VII nerve palsy , VI nerve palsy and otitis media .</li><li>➤ infection</li><li>➤ petrous part</li><li>➤ temporal bone</li><li>➤ triad</li><li>➤ symptoms</li><li>➤ VII nerve palsy</li><li>➤ VI nerve palsy</li><li>➤ otitis media</li><li>➤ The VI nerve passes through the dorello’s canal which lies below the petrosphenoid Ligament at the apex of the petrous part of temporal bone .</li><li>➤ dorello’s canal</li><li>➤ below</li><li>➤ petrosphenoid Ligament</li><li>➤ apex</li><li>➤ petrous part</li><li>➤ temporal bone</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 366</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 366</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which part of vertebral artery lies in suboccipital triangle?", "options": [{"label": "A", "text": "First part", "correct": false}, {"label": "B", "text": "Second part", "correct": false}, {"label": "C", "text": "Third part", "correct": true}, {"label": "D", "text": "Fourth part", "correct": false}], "correct_answer": "C. Third part", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture6.jpg"], "explanation": "<p><strong>Ans. C) Third part</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: First part of vertebral artery includes its origin from first part of subclavian artery and lies in scaleno vertebral triangle .</li><li>• Option A:</li><li>• first part</li><li>• subclavian artery</li><li>• scaleno vertebral triangle</li><li>• Option B: Second part transverse foramen transversaria of C6 to C1 .</li><li>• Option B:</li><li>• foramen transversaria</li><li>• C6</li><li>• C1</li><li>• Option D: Fourth part enters cranial cavity through foramen magnum .</li><li>• Option D:</li><li>• cranial cavity</li><li>• foramen magnum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The part of the vertebral artery that lies within the suboccipital triangle is the V3 segment , also known as the atlantic part or horizontal segment . This segment of the vertebral artery travels between the first cervical vertebra ( atlas ) and the second cervical vertebra ( axis ) and then makes a sharp turn to ascend vertically through the foramen magnum into the cranial cavity . The suboccipital triangle is formed by the rectus capitis posterior major ( superiorly ), the obliquus capitis superior (laterally), and the obliquus capitis inferior (inferiorly), and the vertebral artery's V3 segment is a key structure within this anatomical space .</li><li>➤ The part of the vertebral artery that lies within the suboccipital triangle is the V3 segment , also known as the atlantic part or horizontal segment .</li><li>➤ suboccipital triangle</li><li>➤ V3 segment</li><li>➤ atlantic part</li><li>➤ horizontal segment</li><li>➤ This segment of the vertebral artery travels between the first cervical vertebra ( atlas ) and the second cervical vertebra ( axis ) and then makes a sharp turn to ascend vertically through the foramen magnum into the cranial cavity .</li><li>➤ vertebral artery</li><li>➤ between</li><li>➤ first cervical vertebra</li><li>➤ atlas</li><li>➤ second cervical vertebra</li><li>➤ axis</li><li>➤ sharp turn</li><li>➤ ascend vertically</li><li>➤ foramen magnum</li><li>➤ cranial cavity</li><li>➤ The suboccipital triangle is formed by the rectus capitis posterior major ( superiorly ), the obliquus capitis superior (laterally), and the obliquus capitis inferior (inferiorly), and the vertebral artery's V3 segment is a key structure within this anatomical space .</li><li>➤ rectus capitis posterior major</li><li>➤ superiorly</li><li>➤ obliquus capitis superior</li><li>➤ obliquus capitis inferior</li><li>➤ vertebral artery's V3 segment</li><li>➤ anatomical space</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 335</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 335</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is unpaired Dural Venous Sinus:", "options": [{"label": "A", "text": "Cavernous Sinus", "correct": false}, {"label": "B", "text": "Sphenoparietal Sinus", "correct": false}, {"label": "C", "text": "Basilar Venous Plexus", "correct": true}, {"label": "D", "text": "Petrosquamous Sinus", "correct": false}], "correct_answer": "C. Basilar Venous Plexus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture5.jpg"], "explanation": "<p><strong>Ans. C) Basilar Venous Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The cavernous sinuses are paired structures located on either side of the sella turcica , surrounding the pituitary gland . They receive blood from several veins, including the ophthalmic veins and the sphenoparietal sinus , and drain into the superior and inferior petrosal sinuses .</li><li>• Option A:</li><li>• paired structures</li><li>• either side</li><li>• sella turcica</li><li>• pituitary gland</li><li>• ophthalmic veins</li><li>• sphenoparietal sinus</li><li>• drain</li><li>• superior</li><li>• inferior petrosal sinuses</li><li>• Option B: The sphenoparietal sinus is also typically a paired structure , running along the edge of the lesser wing of the sphenoid bone . It drains blood from the surface of the brain into the cavernous sinus .</li><li>• Option B:</li><li>• paired structure</li><li>• edge</li><li>• lesser wing</li><li>• sphenoid bone</li><li>• blood</li><li>• surface</li><li>• brain</li><li>• cavernous sinus</li><li>• Option D: The petrosquamous sinus is less commonly described and is considered a minor dural venous sinus , not as well-known or consistently identified as the others.</li><li>• Option D:</li><li>• minor dural venous sinus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Unpaired dural venous sinus - superior sagittal sinus , inferior sagittal sinus , straight sinus , occipital sinus , basilar venous plexus , anterior and posterior intercavernous sinus Paired dural venous sinus – transverse sinus , sigmoid sinus , superior and inferior petrosal sinus , cavernous sinus , middle meningeal veins , sphenoparietal sinus , petrosquamous sinus .</li><li>➤ Unpaired dural venous sinus - superior sagittal sinus , inferior sagittal sinus , straight sinus , occipital sinus , basilar venous plexus , anterior and posterior intercavernous sinus</li><li>➤ Unpaired dural venous sinus - superior sagittal sinus , inferior sagittal sinus , straight sinus , occipital sinus , basilar venous plexus , anterior and posterior intercavernous sinus</li><li>➤ Unpaired</li><li>➤ superior sagittal sinus</li><li>➤ inferior sagittal sinus</li><li>➤ straight sinus</li><li>➤ occipital sinus</li><li>➤ basilar venous plexus</li><li>➤ anterior</li><li>➤ posterior intercavernous sinus</li><li>➤ Paired dural venous sinus – transverse sinus , sigmoid sinus , superior and inferior petrosal sinus , cavernous sinus , middle meningeal veins , sphenoparietal sinus , petrosquamous sinus .</li><li>➤ Paired dural venous sinus – transverse sinus , sigmoid sinus , superior and inferior petrosal sinus , cavernous sinus , middle meningeal veins , sphenoparietal sinus , petrosquamous sinus .</li><li>➤ Paired</li><li>➤ transverse sinus</li><li>➤ sigmoid sinus</li><li>➤ superior</li><li>➤ inferior petrosal sinus</li><li>➤ cavernous sinus</li><li>➤ middle meningeal veins</li><li>➤ sphenoparietal sinus</li><li>➤ petrosquamous sinus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 348</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 348</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle innervated by Descendens Hypoglossi?", "options": [{"label": "A", "text": "Geniohyoid", "correct": false}, {"label": "B", "text": "Superior Belly of Omohyoid", "correct": true}, {"label": "C", "text": "Sternohyoid", "correct": false}, {"label": "D", "text": "Mylohyoid", "correct": false}], "correct_answer": "B. Superior Belly of Omohyoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture3.jpg"], "explanation": "<p><strong>Ans. B) Superior Belly of Omohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Geniohyoid and thyrohyoid innervated by C1 fibres which travel along with hypoglossal nerve .</li><li>• Option A:</li><li>• Geniohyoid</li><li>• thyrohyoid</li><li>• C1 fibres</li><li>• hypoglossal nerve</li><li>• Option C: Loop of ansa cervicalis innervates sternohyoid , sternothyroid and inferior belly of omohyoid .</li><li>• Option C:</li><li>• Loop</li><li>• ansa cervicalis</li><li>• sternohyoid</li><li>• sternothyroid</li><li>• inferior belly</li><li>• omohyoid</li><li>• Option D: Mylohyoid innervated by nerve to mylohyoid from inferior alveolar nerve .</li><li>• Option D:</li><li>• Mylohyoid</li><li>• mylohyoid</li><li>• inferior alveolar nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The descendens hypoglossi , also known as the ansa cervicalis , is a nerve loop that is part of the cervical plexus . It is formed from fibers from the first and second cervical spinal nerves ( C1 and C2 ), with contributions from C1 traveling along the hypoglossal nerve (CN XII) before branching off to form the ansa cervicalis . This nerve primarily innervates the infrahyoid muscles , which are muscles located below the hyoid bone and are involved in swallowing and speech . The specific muscles innervated by the descendens hypoglossi ( ansa cervicalis ) include:</li><li>➤ The descendens hypoglossi , also known as the ansa cervicalis , is a nerve loop that is part of the cervical plexus . It is formed from fibers from the first and second cervical spinal nerves ( C1 and C2 ), with contributions from C1 traveling along the hypoglossal nerve (CN XII) before branching off to form the ansa cervicalis .</li><li>➤ descendens hypoglossi</li><li>➤ ansa cervicalis</li><li>➤ nerve loop</li><li>➤ cervical plexus</li><li>➤ fibers</li><li>➤ first</li><li>➤ second</li><li>➤ cervical spinal</li><li>➤ nerves</li><li>➤ C1</li><li>➤ C2</li><li>➤ C1</li><li>➤ hypoglossal nerve</li><li>➤ ansa cervicalis</li><li>➤ This nerve primarily innervates the infrahyoid muscles , which are muscles located below the hyoid bone and are involved in swallowing and speech . The specific muscles innervated by the descendens hypoglossi ( ansa cervicalis ) include:</li><li>➤ innervates</li><li>➤ infrahyoid muscles</li><li>➤ below</li><li>➤ hyoid</li><li>➤ bone</li><li>➤ swallowing</li><li>➤ speech</li><li>➤ descendens hypoglossi</li><li>➤ ansa cervicalis</li><li>➤ Sternohyoid Muscle: This muscle depresses the hyoid bone after it has been elevated during swallowing . Omohyoid Muscle: The omohyoid has two bellies ( superior and inferior ), and its action also depresses the hyoid bone , as well as the larynx , after swallowing . Sternothyroid Muscle: This muscle depresses the thyroid cartilage and also plays a role in the mechanics of swallowing .</li><li>➤ Sternohyoid Muscle: This muscle depresses the hyoid bone after it has been elevated during swallowing .</li><li>➤ Sternohyoid Muscle:</li><li>➤ depresses</li><li>➤ hyoid bone</li><li>➤ after</li><li>➤ swallowing</li><li>➤ Omohyoid Muscle: The omohyoid has two bellies ( superior and inferior ), and its action also depresses the hyoid bone , as well as the larynx , after swallowing .</li><li>➤ Omohyoid Muscle:</li><li>➤ two bellies</li><li>➤ superior</li><li>➤ inferior</li><li>➤ depresses</li><li>➤ hyoid bone</li><li>➤ larynx</li><li>➤ after swallowing</li><li>➤ Sternothyroid Muscle: This muscle depresses the thyroid cartilage and also plays a role in the mechanics of swallowing .</li><li>➤ Sternothyroid Muscle:</li><li>➤ depresses</li><li>➤ thyroid cartilage</li><li>➤ role</li><li>➤ mechanics</li><li>➤ swallowing</li><li>➤ The thyrohyoid muscle, although closely related to these muscles, is innervated directly by fibers from the first cervical spinal nerve ( C1 ) that travel with the hypoglossal nerve but do not form part of the ansa cervicalis.</li><li>➤ innervated</li><li>➤ directly</li><li>➤ fibers</li><li>➤ first cervical spinal nerve</li><li>➤ C1</li><li>➤ hypoglossal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 188</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 188</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle which contributes to Floor of Carotid Triangle?", "options": [{"label": "A", "text": "Hyoglossus", "correct": true}, {"label": "B", "text": "Genioglossus", "correct": false}, {"label": "C", "text": "Superior Constrictor", "correct": false}, {"label": "D", "text": "Middle Constrictor", "correct": false}], "correct_answer": "A. Hyoglossus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture2.jpg"], "explanation": "<p><strong>Ans. A) Hyoglossus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The genioglossus muscle is a fan-shaped muscle of the tongue that originates from the mandible . While it is an important muscle for tongue movements, it does not contribute to the floor of the carotid triangle because of its location and function primarily related to the tongue .</li><li>• Option B:</li><li>• fan-shaped muscle</li><li>• tongue</li><li>• mandible</li><li>• location</li><li>• tongue</li><li>• Option C: The superior constrictor muscle is a part of the pharyngeal constrictors that shape the pharyngeal wall . The superior constrictor is located more posteriorly in the neck and contributes to the pharyngeal wall rather than the floor of the carotid triangle .</li><li>• Option C:</li><li>• pharyngeal constrictors</li><li>• shape</li><li>• pharyngeal wall</li><li>• posteriorly</li><li>• neck</li><li>• pharyngeal wall</li><li>• floor</li><li>• carotid triangle</li><li>• Option D: Like the superior constrictor, the middle constrictor muscle is part of the pharyngeal musculature and is involved in the function of the pharynx . It does not contribute to the floor of the carotid triangle as it is located posteriorly to this anatomical area .</li><li>• Option D:</li><li>• pharyngeal musculature</li><li>• function</li><li>• pharynx</li><li>• posteriorly</li><li>• anatomical area</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The carotid triangle , one of the subdivisions of the anterior triangle of the neck , is an important anatomical region that contains the carotid artery and its branches , the internal jugular vein , and several important nerves. The floor of the carotid triangle is formed by muscles that underlie the structures within the triangle.</li><li>➤ carotid triangle</li><li>➤ subdivisions</li><li>➤ anterior triangle</li><li>➤ neck</li><li>➤ anatomical region</li><li>➤ contains</li><li>➤ carotid artery</li><li>➤ branches</li><li>➤ internal jugular vein</li><li>➤ floor</li><li>➤ carotid triangle</li><li>➤ muscles</li><li>➤ The hyoglossus muscle, which originates from the hyoid bone and inserts into the side of the tongue , forms part of the floor of the carotid triangle. It is a flat , quadrilateral muscle and is located deep to the mylohyoid , stylohyoid , and digastric muscles .</li><li>➤ originates</li><li>➤ hyoid bone</li><li>➤ inserts</li><li>➤ side</li><li>➤ tongue</li><li>➤ floor</li><li>➤ carotid triangle.</li><li>➤ flat</li><li>➤ quadrilateral muscle</li><li>➤ deep</li><li>➤ mylohyoid</li><li>➤ stylohyoid</li><li>➤ digastric muscles</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 196</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 196</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female went to her family physician with complaints of pain over her lower neck for the past 2 months. The pain had increased over the past three days. She insisted that an x-ray should be taken. The given image is the x-ray of the patient. Which of the following is not a feature of cervical vertebra?", "options": [{"label": "A", "text": "Presence of Uncal Process", "correct": false}, {"label": "B", "text": "Vertebral Foramen is Small &amp; Circular", "correct": true}, {"label": "C", "text": "Spine Sort &amp; Bifid", "correct": false}, {"label": "D", "text": "Foramen Transversarium", "correct": false}], "correct_answer": "B. Vertebral Foramen is Small & Circular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture46_yXBotjQ.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture25.jpg"], "explanation": "<p><strong>Ans. B) Vertebral Foramen is Small &amp; Circular</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: This is true . The uncinate processes , also known as the uncus or uncal process , are hook-shaped processes on the lateral edges of the top surface of the bodies of the third to the seventh cervical vertebrae . They are involved in the formation of the uncovertebral joints (joints of Luschka), which are unique to the cervical spine , the upper surface of which presents with raised lips called uncal process .</li><li>• Option A:</li><li>• true</li><li>• uncinate processes</li><li>• uncus</li><li>• uncal process</li><li>• hook-shaped processes</li><li>• lateral edges</li><li>• top surface</li><li>• bodies</li><li>• third</li><li>• seventh cervical vertebrae</li><li>• uncovertebral joints</li><li>• unique</li><li>• cervical spine</li><li>• upper surface</li><li>• raised lips</li><li>• uncal process</li><li>• Option C: This is true for most cervical vertebrae ( C2-C6 ). The spinous processes of these vertebrae are typically short and bifid ( split at the end ), which is a distinctive feature of cervical vertebrae , allowing for greater movement and muscle attachment .</li><li>• Option C:</li><li>• true</li><li>• most cervical vertebrae</li><li>• C2-C6</li><li>• spinous processes</li><li>• typically short</li><li>• bifid</li><li>• split</li><li>• end</li><li>• cervical vertebrae</li><li>• allowing</li><li>• greater movement</li><li>• muscle attachment</li><li>• Option D: This is true . The cervical vertebrae are unique in having the foramen transversarium within each transverse process . These foramina serve as passages for the vertebral arteries (except for the seventh cervical vertebra , where the foramen transversarium may transmit only accessory veins rather than the artery ).</li><li>• Option D:</li><li>• true</li><li>• foramen transversarium</li><li>• transverse process</li><li>• passages</li><li>• vertebral arteries</li><li>• seventh cervical vertebra</li><li>• foramen transversarium</li><li>• only accessory</li><li>• veins</li><li>• artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The vertebral foramen in cervical vertebrae is actually relatively large and triangular (or heart-shaped) to accommodate the cervical enlargement of the spinal cord . This feature is more characteristic of thoracic vertebrae , where the vertebral foramen tends to be smaller and more circular . Therefore, option B is not a feature of cervical vertebrae.</li><li>➤ The vertebral foramen in cervical vertebrae is actually relatively large and triangular (or heart-shaped) to accommodate the cervical enlargement of the spinal cord .</li><li>➤ The vertebral foramen in cervical vertebrae is actually relatively large and triangular (or heart-shaped) to accommodate the cervical enlargement of the spinal cord .</li><li>➤ vertebral foramen</li><li>➤ cervical vertebrae</li><li>➤ relatively large</li><li>➤ triangular</li><li>➤ cervical enlargement</li><li>➤ spinal cord</li><li>➤ This feature is more characteristic of thoracic vertebrae , where the vertebral foramen tends to be smaller and more circular . Therefore, option B is not a feature of cervical vertebrae.</li><li>➤ This feature is more characteristic of thoracic vertebrae , where the vertebral foramen tends to be smaller and more circular . Therefore, option B is not a feature of cervical vertebrae.</li><li>➤ characteristic</li><li>➤ thoracic vertebrae</li><li>➤ vertebral foramen</li><li>➤ smaller</li><li>➤ circular</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 720</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 720</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient undergoes surgery at the lateral part of the skull. Postoperative complication of the patient is aspirations without voice change. The nerve involved in this condition supplies which of the following muscle?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-12_79r0Qb3.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The posterior belly of the digastric muscle is innervated by the facial nerve (CN VII). While injury to the facial nerve can affect some functions of the face , it is not typically associated with aspiration , as the digastric muscle primarily functions in the opening of the mouth and does not play a direct role in the swallowing process .</li><li>• Option B.</li><li>• posterior belly</li><li>• digastric muscle</li><li>• innervated</li><li>• facial nerve (CN VII).</li><li>• injury</li><li>• affect</li><li>• functions of the face</li><li>• not</li><li>• typically associated</li><li>• aspiration</li><li>• digastric muscle</li><li>• opening</li><li>• mouth</li><li>• does not play</li><li>• swallowing process</li><li>• Option C. The medial pterygoid muscle , innervated by the mandibular branch of the trigeminal nerve (CN V3), is a muscle of mastication . Damage to this nerve would primarily affect chewing rather than swallowing or voice , so it is unlikely to cause aspiration without voice change.</li><li>• Option C.</li><li>• medial pterygoid muscle</li><li>• mandibular branch</li><li>• trigeminal nerve (CN V3),</li><li>• muscle of mastication</li><li>• primarily affect</li><li>• chewing</li><li>• swallowing or voice</li><li>• Option D. The thyropharyngeus muscle , a part of the inferior constrictor muscle of the pharynx , is innervated by branches from the recurrent laryngeal nerve , a branch of the vagus nerve (CN X). Damage to this nerve could lead to impaired swallowing because the inferior constrictor muscle helps in the swallowing mechanism by constricting the pharynx . However, the recurrent laryngeal nerve also innervates the vocal cords, and its damage typically leads to voice changes, which is not the case here.</li><li>• Option D.</li><li>• thyropharyngeus muscle</li><li>• inferior constrictor</li><li>• muscle</li><li>• pharynx</li><li>• innervated by branches</li><li>• recurrent laryngeal nerve</li><li>• vagus nerve (CN X).</li><li>• Damage</li><li>• impaired swallowing</li><li>• inferior constrictor muscle</li><li>• swallowing mechanism</li><li>• constricting</li><li>• pharynx</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The glossopharyngeal nerve (CN IX) innervates the stylopharyngeus muscle , which elevates the pharynx during swallowing . Damage to this nerve could potentially contribute to swallowing difficulties . However, the glossopharyngeal nerve primarily affects sensation and taste in the posterior third of the tongue and does not typically lead to aspiration. The glossopharyngeal nerve is the ninth cranial nerve (CN IX) and plays a key role in the sensory and motor functions of the pharynx and back of the tongue. It is responsible for sensation in the posterior part of the tongue, tonsils , pharynx, and the middle ear . It also plays a role in taste sensation for the posterior third of the tongue . Motor functions include aiding in swallowing and the secretion of saliva from the parotid gland . This nerve originates in the brainstem , specifically in the medulla oblongata . It exits the skull through the jugular foramen before branching to various parts of the throat and tongue . Damage to the glossopharyngeal nerve can lead to a variety of symptoms, including loss of taste in the posterior third of the tongue , difficulty swallowing , loss of gag reflex , and altered sensation in the throat and tongue . Glossopharyngeal neuralgia , a condition characterized by severe pain in areas innervated by this nerve , can also occur.</li><li>➤ The glossopharyngeal nerve (CN IX) innervates the stylopharyngeus muscle , which elevates the pharynx during swallowing . Damage to this nerve could potentially contribute to swallowing difficulties . However, the glossopharyngeal nerve primarily affects sensation and taste in the posterior third of the tongue and does not typically lead to aspiration.</li><li>➤ stylopharyngeus muscle</li><li>➤ elevates</li><li>➤ pharynx during swallowing</li><li>➤ Damage</li><li>➤ swallowing difficulties</li><li>➤ affects sensation</li><li>➤ taste</li><li>➤ posterior third</li><li>➤ tongue</li><li>➤ The glossopharyngeal nerve is the ninth cranial nerve (CN IX) and plays a key role in the sensory and motor functions of the pharynx and back of the tongue. It is responsible for sensation in the posterior part of the tongue, tonsils , pharynx, and the middle ear . It also plays a role in taste sensation for the posterior third of the tongue . Motor functions include aiding in swallowing and the secretion of saliva from the parotid gland .</li><li>➤ ninth cranial nerve</li><li>➤ (CN IX)</li><li>➤ sensory</li><li>➤ motor functions</li><li>➤ pharynx and back</li><li>➤ tongue.</li><li>➤ sensation</li><li>➤ posterior part</li><li>➤ tongue,</li><li>➤ tonsils</li><li>➤ pharynx,</li><li>➤ middle ear</li><li>➤ taste sensation</li><li>➤ posterior third</li><li>➤ tongue</li><li>➤ Motor functions</li><li>➤ swallowing</li><li>➤ secretion of saliva</li><li>➤ parotid gland</li><li>➤ This nerve originates in the brainstem , specifically in the medulla oblongata . It exits the skull through the jugular foramen before branching to various parts of the throat and tongue .</li><li>➤ originates</li><li>➤ brainstem</li><li>➤ medulla oblongata</li><li>➤ exits</li><li>➤ skull</li><li>➤ jugular foramen</li><li>➤ branching</li><li>➤ throat</li><li>➤ tongue</li><li>➤ Damage to the glossopharyngeal nerve can lead to a variety of symptoms, including loss of taste in the posterior third of the tongue , difficulty swallowing , loss of gag reflex , and altered sensation in the throat and tongue . Glossopharyngeal neuralgia , a condition characterized by severe pain in areas innervated by this nerve , can also occur.</li><li>➤ Damage</li><li>➤ loss of taste</li><li>➤ posterior third</li><li>➤ tongue</li><li>➤ difficulty swallowing</li><li>➤ loss of gag reflex</li><li>➤ altered sensation</li><li>➤ throat</li><li>➤ tongue</li><li>➤ Glossopharyngeal neuralgia</li><li>➤ severe pain</li><li>➤ areas innervated</li><li>➤ nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 405</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 405</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male sustained head injury due to fall from his bike. CT brain showed extradural hematoma. The blood vessel injured is:", "options": [{"label": "A", "text": "Middle Cerebral Artery", "correct": false}, {"label": "B", "text": "Superior Cerebral Vein", "correct": false}, {"label": "C", "text": "Middle Meningeal Artery", "correct": true}, {"label": "D", "text": "Accessory Meningeal Artery", "correct": false}], "correct_answer": "C. Middle Meningeal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture13.jpg"], "explanation": "<p><strong>Ans. C) Middle Meningeal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Middle Cerebral Artery is a major artery in the brain that supplies blood to lateral parts of the brain , including the lateral temporal and frontal lobes , and part of the parietal lobe . Injury to the Middle Cerebral Artery usually leads to an intracerebral hemorrhage or a subarachnoid hemorrhage , not an extradural hematoma . This artery is located deep within the brain tissue and is not typically involved in extradural bleedings .</li><li>• Option A.</li><li>• major artery</li><li>• brain</li><li>• supplies blood to lateral parts</li><li>• brain</li><li>• lateral temporal</li><li>• frontal lobes</li><li>• part of</li><li>• parietal lobe</li><li>• Injury</li><li>• intracerebral hemorrhage</li><li>• subarachnoid hemorrhage</li><li>• not</li><li>• extradural hematoma</li><li>• located</li><li>• deep</li><li>• brain tissue</li><li>• not</li><li>• involved</li><li>• extradural bleedings</li><li>• Option B. Superior cerebral veins drain the cerebral hemispheres and empty into the superior sagittal sinus . While venous bleeding can occur due to head trauma , it is more likely to result in a subdural hematoma rather than an extradural one . The venous bleeding is usually slower than arterial bleeding and often occurs over a larger surface area.</li><li>• Option B.</li><li>• drain</li><li>• cerebral hemispheres</li><li>• empty</li><li>• into</li><li>• superior sagittal sinus</li><li>• venous bleeding</li><li>• head trauma</li><li>• result</li><li>• subdural hematoma</li><li>• rather than</li><li>• extradural one</li><li>• Option D. The Accessory Meningeal Artery is a smaller artery that also supplies the meninges . While it could potentially be involved in an extradural bleed , it is much less likely than the Middle Meningeal Artery, given its smaller size and different anatomical course.</li><li>• Option D.</li><li>• smaller artery</li><li>• supplies</li><li>• meninges</li><li>• involved</li><li>• extradural bleed</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anatomy: The Middle Meningeal Artery is a branch of the maxillary artery and runs between the skull and the dura mater. Relation to Extradural Hematoma: This artery is the most commonly injured vessel in extradural hematomas , particularly when there is a fracture of the temporal bone , as it runs within the grooves on the inner surface of the skull. Trauma can lead to its rupture , causing rapid bleeding and the formation of an extradural hematoma .</li><li>➤ Anatomy: The Middle Meningeal Artery is a branch of the maxillary artery and runs between the skull and the dura mater.</li><li>➤ branch</li><li>➤ maxillary artery</li><li>➤ between</li><li>➤ skull</li><li>➤ dura mater.</li><li>➤ Relation to Extradural Hematoma: This artery is the most commonly injured vessel in extradural hematomas , particularly when there is a fracture of the temporal bone , as it runs within the grooves on the inner surface of the skull.</li><li>➤ injured</li><li>➤ vessel</li><li>➤ extradural hematomas</li><li>➤ fracture</li><li>➤ temporal bone</li><li>➤ grooves</li><li>➤ inner surface</li><li>➤ skull.</li><li>➤ Trauma can lead to its rupture , causing rapid bleeding and the formation of an extradural hematoma .</li><li>➤ Trauma</li><li>➤ rupture</li><li>➤ rapid bleeding</li><li>➤ formation</li><li>➤ extradural hematoma</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old man underwent parotidectomy following which he complained that there was loss of sensation while shaving. Which nerve is affected most?", "options": [{"label": "A", "text": "Auriculotemporal Nerve", "correct": false}, {"label": "B", "text": "Greater auricular Nerve", "correct": true}, {"label": "C", "text": "Mandibular Nerve", "correct": false}, {"label": "D", "text": "Facial Nerve", "correct": false}], "correct_answer": "B. Greater auricular Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture27.jpg"], "explanation": "<p><strong>Ans. B) Greater Auricular Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Auriculotemporal nerve is a branch of the mandibular nerve (CN V3) and provides sensory innervation to the ear and temporal region of the scalp. While it is in the vicinity of the surgical site , the auriculotemporal nerve primarily innervates the area around the ear and the temple , not the lower face or jawline where shaving typically occurs.</li><li>• Option A.</li><li>• branch</li><li>• mandibular nerve (CN V3)</li><li>• sensory innervation</li><li>• ear</li><li>• temporal region</li><li>• scalp.</li><li>• vicinity</li><li>• surgical site</li><li>• auriculotemporal nerve</li><li>• innervates</li><li>• area around</li><li>• ear</li><li>• temple</li><li>• not</li><li>• lower face</li><li>• jawline</li><li>• shaving</li><li>• Option C. The Mandibular nerve is the third division of the trigeminal nerve (CN V3) and provides sensory innervation to the lower lip , lower part of the face , and motor innervation to the muscles of mastication.</li><li>• Option C.</li><li>• third division</li><li>• trigeminal nerve (CN V3)</li><li>• sensory innervation</li><li>• lower lip</li><li>• lower part</li><li>• face</li><li>• motor innervation</li><li>• muscles of mastication.</li><li>• Although it is a major nerve in the area, its sensory distribution is more focused on the lower lip and chin rather than the area typically affected by shaving.</li><li>• major nerve</li><li>• sensory distribution</li><li>• lower lip</li><li>• chin</li><li>• Option D. The Facial nerve (CN VII) is primarily a motor nerve , controlling muscles of facial expression . It also carries some sensory fibers and taste fibers but does not provide general sensation to the face. Damage to the facial nerve would more likely result in muscle weakness or paralysis (like an inability to close the eye or smile), not a loss of sensation.</li><li>• Option D.</li><li>• motor nerve</li><li>• muscles of facial expression</li><li>• carries</li><li>• sensory fibers</li><li>• taste fibers</li><li>• Damage</li><li>• muscle weakness</li><li>• paralysis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Greater Auricular nerve, a branch of the cervical plexus (arising from C2 and C3), provides sensory innervation to the skin over the parotid gland , the angle of the jaw , and the earlobe . This nerve's sensory distribution includes the lower part of the face around the angle of the jaw , which is a common area for shaving. Damage to this nerve during parotidectomy could lead to loss of sensation in this area , aligning with the patient's complaint.</li><li>➤ The Greater Auricular nerve, a branch of the cervical plexus (arising from C2 and C3), provides sensory innervation to the skin over the parotid gland , the angle of the jaw , and the earlobe .</li><li>➤ The Greater Auricular nerve, a branch of the cervical plexus (arising from C2 and C3), provides sensory innervation to the skin over the parotid gland , the angle of the jaw , and the earlobe .</li><li>➤ branch</li><li>➤ cervical plexus</li><li>➤ sensory innervation</li><li>➤ skin over the parotid gland</li><li>➤ angle of the jaw</li><li>➤ earlobe</li><li>➤ This nerve's sensory distribution includes the lower part of the face around the angle of the jaw , which is a common area for shaving.</li><li>➤ This nerve's sensory distribution includes the lower part of the face around the angle of the jaw , which is a common area for shaving.</li><li>➤ sensory distribution</li><li>➤ lower part of the face</li><li>➤ angle of the jaw</li><li>➤ Damage to this nerve during parotidectomy could lead to loss of sensation in this area , aligning with the patient's complaint.</li><li>➤ Damage to this nerve during parotidectomy could lead to loss of sensation in this area , aligning with the patient's complaint.</li><li>➤ Damage</li><li>➤ during parotidectomy</li><li>➤ loss of sensation in this area</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 88</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 88</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Following thyroid surgery patient presented with hoarseness of voice, the nerve injured is:", "options": [{"label": "A", "text": "External Laryngeal nerve", "correct": false}, {"label": "B", "text": "Internal Laryngeal nerve", "correct": false}, {"label": "C", "text": "Superior Laryngeal nerve", "correct": false}, {"label": "D", "text": "Recurrent Laryngeal Nerve", "correct": true}], "correct_answer": "D. Recurrent Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture30.jpg"], "explanation": "<p><strong>Ans. D) Recurrent Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The External Laryngeal Nerve is a branch of the Superior Laryngeal Nerve . It primarily innervates the cricothyroid muscle , which helps in the tension and lengthening of the vocal cords . Injury to this nerve may affect the quality of voice by altering the pitch , but it is less likely to cause hoarseness or significant voice changes compared to damage to the Recurrent Laryngeal Nerve.</li><li>• Option A</li><li>• branch</li><li>• Superior Laryngeal Nerve</li><li>• innervates</li><li>• cricothyroid muscle</li><li>• tension</li><li>• lengthening</li><li>• vocal cords</li><li>• Injury</li><li>• quality of voice</li><li>• altering the pitch</li><li>• less likely</li><li>• cause hoarseness</li><li>• voice changes</li><li>• Option B. This is also a branch of the Superior Laryngeal Nerve . The Internal Laryngeal Nerve provides sensory innervation to the mucosa above the vocal cords . An injury to this nerve might lead to sensory deficits but would not typically cause hoarseness, as it does not innervate vocal cord muscles.</li><li>• Option B.</li><li>• branch</li><li>• Superior Laryngeal Nerve</li><li>• sensory</li><li>• innervation</li><li>• mucosa</li><li>• above the vocal cords</li><li>• injury</li><li>• sensory deficits</li><li>• Option C. The Superior Laryngeal Nerve, a branch of the Vagus Nerve (CN X), divides into the internal and external laryngeal nerves . While the external branch is involved in voice modulation , its injury typically does not cause hoarseness to the extent seen with Recurrent Laryngeal Nerve damage.</li><li>• Option C.</li><li>• branch</li><li>• Vagus Nerve (CN X),</li><li>• internal</li><li>• external laryngeal nerves</li><li>• external branch</li><li>• voice modulation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Recurrent Laryngeal Nerve, a branch of the Vagus Nerve (CN X), innervates all the intrinsic muscles of the larynx except the cricothyroid muscle . It is crucial for controlling the vocal cords . Injury to this nerve can lead to paralysis or paresis of the vocal cords on the affected side, causing hoarseness or even aphonia (loss of voice). This is a well-known risk in thyroid surgery , particularly because of the nerve's proximity to the thyroid gland.</li><li>➤ The Recurrent Laryngeal Nerve, a branch of the Vagus Nerve (CN X), innervates all the intrinsic muscles of the larynx except the cricothyroid muscle . It is crucial for controlling the vocal cords .</li><li>➤ The Recurrent Laryngeal Nerve, a branch of the Vagus Nerve (CN X), innervates all the intrinsic muscles of the larynx except the cricothyroid muscle . It is crucial for controlling the vocal cords .</li><li>➤ branch</li><li>➤ Vagus Nerve (CN X),</li><li>➤ intrinsic muscles</li><li>➤ larynx</li><li>➤ except</li><li>➤ cricothyroid muscle</li><li>➤ controlling</li><li>➤ vocal cords</li><li>➤ Injury to this nerve can lead to paralysis or paresis of the vocal cords on the affected side, causing hoarseness or even aphonia (loss of voice). This is a well-known risk in thyroid surgery , particularly because of the nerve's proximity to the thyroid gland.</li><li>➤ Injury to this nerve can lead to paralysis or paresis of the vocal cords on the affected side, causing hoarseness or even aphonia (loss of voice). This is a well-known risk in thyroid surgery , particularly because of the nerve's proximity to the thyroid gland.</li><li>➤ Injury</li><li>➤ paralysis or paresis</li><li>➤ vocal cords</li><li>➤ hoarseness or even aphonia</li><li>➤ risk</li><li>➤ thyroid surgery</li><li>➤ nerve's proximity</li><li>➤ thyroid gland.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45 -year-old male teacher working in a high school visited his family physician complaining of a swelling on the front of the neck and breathlessness. On examination, a small, solitary swelling of firm consistency was found to the right of the midline of the neck below the thyroid cartilage of the larynx. The swelling was not attached to the skin but moved upward on swallowing. he had slight tremors on outstretched hands, pulse rate was 96/min and there was slight bulging of eyes. Blood levels of T3 and T4 were high and TSH level was low. Which of the following statement is not true about the condition?", "options": [{"label": "A", "text": "The above case is diagnosed as Thyrotoxicosis", "correct": false}, {"label": "B", "text": "The pretracheal layer of deep Cervical Fascia binds the thyroid gland to the Larynx, which moves upward on swallowing.", "correct": false}, {"label": "C", "text": "The swelling was located deep to the right Sternothyroid muscle.", "correct": false}, {"label": "D", "text": "The Venous Plexus lies between true and false capsule", "correct": true}], "correct_answer": "D. The Venous Plexus lies between true and false capsule", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture33.jpg"], "explanation": "<p><strong>Ans. D) The venous plexus lies between true and false capsule</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The symptoms described, including a swelling in the neck , breathlessness , slight tremors , increased pulse rate , and bulging eyes , along with high levels of T3 and T4 and low TSH , are characteristic of thyrotoxicosis . This is a correct statement.</li><li>• Option A.</li><li>• swelling in the neck</li><li>• breathlessness</li><li>• slight tremors</li><li>• increased pulse rate</li><li>• bulging eyes</li><li>• high levels of T3 and T4</li><li>• low TSH</li><li>• thyrotoxicosis</li><li>• correct</li><li>• Option B. The thyroid gland is indeed bound to the trachea and larynx by the pretracheal fascia , which is why it moves upward during swallowing . This statement is accurate and pertains to the normal anatomical relationship of the thyroid gland.</li><li>• Option B.</li><li>• thyroid gland</li><li>• bound</li><li>• trachea</li><li>• larynx</li><li>• pretracheal fascia</li><li>• upward during swallowing</li><li>• accurate</li><li>• normal anatomical relationship</li><li>• Option C. The thyroid gland is located deep to the sternothyroid muscle . Given that the swelling described is consistent with an enlarged thyroid gland , this statement is likely true.</li><li>• Option C.</li><li>• located</li><li>• deep</li><li>• sternothyroid muscle</li><li>• swelling</li><li>• enlarged thyroid gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The thyroid gland is typically encapsulated by a true capsule and is surrounded by a false capsule formed by the pretracheal layer of the deep cervical fascia . However, the venous plexus of the thyroid gland , known as the thyroid venous plexus , does not lie between these two capsules . Instead, it lies on the surface of the gland , within the layers of the pretracheal fascia . Thus, this statement is not accurate regarding the anatomical position of the venous plexus.</li><li>➤ The thyroid gland is typically encapsulated by a true capsule and is surrounded by a false capsule formed by the pretracheal layer of the deep cervical fascia .</li><li>➤ typically encapsulated</li><li>➤ true capsule</li><li>➤ surrounded</li><li>➤ false capsule</li><li>➤ pretracheal layer</li><li>➤ deep cervical fascia</li><li>➤ However, the venous plexus of the thyroid gland , known as the thyroid venous plexus , does not lie between these two capsules .</li><li>➤ venous plexus</li><li>➤ thyroid gland</li><li>➤ thyroid venous plexus</li><li>➤ not lie</li><li>➤ two capsules</li><li>➤ Instead, it lies on the surface of the gland , within the layers of the pretracheal fascia . Thus, this statement is not accurate regarding the anatomical position of the venous plexus.</li><li>➤ lies on the surface</li><li>➤ gland</li><li>➤ layers</li><li>➤ pretracheal fascia</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 470</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 470</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A student, after a heavy lunch from the hostel got ready for his afternoon class. He sat on the first bench and began to take notes. After a while he yawned widely. To his surprise sadly he could not close his mouth. The jaw was stuck. Which of the following statements is not true in the above scenario?", "options": [{"label": "A", "text": "This is a case of Anterior dislocation of Temporomandibular joint", "correct": false}, {"label": "B", "text": "Temporomandibular joint is a Bicondylar type of Synovial joint", "correct": false}, {"label": "C", "text": "Contraction of Medial Pterygoid depresses the Mandible", "correct": true}, {"label": "D", "text": "Sphenomandibular ligament is situated medial to Temporomandibular joint", "correct": false}], "correct_answer": "C. Contraction of Medial Pterygoid depresses the Mandible", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture27.jpg"], "explanation": "<p><strong>Ans. C) Contraction of medial pterygoid depresses the mandible</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. An anterior dislocation of the temporomandibular joint (TMJ) can occur when the mouth is opened widely , as in yawning , and the condyle of the mandible moves too far anteriorly and gets stuck in front of the articular eminence . This would prevent the mouth from closing .</li><li>• Option A.</li><li>• mouth is opened widely</li><li>• yawning</li><li>• condyle of the mandible</li><li>• far anteriorly</li><li>• stuck</li><li>• front</li><li>• articular eminence</li><li>• mouth from closing</li><li>• Option B. The TMJ is indeed a bicondylar joint, meaning it involves two condyles (the condylar process of the mandible and the mandibular fossa of the temporal bone ). It is a synovial joint , allowing for the movement of the mandible .</li><li>• Option B.</li><li>• involves two condyles</li><li>• condylar process</li><li>• mandible</li><li>• mandibular fossa</li><li>• temporal bone</li><li>• synovial joint</li><li>• movement</li><li>• mandible</li><li>• Option D. The sphenomandibular ligament runs medially to the TMJ and is a supporting structure of the joint.</li><li>• Option D.</li><li>• medially</li><li>• TMJ</li><li>• supporting structure</li><li>• joint.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The medial pterygoid muscle , along with the lateral pterygoid , masseter , and temporalis muscles , are the muscles of mastication . The medial pterygoid muscle actually elevates the mandible , not depresses it. The muscles that depress the mandible include the lateral pterygoid and the suprahyoid muscles .</li><li>➤ The medial pterygoid muscle , along with the lateral pterygoid , masseter , and temporalis muscles , are the muscles of mastication . The medial pterygoid muscle actually elevates the mandible , not depresses it. The muscles that depress the mandible include the lateral pterygoid and the suprahyoid muscles .</li><li>➤ medial pterygoid muscle</li><li>➤ lateral pterygoid</li><li>➤ masseter</li><li>➤ temporalis muscles</li><li>➤ muscles of mastication</li><li>➤ elevates the mandible</li><li>➤ depress</li><li>➤ lateral pterygoid</li><li>➤ suprahyoid muscles</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 541</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 541</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A mother brought her 6-year-old son to the hospital with complaints of frequent episodes sore throat in the past one month. On examination of the oral cavity the palatine tonsils almost touched each other in the midline. Which of the following statement is correct?", "options": [{"label": "A", "text": "Crypta Magna is situated close to the lower pole of Tonsil", "correct": false}, {"label": "B", "text": "Middle Constrictor Muscle forms lateral relation for Tonsil", "correct": false}, {"label": "C", "text": "Paratonsillar Vein is located in the Peritonsillar space", "correct": true}, {"label": "D", "text": "The Hypoglossal Nerve is in danger of injury during Tonsillectomy", "correct": false}], "correct_answer": "C. Paratonsillar Vein is located in the Peritonsillar space", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture10.jpg"], "explanation": "<p><strong>Ans. C) Paratonsillar Vein is located in the Peritonsillar space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Crypta Magna is situated close to the lower pole of tonsil: Crypta Magna refers to a large tonsillar crypt, but it is not typically characterized as being specifically close to the lower pole of the tonsil. The tonsillar crypts are spread throughout the tonsils.</li><li>• Option A</li><li>• Crypta Magna is situated close to the lower pole of tonsil:</li><li>• Option B. The tonsil is actually situated in the tonsillar bed , which is bordered laterally by the superior constrictor muscle of the pharynx , not the middle constrictor muscle . The middle constrictor muscle is located inferiorly to the tonsil .</li><li>• Option B.</li><li>• situated</li><li>• tonsillar bed</li><li>• bordered laterally</li><li>• superior constrictor muscle</li><li>• pharynx</li><li>• middle constrictor muscle</li><li>• inferiorly</li><li>• tonsil</li><li>• Option D. The hypoglossal nerve (CN XII), which innervates the tongue muscles , is not typically at risk during a tonsillectomy . The nerve that is more at risk is the glossopharyngeal nerve ( CN IX ), which provides sensory innervation to the tonsils .</li><li>• Option D.</li><li>• innervates</li><li>• tongue muscles</li><li>• not</li><li>• risk</li><li>• tonsillectomy</li><li>• at risk</li><li>• glossopharyngeal nerve</li><li>• CN IX</li><li>• sensory innervation</li><li>• tonsils</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The paratonsillar vein is an important anatomical structure in the peritonsillar space and is of clinical significance , especially in conditions like peritonsillar abscess and during tonsillectomy , as it can be a source of bleeding .</li><li>➤ The paratonsillar vein is an important anatomical structure in the peritonsillar space and is of clinical significance , especially in conditions like peritonsillar abscess and during tonsillectomy , as it can be a source of bleeding .</li><li>➤ important anatomical structure</li><li>➤ peritonsillar space</li><li>➤ clinical significance</li><li>➤ peritonsillar abscess</li><li>➤ tonsillectomy</li><li>➤ bleeding</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 576</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st Edition Pg No 576</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The mother of a 10-month-old female child noticed that her daughter held her head in a tilted manner. She brought her to the pediatrician. On examination it was noticed that the head of the girl was tilted towards the right shoulder and her face was turned towards left and upwards. History revealed that the mother had a difficult labour and baby was delivered using forceps during which baby suffered soft tissue injury in the neck. Which of the following statements is not correct?", "options": [{"label": "A", "text": "Right Sternocleidomastoid is involved in the above case scenario", "correct": false}, {"label": "B", "text": "Sternocleidomastoid is supplied by Spinal Accessory Nerve", "correct": false}, {"label": "C", "text": "Internal Jugular Vein lies in the space between the two heads of Sternocleidomastoid", "correct": false}, {"label": "D", "text": "Midpoint of Anterior border of Sternocleidomastoid is called Nervepoint of the neck", "correct": true}], "correct_answer": "D. Midpoint of Anterior border of Sternocleidomastoid is called Nervepoint of the neck", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture14.jpg"], "explanation": "<p><strong>Ans. D) Midpoint of anterior border of sternocleidomastoid is called nervepoint of the neck</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The described head position (tilt towards the right shoulder and face turned to the left and upwards) suggests involvement of the right sternocleidomastoid muscle . This muscle's contraction would tilt the head towards the affected side (right) and rotate it to the opposite side (left).</li><li>• Option A.</li><li>• involvement</li><li>• right sternocleidomastoid muscle</li><li>• muscle's contraction</li><li>• tilt</li><li>• head towards</li><li>• affected side</li><li>• rotate</li><li>• opposite side (left).</li><li>• Option B. The sternocleidomastoid muscle is innervated by the spinal accessory nerve ( cranial nerve XI ).</li><li>• Option B.</li><li>• innervated</li><li>• spinal accessory nerve</li><li>• cranial nerve XI</li><li>• Option C. The internal jugular vein lies deep to the confluence of two heads of sternocleidomastoid muscle . Sternocleidomastoid muscle overlaps the Internal jugular vein superficially . The posterior belly of digastric and superior belly of omohyoid also cross over the Internal jugular vein.</li><li>• Option C.</li><li>• internal jugular vein</li><li>• deep</li><li>• two heads</li><li>• sternocleidomastoid muscle</li><li>• overlaps</li><li>• Internal jugular vein</li><li>• superficially</li><li>• posterior belly</li><li>• digastric</li><li>• superior belly</li><li>• omohyoid</li><li>• Internal jugular vein.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The \" nerve point of the neck ,\" also known as Erb's point , is not located at the midpoint of the anterior border of the sternocleidomastoid . It is typically located at the posterior border of the sternocleidomastoid, around the midpoint of its length. This point is significant because several important nerves ( including the spinal accessory nerve , branches of the cervical plexus , and the supraclavicular nerves ) are located superficially here.</li><li>➤ The \" nerve point of the neck ,\" also known as Erb's point , is not located at the midpoint of the anterior border of the sternocleidomastoid .</li><li>➤ nerve point of the neck</li><li>➤ Erb's point</li><li>➤ not located</li><li>➤ midpoint</li><li>➤ anterior border</li><li>➤ sternocleidomastoid</li><li>➤ It is typically located at the posterior border of the sternocleidomastoid, around the midpoint of its length.</li><li>➤ posterior border</li><li>➤ midpoint</li><li>➤ This point is significant because several important nerves ( including the spinal accessory nerve , branches of the cervical plexus , and the supraclavicular nerves ) are located superficially here.</li><li>➤ including</li><li>➤ spinal accessory nerve</li><li>➤ branches</li><li>➤ cervical plexus</li><li>➤ supraclavicular nerves</li><li>➤ superficially</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 449</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st Edition Pg No 449</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male underwent total thyroidectomy. Four days after the surgery the patient complained of altered sensation around the mouth followed by tingling and numbness in fingers and toes and painful cramps on hands and feet. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Hypocalcemia is a feature of Tetany", "correct": false}, {"label": "B", "text": "The Superior Parathyroid gland lies ventral to recurrent Laryngeal Nerve", "correct": true}, {"label": "C", "text": "The patient’s Parathyroid glands were inadvertently removed during total Thyroidectomy", "correct": false}, {"label": "D", "text": "The position of Inferior Parathyroid gland is variable", "correct": false}], "correct_answer": "B. The Superior Parathyroid gland lies ventral to recurrent Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture28.jpg"], "explanation": "<p><strong>Ans. B) The Superior Parathyroid Gland lies ventral to recurrent Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tetany, which is characterized by symptoms like tingling, numbness, and muscle cramps , is often a result of hypocalcemia . This condition can occur after total thyroidectomy due to inadvertent removal or damage to the parathyroid glands , which regulate calcium levels in the body .</li><li>• Option A.</li><li>• characterized</li><li>• tingling, numbness,</li><li>• muscle cramps</li><li>• hypocalcemia</li><li>• total thyroidectomy</li><li>• inadvertent removal</li><li>• parathyroid glands</li><li>• regulate calcium levels</li><li>• body</li><li>• Option C. During total thyroidectomy, there is a risk of inadvertently removing or damaging the parathyroid glands , leading to hypocalcemia and subsequent tetany .</li><li>• Option C.</li><li>• total thyroidectomy,</li><li>• inadvertently</li><li>• removing</li><li>• parathyroid glands</li><li>• hypocalcemia</li><li>• subsequent tetany</li><li>• Option D. The position of the inferior parathyroid glands is known to be more variable than the superior glands , which can pose a challenge during thyroid surgery .</li><li>• Option D.</li><li>• position</li><li>• inferior parathyroid glands</li><li>• variable</li><li>• superior glands</li><li>• challenge</li><li>• thyroid surgery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior parathyroid glands are typically located dorsal (posterior) to the recurrent laryngeal nerve , not ventral (anterior). This anatomical relationship is important during thyroid surgery to avoid damage to the parathyroid glands.</li><li>➤ The superior parathyroid glands are typically located dorsal (posterior) to the recurrent laryngeal nerve , not ventral (anterior). This anatomical relationship is important during thyroid surgery to avoid damage to the parathyroid glands.</li><li>➤ superior parathyroid glands</li><li>➤ dorsal (posterior)</li><li>➤ recurrent laryngeal nerve</li><li>➤ important</li><li>➤ thyroid surgery</li><li>➤ damage</li><li>➤ parathyroid glands.</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg no 471</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg no 471</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male visited ENT OPD with complaints of recurrent sinusitis, weight loss and severe pain in upper teeth and left cheek. On examination it was noted that his left cheek was swollen and there was proptosis of left eye. CT scan confirmed presence of growth inside the left maxillary sinus. Which of the following statements is correct?", "options": [{"label": "A", "text": "Accumulation of pus in the maxillary sinus is drained through the middle meatus of nasal cavity", "correct": true}, {"label": "B", "text": "The infraorbital nerve travels in the roof of maxillary sinus", "correct": false}, {"label": "C", "text": "Growth in the maxillary sinus spreads anteriorly, medially, posteriorly and upwards", "correct": false}, {"label": "D", "text": "Maxillary sinus is described as reservoir of frontal sinus", "correct": false}], "correct_answer": "A. Accumulation of pus in the maxillary sinus is drained through the middle meatus of nasal cavity", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture32.jpg"], "explanation": "<p><strong>Ans. A) Accumulation of pus in the maxillary sinus is drained through the middle meatus of nasal cavity</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The infraorbital nerve , a branch of the maxillary division of the trigeminal nerve ( CN V2 ), travels in the floor of the orbit , not in the roof of the maxillary sinus. It runs in the infraorbital groove, canal, and eventually exits via the infraorbital foramen .</li><li>• Option B.</li><li>• infraorbital nerve</li><li>• maxillary division</li><li>• trigeminal nerve</li><li>• CN V2</li><li>• floor</li><li>• orbit</li><li>• infraorbital groove,</li><li>• exits</li><li>• infraorbital foramen</li><li>• Option C. A tumor or growth in the maxillary sinus can potentially spread in various directions , including anteriorly towards the face , medially towards the nasal cavity, posteriorly towards the pterygopalatine fossa , and upwards into the orbit , as evidenced by the patient's proptosis .</li><li>• Option C.</li><li>• tumor</li><li>• maxillary sinus</li><li>• spread</li><li>• directions</li><li>• anteriorly</li><li>• face</li><li>• medially</li><li>• nasal cavity,</li><li>• posteriorly</li><li>• pterygopalatine fossa</li><li>• upwards</li><li>• orbit</li><li>• proptosis</li><li>• Option D. The maxillary sinus is not typically described as a \"reservoir\" of the frontal sinus . Each paranasal sinus , including the maxillary and frontal sinuses , has its own distinct drainage pathway and function. The frontal sinus drains independently into the nasal cavity via the frontonasal duct , which opens into the middle meatus but is not directly connected to the maxillary sinus .</li><li>• Option D.</li><li>• not</li><li>• \"reservoir\"</li><li>• frontal sinus</li><li>• paranasal sinus</li><li>• maxillary</li><li>• frontal sinuses</li><li>• distinct drainage</li><li>• frontal sinus</li><li>• nasal cavity</li><li>• frontonasal duct</li><li>• middle meatus</li><li>• maxillary sinus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The maxillary sinus drains into the nasal cavity via the maxillary ostium , which opens into the semilunar hiatus located in the middle meatus of the nasal cavity.</li><li>➤ The maxillary sinus drains into the nasal cavity via the maxillary ostium , which opens into the semilunar hiatus located in the middle meatus of the nasal cavity.</li><li>➤ maxillary sinus</li><li>➤ nasal cavity</li><li>➤ maxillary ostium</li><li>➤ semilunar hiatus</li><li>➤ middle meatus</li><li>➤ nasal cavity.</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 568</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 568</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old male visited the surgery OPD with complaints of fever, burning sensation on forehead and around left eye vesicles over his upper face, he also said that these lesions are painful. On examination it was found that these painful vesicles were distributed along the ophthalmic division of the trigeminal nerve. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "This condition is diagnosed as Herpes Zoster Ophthalmicus", "correct": false}, {"label": "B", "text": "The Ophthalmic nerve is the largest division of the Trigeminal Nerve", "correct": true}, {"label": "C", "text": "The Ophthalmic nerve divides into Lacrimal, Frontal and Nasociliary Nerve", "correct": false}, {"label": "D", "text": "The Trigeminal Ganglion is located in the Middle Cranial Fossa", "correct": false}], "correct_answer": "B. The Ophthalmic nerve is the largest division of the Trigeminal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture2_UKptdfF.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture3_sSGwk48.jpg"], "explanation": "<p><strong>Ans. B) The Ophthalmic nerve is the largest division of the Trigeminal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Herpes Zoster Ophthalmicus is characterized by painful vesicular eruptions on the face , particularly in the distribution of the ophthalmic division of the trigeminal nerve , as described in the patient's symptoms.</li><li>• Option A.</li><li>• characterized</li><li>• painful vesicular eruptions</li><li>• face</li><li>• distribution</li><li>• ophthalmic division</li><li>• trigeminal nerve</li><li>• Option C. The ophthalmic division of the trigeminal nerve branches into the lacrimal , frontal , and nasociliary nerves , which provide sensory innervation to different parts of the upper face and scalp .</li><li>• Option C.</li><li>• branches</li><li>• lacrimal</li><li>• frontal</li><li>• nasociliary nerves</li><li>• provide sensory innervation</li><li>• upper face</li><li>• scalp</li><li>• Option D. The trigeminal ganglion, which is the sensory ganglion of the trigeminal nerve, is indeed located in the middle cranial fossa of the skull .</li><li>• Option D.</li><li>• sensory ganglion</li><li>• located</li><li>• middle cranial fossa</li><li>• skull</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The largest division of the trigeminal nerve (CN V) is actually the mandibular division ( V3 ). The ophthalmic division ( V1 ) is the smallest of the three divisions of the trigeminal nerve.</li><li>➤ The largest division of the trigeminal nerve (CN V) is actually the mandibular division ( V3 ). The ophthalmic division ( V1 ) is the smallest of the three divisions of the trigeminal nerve.</li><li>➤ The largest division of the trigeminal nerve (CN V) is actually the mandibular division ( V3 ). The ophthalmic division ( V1 ) is the smallest of the three divisions of the trigeminal nerve.</li><li>➤ largest division</li><li>➤ trigeminal nerve (CN V)</li><li>➤ mandibular division</li><li>➤ V3</li><li>➤ ophthalmic division</li><li>➤ V1</li><li>➤ smallest</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 501</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 501</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old female complained of pain, tingling, numbness along the medial side of right forearm and hand. She was unable to hold a pen and write. On examination the radial pulse was weaker on the right side compared to the left. Adson’s test was positive on the right side. X-ray showed the following. Which of the following statements is incorrect about this x-ray?", "options": [{"label": "A", "text": "Cervical Rib is the enlarged Costal element of 7 th Cervical Vertebra", "correct": false}, {"label": "B", "text": "It can compress the first part of Subclavian Artery", "correct": false}, {"label": "C", "text": "It can compress the upper trunk of Brachial Plexus", "correct": true}, {"label": "D", "text": "Cervical rib is surgically removed with its Periosteum", "correct": false}], "correct_answer": "C. It can compress the upper trunk of Brachial Plexus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/11/100.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture1.jpg"], "explanation": "<p><strong>Ans. C) It can compress the upper trunk of Brachial Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A cervical rib is the enlarged costal element of transverse process of the 7th cervical vertebrae .</li><li>• Option A.</li><li>• cervical rib</li><li>• enlarged costal element</li><li>• transverse process</li><li>• 7th cervical vertebrae</li><li>• Option B. A cervical rib can compress the subclavian artery , especially the first part , leading to vascular symptoms . This could explain the weaker radial pulse on the right side in this patient.</li><li>• Option B.</li><li>• compress</li><li>• subclavian artery</li><li>• first part</li><li>• vascular symptoms</li><li>• weaker radial pulse</li><li>• right side</li><li>• Option D. As during the surgical removal of cervical rib , periosteum should be removed to avoid the regeneration of the cervical rib</li><li>• Option D.</li><li>• surgical removal</li><li>• cervical rib</li><li>• periosteum</li><li>• removed</li><li>• regeneration</li><li>• cervical rib</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ A cervical rib can compress the lower trunk of the brachial plexus ( C8 and T1 nerve roots ), leading to neurological symptoms such as pain , tingling , and numbness in the ulnar distribution , which aligns with the patient's symptoms . However, the x-ray might not directly show this compression</li><li>➤ A cervical rib can compress the lower trunk of the brachial plexus ( C8 and T1 nerve roots ), leading to neurological symptoms such as pain , tingling , and numbness in the ulnar distribution , which aligns with the patient's symptoms . However, the x-ray might not directly show this compression</li><li>➤ cervical rib</li><li>➤ compress</li><li>➤ lower trunk</li><li>➤ brachial plexus</li><li>➤ C8</li><li>➤ T1 nerve</li><li>➤ roots</li><li>➤ neurological symptoms</li><li>➤ pain</li><li>➤ tingling</li><li>➤ numbness</li><li>➤ ulnar distribution</li><li>➤ aligns</li><li>➤ patient's symptoms</li><li>➤ x-ray</li><li>➤ compression</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No:455</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No:455</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44-year-old female presented to the surgery OPD with complaints of swelling below the lower jaw on the left side. She said that the size of the swelling increased during eating. The surgeon inspected the sublingual papilla in the floor of the mouth and did a bidigital examination by putting index finger inside the oral cavity and the thumb outside in front of the angle of mandible. Which of the following statements is correct?", "options": [{"label": "A", "text": "The Submandibular gland is palpated by bidigital examination", "correct": true}, {"label": "B", "text": "The Superficial and deep part of Submandibular gland are continuous with each other around the Anterior border of Mylohyoid muscle", "correct": false}, {"label": "C", "text": "The Submandibular lymph nodes are related to the Lateral surface of the gland", "correct": false}, {"label": "D", "text": "The distal part of submandibular duct runs between the Sublingual Hyoglossus and Genioglossus and finally opens into the floor of the mouth", "correct": false}], "correct_answer": "A. The Submandibular gland is palpated by bidigital examination", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture16.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture17.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture18.jpg"], "explanation": "<p><strong>Ans. A) The Submandibular gland is palpated by bidigital examination</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The submandibular gland has two parts , superficial and deep, which wrap around the posterior border of the mylohyoid muscle , not the anterior border . The mylohyoid muscle acts as a dividing plane between these two parts.</li><li>• Option B.</li><li>• submandibular gland</li><li>• two parts</li><li>• superficial</li><li>• deep,</li><li>• posterior border</li><li>• mylohyoid muscle</li><li>• anterior border</li><li>• mylohyoid muscle</li><li>• dividing plane</li><li>• Option C. The submandibular lymph nodes are indeed situated along the superficial surface of the submandibular gland. They are typically involved in the lymphatic drainage of the oral cavity and can be palpable in various pathological conditions .</li><li>• Option C.</li><li>• superficial surface</li><li>• submandibular gland.</li><li>• lymphatic drainage</li><li>• oral cavity</li><li>• palpable</li><li>• pathological conditions</li><li>• Option D. The submandibular duct ( Wharton's duct ) runs forward between the sublingual gland and the lingual nerve , then passes between the hyoglossus and mylohyoid muscles , and finally opens at the sublingual caruncle in the floor of the mouth. It does not run between the sublingual hyoglossus and genioglossus muscles as described.</li><li>• Option D.</li><li>• Wharton's duct</li><li>• forward</li><li>• sublingual gland</li><li>• lingual nerve</li><li>• hyoglossus</li><li>• mylohyoid muscles</li><li>• sublingual caruncle</li><li>• floor</li><li>• mouth.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The submandibular gland can be palpated using a bidigital examination technique , where one finger is placed inside the oral cavity (often on the floor of the mouth ) and the other finger is placed externally under the jaw. This technique is commonly used to assess the size, texture , and any abnormalities of the submandibular gland .</li><li>➤ The submandibular gland can be palpated using a bidigital examination technique , where one finger is placed inside the oral cavity (often on the floor of the mouth ) and the other finger is placed externally under the jaw.</li><li>➤ palpated</li><li>➤ bidigital examination technique</li><li>➤ one finger</li><li>➤ floor of the mouth</li><li>➤ finger</li><li>➤ externally</li><li>➤ under</li><li>➤ jaw.</li><li>➤ This technique is commonly used to assess the size, texture , and any abnormalities of the submandibular gland .</li><li>➤ assess</li><li>➤ size,</li><li>➤ texture</li><li>➤ abnormalities</li><li>➤ submandibular gland</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No 469</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No 469</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man who had undergone left-sided pneumonectomy for carcinoma of the bronchus was seen by his thoracic surgeon as a follow-up after the operation. The patient said that he noticed a week ago his left upper eyelid tended to droop slightly when he was tired at the end of the day. On examination it was noted that in addition to the drooping of the left eye, the patient's left pupil was constricted and that his face was slightly flushed on the left side. Further examination revealed that the skin on the left side of the face appeared to be warmer and drier than normal. Palpation of the deep cervical lymph nodes revealed a large hard fixed node just above the left clavicle. Ptosis seen in this case is due to injury:", "options": [{"label": "A", "text": "Oculomotor Nerve", "correct": false}, {"label": "B", "text": "Facial Nerve", "correct": false}, {"label": "C", "text": "Parasympathetic Fibres", "correct": false}, {"label": "D", "text": "Sympathetic Fibres", "correct": true}], "correct_answer": "D. Sympathetic Fibres", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Sympathetic Fibres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Though oculomotor nerve injury can cause paralysis of levator palpebrae superioris and cause ptosis , in this patient presenting with Horner’s syndrome this is not the cause for ptosis .</li><li>• Option A.</li><li>• oculomotor nerve injury</li><li>• paralysis</li><li>• levator palpebrae superioris</li><li>• ptosis</li><li>• Horner’s syndrome</li><li>• not the cause</li><li>• ptosis</li><li>• Option B. Facial nerve innervates orbicularis oculi , the contraction of which cause closure of eyes and its injury is not related to ptosis</li><li>• Option B.</li><li>• innervates orbicularis oculi</li><li>• contraction</li><li>• cause closure of eyes</li><li>• injury</li><li>• not related to ptosis</li><li>• Option C. Parasympathetic fiber involvement could potentially lead to pupil constriction. However, it wouldn't explain the ptosis, facial flushing, and anhidrosis observed in this case. Parasympathetic fibers also don't typically cause Horner's syndrome.</li><li>• Option C.</li><li>• pupil constriction.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Injury to the sympathetic fibers , particularly those in the cervical sympathetic chain , can lead to Horner's syndrome , which is characterized by ptosis , miosis , facial flushing , and anhidrosis on the affected side. This condition can occur as a complication of thoracic surgeries , like pneumonectomy , particularly when the surgery involves structures near the sympathetic chain in the neck and upper chest .</li><li>➤ Injury to the sympathetic fibers , particularly those in the cervical sympathetic chain , can lead to Horner's syndrome , which is characterized by ptosis , miosis , facial flushing , and anhidrosis on the affected side.</li><li>➤ Injury</li><li>➤ sympathetic fibers</li><li>➤ cervical sympathetic chain</li><li>➤ Horner's syndrome</li><li>➤ characterized by ptosis</li><li>➤ miosis</li><li>➤ facial flushing</li><li>➤ anhidrosis</li><li>➤ This condition can occur as a complication of thoracic surgeries , like pneumonectomy , particularly when the surgery involves structures near the sympathetic chain in the neck and upper chest .</li><li>➤ complication</li><li>➤ thoracic surgeries</li><li>➤ pneumonectomy</li><li>➤ sympathetic chain</li><li>➤ neck</li><li>➤ upper chest</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 393,294</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 393,294</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 12-year-old boy presents to the otolaryngologist with complaints of an earache, fever and some degree of hearing loss for the past three days. He had similar episodes in the past. On examination of the patient with an otoscope, an inflamed tympanic membrane that was bulging and opacified was noted. Pneumatic otoscopy confirmed the presence of fluid in the middle ear. The patient is diagnosed with acute otitis media. It was decided to perform a myringotomy in this patient. Where will the incision be placed in the tympanic membraneduring this procedure?", "options": [{"label": "A", "text": "Anterosuperior part", "correct": false}, {"label": "B", "text": "Anteroinferior part", "correct": false}, {"label": "C", "text": "Posterosuperior portion", "correct": false}, {"label": "D", "text": "Posterioinferior portion", "correct": true}], "correct_answer": "D. Posterioinferior portion", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture3.jpg"], "explanation": "<p><strong>Ans. D) Posterioinferior portion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterosuperior part: Myringotomy is a procedure where an incision is made in the tympanic membrane to let out the fluid collection. Deep to anterosuperior quadrant of tympanic membrane lies the tympanic opening of auditory tube . This area is typically not chosen for a myringotomy because it may not provide effective drainage of fluid from the middle ear .</li><li>• Option A.</li><li>• Myringotomy</li><li>• incision</li><li>• tympanic membrane</li><li>• let out the fluid collection.</li><li>• Deep</li><li>• anterosuperior quadrant</li><li>• tympanic membrane</li><li>• tympanic opening</li><li>• auditory tube</li><li>• not chosen</li><li>• myringotomy</li><li>• may not provide</li><li>• drainage of fluid</li><li>• middle ear</li><li>• Option B. Anteroinferior part: This area is also not commonly chosen for myringotomy as it may not allow for optimal drainage. Deep to anteroInferior portion of tympanic membrane lies the carotid canal</li><li>• Option B.</li><li>• not commonly chosen</li><li>• optimal drainage.</li><li>• Deep to anteroInferior portion</li><li>• tympanic membrane</li><li>• carotid canal</li><li>• Option C. Posterosuperior portion: This area is less commonly chosen for myringotomy because it may not provide the best access for drainage . Deep to posterosuperior quadrant of tympanic membrane lies the long process of incus , stapes , fenestra vestibuli</li><li>• Option C.</li><li>• not provide</li><li>• best access for drainage</li><li>• Deep to posterosuperior quadrant</li><li>• lies</li><li>• long process of incus</li><li>• stapes</li><li>• fenestra vestibuli</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterioinferior portion: This area is the most commonly chosen location for myringotomy. It allows for effective drainage of fluid or pus from the middle ear , relieving pressure and pain associated with conditions like acute otitis media.</li><li>➤ allows</li><li>➤ effective drainage</li><li>➤ fluid</li><li>➤ pus from the middle ear</li><li>➤ relieving pressure</li><li>➤ pain</li><li>➤ acute otitis media.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 273</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 273</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman whose impacted left lower wisdom tooth was surgically removed. The operation lasted about an hour, and the dental surgeon suspected that some nerves might have been bruised during the operation. The patient presented with loss of sensation in the gums of her lower jaw, and her mouth was slightly dry. On examination the taste sensation in the tongue was diminished in the anterior two-thirds but it was normal in the posterior portion. Which among the following nerves has been injured in this patient?", "options": [{"label": "A", "text": "Hypoglossal Nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "C", "text": "Lingual Nerve", "correct": true}, {"label": "D", "text": "Vagus Nerve", "correct": false}], "correct_answer": "C. Lingual Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture17.jpg"], "explanation": "<p><strong>Ans. C) Lingual Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The hypoglossal nerve primarily controls all the muscles of the tongue except palatoglossus . Injury to the hypoglossal nerve would typically result in tongue muscle weakness or paralysis , affecting tongue movement.</li><li>• Option A.</li><li>• controls</li><li>• muscles</li><li>• tongue</li><li>• except palatoglossus</li><li>• Injury</li><li>• tongue muscle weakness</li><li>• paralysis</li><li>• Option B. The glossopharyngeal nerve is responsible for various functions in the throat and mouth, including taste sensation from the posterior one-third of the tongue . Injury to the glossopharyngeal nerve could result in loss of taste sensation in the posterior portion of the tongue but would not directly affect the sensation in the gums.</li><li>• Option B.</li><li>• functions</li><li>• throat</li><li>• mouth,</li><li>• taste sensation</li><li>• posterior one-third</li><li>• tongue</li><li>• Injury</li><li>• loss of taste sensation</li><li>• posterior portion</li><li>• tongue</li><li>• not directly</li><li>• sensation</li><li>• gums.</li><li>• Option D. The vagus nerve has extensive functions related to the autonomic nervous system and controls various organs in the thoracic and abdominal cavities. It does not play a direct role in taste sensation or sensation in the gums and mouth .</li><li>• Option D.</li><li>• functions</li><li>• autonomic nervous system</li><li>• controls</li><li>• organs</li><li>• thoracic</li><li>• abdominal cavities.</li><li>• does not</li><li>• taste sensation</li><li>• sensation</li><li>• gums</li><li>• mouth</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lingual nerve is a branch of the mandibular division of the trigeminal nerve (V3) . It provides sensory innervation to the anterior two-thirds of the tongue and also plays a role in providing sensation to the lower gums and floor of the mouth . Injury to the lingual nerve during dental surgery can result in loss of sensation in the gums and tongue .</li><li>➤ The lingual nerve is a branch of the mandibular division of the trigeminal nerve (V3) . It provides sensory innervation to the anterior two-thirds of the tongue and also plays a role in providing sensation to the lower gums and floor of the mouth . Injury to the lingual nerve during dental surgery can result in loss of sensation in the gums and tongue .</li><li>➤ branch</li><li>➤ mandibular division</li><li>➤ trigeminal nerve (V3)</li><li>➤ sensory innervation</li><li>➤ anterior two-thirds</li><li>➤ tongue</li><li>➤ providing sensation</li><li>➤ lower gums</li><li>➤ floor of the mouth</li><li>➤ Injury</li><li>➤ loss of sensation</li><li>➤ gums</li><li>➤ tongue</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 390</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 390</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man complained of inability to shut his left eye, difficulty in chewing food inside his mouth and weakness on the same side of his mouth with slight numbness on the left cheek. All these symptoms manifested two weeks prior, following an excisional biopsy of a left facial lump that proved to be a benign parotid tumor. On examination there was an area of mild numbness on the left cheek. Examination of facial muscles revealed paralysis of facial muscles as a result of injury to facial nerve branches that must have happened during the biopsy. The patient was suggested intensive physiotherapy sessions and regular checkups to monitor the progress. Which among the following statements pertaining to the above case is false?", "options": [{"label": "A", "text": "Patient is not able to whistle due to paralysis of orbicularis oris", "correct": true}, {"label": "B", "text": "Facial nerve lies deep within the parotid gland", "correct": false}, {"label": "C", "text": "Buccinator prevents accumulation of food within vestibule of mouth", "correct": false}, {"label": "D", "text": "Orbicularis oculi is innervated by temporal &amp; zygomatic branch of facial nerve", "correct": false}], "correct_answer": "A. Patient is not able to whistle due to paralysis of orbicularis oris", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Patient is not able to whistle due to paralysis of orbicularis oris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The facial nerve passes through the parotid gland, and surgical procedures involving the parotid gland carry a risk of injury to the facial nerve branches . It lies superficial within the parotid gland , superficial to the retromandibular vein and external carotid artery .</li><li>• Option B.</li><li>• facial nerve passes</li><li>• parotid gland,</li><li>• surgical procedures</li><li>• parotid gland</li><li>• injury</li><li>• facial nerve branches</li><li>• superficial</li><li>• parotid gland</li><li>• superficial</li><li>• retromandibular vein</li><li>• external carotid artery</li><li>• Option C. The buccinator muscle is indeed involved in the movement of food during chewing and helps prevent the accumulation of food within the vestibule of the mouth . Contraction of buccinator flattens the cheek against the gums and prevents food accumulation within the vestibule</li><li>• Option C.</li><li>• buccinator muscle</li><li>• movement of food</li><li>• chewing</li><li>• helps prevent</li><li>• accumulation of food</li><li>• vestibule</li><li>• mouth</li><li>• Contraction</li><li>• flattens the cheek</li><li>• gums</li><li>• prevents food accumulation</li><li>• Option D. The orbicularis oculi muscle , which controls eyelid closure , is primarily innervated by the facial nerve , specifically the temporal and zygomatic branches .</li><li>• Option D.</li><li>• orbicularis oculi muscle</li><li>• eyelid closure</li><li>• innervated</li><li>• facial nerve</li><li>• temporal</li><li>• zygomatic branches</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In cases of facial palsy , paralysis of the buccinator muscle , commonly known as the \" whistling muscle ,\" occurs. This impairment primarily affects the ability to whistle , as opposed to the orbicularis oris muscle , which is not the primary muscle involved in this activity.</li><li>➤ In cases of facial palsy , paralysis of the buccinator muscle , commonly known as the \" whistling muscle ,\" occurs.</li><li>➤ facial palsy</li><li>➤ paralysis</li><li>➤ buccinator muscle</li><li>➤ whistling muscle</li><li>➤ This impairment primarily affects the ability to whistle , as opposed to the orbicularis oris muscle , which is not the primary muscle involved in this activity.</li><li>➤ impairment</li><li>➤ ability to whistle</li><li>➤ orbicularis oris muscle</li><li>➤ not</li><li>➤ primary muscle</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 389</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 389</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman had been hit on the side of the head by a bus while she tried to cross the highway. She was unconscious when admitted to the emergency department. Within an hour, she was found to have a large, dough-like swelling over the left temporal region. She also had signs of muscular paralysis on the right side of the body. A lateral radiograph of the skull showed a fracture line running downward and forward across the anterior—inferior angle of the left parietal bone. CT scan showed features suggestive of extradural haemorrhage. Craniotomy was planned. Which of the following statements is correct?", "options": [{"label": "A", "text": "Anteroinferior angle of parietal bone is called Asterion", "correct": false}, {"label": "B", "text": "The enlarging blood clot exerts local pressure on the underlying Paracentral lobule", "correct": false}, {"label": "C", "text": "CT scan showed a long crescentic hematoma underneath the Temporal &amp; Parietal bone", "correct": false}, {"label": "D", "text": "The burr hole through the Skull wall should be placed about 1.5 in (4 cm) above the midpoint of the Zygomatic Arch", "correct": true}], "correct_answer": "D. The burr hole through the Skull wall should be placed about 1.5 in (4 cm) above the midpoint of the Zygomatic Arch", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture11.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-102846.jpg"], "explanation": "<p><strong>Ans. D) The burr hole through the skull wall should be placed about 1.5 in (4 cm) above the midpoint of the zygomatic arch</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The asterion is the anatomical landmark located where the occipital bone, parietal bone , and mastoid portion of the temporal bone meet . It is not the anteroinferior angle of the parietal bone . The anteroinferior angle of the parietal bone is at the front and bottom edge of the parietal bone, not at the junction described for the asterion.</li><li>• Option A.</li><li>• located</li><li>• occipital bone, parietal bone</li><li>• mastoid portion</li><li>• temporal bone meet</li><li>• not</li><li>• anteroinferior angle</li><li>• parietal bone</li><li>• anteroinferior angle</li><li>• parietal bone</li><li>• front</li><li>• bottom edge</li><li>• parietal bone,</li><li>• Option B. While an enlarging hematoma can indeed exert pressure on underlying brain structures, the paracentral lobule is not typically affected in extradural hemorrhages associated with fractures of the temporal bone . Extradural hemorrhages often impact areas closer to the site of the fracture, such as the temporal lobe or underlying meningeal arteries , rather than the paracentral lobule , which is located more centrally on the medial surface of the brain.</li><li>• Option B.</li><li>• enlarging hematoma</li><li>• exert pressure</li><li>• underlying brain</li><li>• paracentral lobule</li><li>• not</li><li>• affected</li><li>• extradural hemorrhages</li><li>• fractures</li><li>• temporal bone</li><li>• Extradural hemorrhages</li><li>• impact</li><li>• temporal lobe</li><li>• underlying meningeal arteries</li><li>• rather than</li><li>• paracentral lobule</li><li>• centrally</li><li>• medial surface</li><li>• brain.</li><li>• Option C. Extradural hematomas are often crescent-shaped and can occur under the temporal and parietal bones , as they often result from arterial bleeding, typically from the middle meningeal artery , in the case of temporal bone fractures. However, without more information from the CT scan, it's challenging to confirm the full extent and exact location of the hematoma.</li><li>• Option C.</li><li>• Extradural hematomas</li><li>• crescent-shaped</li><li>• under</li><li>• temporal</li><li>• parietal bones</li><li>• arterial bleeding,</li><li>• middle meningeal artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This is a standard approach for a burr hole in cases of extradural hematoma, especially when the hematoma is located in the temporal region. The location described is typically used to access the temporal fossa , where extradural hematomas commonly accumulate. The placement allows for safe and effective drainage of the hematoma while avoiding damage to the underlying brain tissue.</li><li>➤ This is a standard approach for a burr hole in cases of extradural hematoma, especially when the hematoma is located in the temporal region.</li><li>➤ extradural hematoma,</li><li>➤ temporal region.</li><li>➤ The location described is typically used to access the temporal fossa , where extradural hematomas commonly accumulate.</li><li>➤ temporal fossa</li><li>➤ extradural hematomas</li><li>➤ The placement allows for safe and effective drainage of the hematoma while avoiding damage to the underlying brain tissue.</li><li>➤ effective drainage</li><li>➤ hematoma</li><li>➤ underlying brain tissue.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 14</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 14</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 33-year-old male presented to ENT OPD with infection of his external ear. During examination the doctor inserted a speculum into his external auditory canal close to the posterior wall. The patient suddenly fainted. Irritation of which of the following nerves could have caused the patient to faint?", "options": [{"label": "A", "text": "Vestibulocochlear Nerve", "correct": false}, {"label": "B", "text": "Vagus Nerve", "correct": true}, {"label": "C", "text": "Trigeminal Nerve", "correct": false}, {"label": "D", "text": "Glossopharyngeal Nerve", "correct": false}], "correct_answer": "B. Vagus Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture4.jpg"], "explanation": "<p><strong>Ans. B) Vagus Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The vestibulocochlear nerve is responsible for hearing and balance . Irritation of this nerve could potentially cause vertigo or hearing changes , but it is unlikely to cause syncope . It is concerned with hearing and equilibrium and not related to cutaneous sensation</li><li>• Option A.</li><li>• hearing</li><li>• balance</li><li>• Irritation</li><li>• vertigo</li><li>• hearing changes</li><li>• unlikely</li><li>• syncope</li><li>• concerned</li><li>• hearing</li><li>• equilibrium</li><li>• not</li><li>• cutaneous sensation</li><li>• Option C. The trigeminal nerve is primarily responsible for facial sensation and motor functions associated with mastication . While it does provide sensory innervation to parts of the ear , irritation of the trigeminal nerve is more likely to cause pain rather than fainting. The auriculotemporal branch from the mandibular division of trigeminal nerve supplies most of the external auditory canal except the posterior wall</li><li>• Option C.</li><li>• facial sensation</li><li>• motor functions</li><li>• mastication</li><li>• sensory innervation</li><li>• ear</li><li>• irritation</li><li>• trigeminal nerve</li><li>• cause pain</li><li>• auriculotemporal branch</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• external auditory canal</li><li>• posterior wall</li><li>• Option D. The glossopharyngeal nerve has various functions, including sensation in the throat and back of the tongue , as well as some ear structures. The glossopharyngeal nerve supplies the inner aspect of the tympanic membrane. However, its stimulation is less likely to cause fainting compared to the vagus nerve. The glossopharyngeal nerve is more commonly associated with the gag reflex and swallowing functions .Top of Form</li><li>• Option D.</li><li>• sensation</li><li>• throat</li><li>• back</li><li>• tongue</li><li>• supplies</li><li>• inner aspect</li><li>• tympanic membrane.</li><li>• associated</li><li>• gag reflex</li><li>• swallowing functions</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It innervates various structures in the head and neck , including parts of the ear . Stimulation of the vagus nerve, particularly in sensitive individuals, can lead to a vasovagal reflex . This reflex can cause a sudden decrease in heart rate and blood pressure , leading to fainting . The insertion of a speculum into the external auditory canal, especially if it is close to the posterior wall , could stimulate the auricular branch of the vagus nerve, triggering this response.</li><li>➤ It innervates various structures in the head and neck , including parts of the ear . Stimulation of the vagus nerve, particularly in sensitive individuals, can lead to a vasovagal reflex . This reflex can cause a sudden decrease in heart rate and blood pressure , leading to fainting . The insertion of a speculum into the external auditory canal, especially if it is close to the posterior wall , could stimulate the auricular branch of the vagus nerve, triggering this response.</li><li>➤ It innervates various structures in the head and neck , including parts of the ear . Stimulation of the vagus nerve, particularly in sensitive individuals, can lead to a vasovagal reflex . This reflex can cause a sudden decrease in heart rate and blood pressure , leading to fainting . The insertion of a speculum into the external auditory canal, especially if it is close to the posterior wall , could stimulate the auricular branch of the vagus nerve, triggering this response.</li><li>➤ innervates</li><li>➤ head and neck</li><li>➤ parts</li><li>➤ ear</li><li>➤ Stimulation</li><li>➤ vagus nerve,</li><li>➤ vasovagal reflex</li><li>➤ sudden decrease</li><li>➤ heart rate</li><li>➤ blood pressure</li><li>➤ fainting</li><li>➤ insertion</li><li>➤ speculum</li><li>➤ external auditory</li><li>➤ canal,</li><li>➤ posterior wall</li><li>➤ auricular branch</li><li>➤ vagus nerve,</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 411</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 411</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old male of moderate built, non-smoker leading a healthy lifestyle presented to OPD with complaints of double vision while walking down the stairs. He also had a similar problem while reading the newspaper. He had no other concerns. Which of the following would be responsible for the patient’ symptoms in this case?", "options": [{"label": "A", "text": "Oculomotor Nerve", "correct": false}, {"label": "B", "text": "Trochlear Nerve", "correct": true}, {"label": "C", "text": "Abducens Nerve", "correct": false}, {"label": "D", "text": "Optic Nerve", "correct": false}], "correct_answer": "B. Trochlear Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture19.jpg"], "explanation": "<p><strong>Ans. B) Trochlear Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The oculomotor nerve innervates most of the eye muscles , including the superior, inferior , and medial rectus muscles , and the inferior oblique muscle . It also controls the levator palpebrae muscle , which raises the eyelid . Since oculomotor nerve supplies all extraocular muscles except lateral rectus &amp; superior oblique , its lesion will produce vertical &amp; horizontal diplopia , ptosis , enlarged and non-reactive pupil</li><li>• Option A.</li><li>• innervates</li><li>• eye muscles</li><li>• superior, inferior</li><li>• medial rectus muscles</li><li>• inferior oblique muscle</li><li>• controls</li><li>• levator palpebrae muscle</li><li>• raises</li><li>• eyelid</li><li>• supplies</li><li>• extraocular muscles</li><li>• except</li><li>• lateral rectus</li><li>• superior oblique</li><li>• vertical</li><li>• horizontal diplopia</li><li>• ptosis</li><li>• enlarged</li><li>• non-reactive pupil</li><li>• Option C. The abducens nerve innervates the lateral rectus muscle , which abducts the eye . Dysfunction in this nerve typically causes horizontal double vision , where the images are side by side, and is most apparent when the patient tries to look towards the side of the affected nerve . Damage to abducens nerve will result in internal squint , as abducens nerve supplies lateral rectus.</li><li>• Option C.</li><li>• innervates</li><li>• lateral rectus muscle</li><li>• abducts</li><li>• eye</li><li>• Dysfunction</li><li>• horizontal double vision</li><li>• look towards</li><li>• side</li><li>• affected nerve</li><li>• Damage</li><li>• internal squint</li><li>• Option D. The optic nerve is responsible for transmitting visual information from the retina to the brain . While damage to the optic nerve can lead to visual disturbances , it does not typically cause double vision . Instead, it would more likely result in loss of visual acuity or visual field deficits .</li><li>• Option D.</li><li>• transmitting visual information</li><li>• retina</li><li>• brain</li><li>• damage</li><li>• optic nerve</li><li>• visual disturbances</li><li>• not</li><li>• double vision</li><li>• loss</li><li>• visual acuity</li><li>• visual field deficits</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The trochlear nerve innervates the superior oblique muscle of the eye. This muscle primarily helps in downward and inward movement of the eye. Dysfunction of the trochlear nerve can lead to difficulty with downward gaze , particularly when the eye is adducted, which aligns with the patient’s symptoms of double vision while reading or walking downstairs.</li><li>➤ The trochlear nerve innervates the superior oblique muscle of the eye. This muscle primarily helps in downward and inward movement of the eye.</li><li>➤ innervates</li><li>➤ superior oblique muscle</li><li>➤ eye.</li><li>➤ downward</li><li>➤ inward</li><li>➤ movement</li><li>➤ eye.</li><li>➤ Dysfunction of the trochlear nerve can lead to difficulty with downward gaze , particularly when the eye is adducted, which aligns with the patient’s symptoms of double vision while reading or walking downstairs.</li><li>➤ Dysfunction</li><li>➤ trochlear nerve</li><li>➤ difficulty</li><li>➤ downward gaze</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 376</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 376</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female presented to surgery OPD with complaints of a swollen neck. She had first noticed the swelling two months ago and it had been increasing in size since then. She also had complaints of breathlessness. On examination, a solitary swelling of firm consistency was found on the left side of the larynx and trachea. The small mass was not attached to the skin and there were no changes to the overlying skin. The swelling moved upward with swallowing. Further tests showed that the mass was a carcinoma of the thyroid gland. The mass was surgically removed. Post-operatively, the surgeon carefully ensured that the patient was speaking properly to test which of the following nerves?", "options": [{"label": "A", "text": "Internal Laryngeal Nerve", "correct": false}, {"label": "B", "text": "External Laryngeal Nerve", "correct": true}, {"label": "C", "text": "Both A &amp; B", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. External Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture21.jpg"], "explanation": "<p><strong>Ans. B) External Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The internal laryngeal nerve, a branch of the superior laryngeal nerve (itself a branch of the vagus nerve), provides sensory innervation to the mucosa above the vocal cords . While damage to this nerve can affect sensation in the larynx , it is not typically associated with changes in the voice . Thus, speaking would not be an effective test for injury to this nerve. Internal laryngeal nerve is entirely sensory , it pierces the thyrohyoid membrane and supplies the larynx above the level of vocal cords</li><li>• Option A.</li><li>• superior laryngeal nerve</li><li>• sensory innervation</li><li>• mucosa</li><li>• vocal cords</li><li>• damage</li><li>• affect</li><li>• sensation</li><li>• larynx</li><li>• changes</li><li>• voice</li><li>• Internal laryngeal nerve</li><li>• sensory</li><li>• pierces</li><li>• thyrohyoid membrane</li><li>• larynx</li><li>• vocal cords</li><li>• Option C. While both nerves are important, the internal laryngeal nerve is more involved in sensation rather than vocalization . Therefore, speaking tests are more specifically directed towards assessing the function of the external laryngeal nerve .</li><li>• Option C.</li><li>• internal laryngeal nerve</li><li>• involved</li><li>• sensation</li><li>• vocalization</li><li>• speaking tests</li><li>• assessing</li><li>• function</li><li>• external laryngeal nerve</li><li>• Option D. This option is incorrect because one of the above-mentioned nerves, specifically the external laryngeal nerve, is indeed tested by assessing speech post-operatively in thyroid surgery.</li><li>• Option D.</li><li>• external laryngeal nerve,</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ External laryngeal nerve, another branch of the superior laryngeal nerve , innervates the cricothyroid muscle . This muscle adjusts tension in the vocal cords , which is crucial for speech modulation , especially for high-pitched sounds. Injury to this nerve can lead to a hoarse voice or difficulty in voice modulation . Testing the patient's ability to speak, particularly in varying pitches , is a direct way to assess the integrity of the external laryngeal nerve.</li><li>➤ External laryngeal nerve, another branch of the superior laryngeal nerve , innervates the cricothyroid muscle . This muscle adjusts tension in the vocal cords , which is crucial for speech modulation , especially for high-pitched sounds.</li><li>➤ superior laryngeal nerve</li><li>➤ innervates</li><li>➤ cricothyroid muscle</li><li>➤ adjusts tension</li><li>➤ vocal cords</li><li>➤ speech modulation</li><li>➤ high-pitched sounds.</li><li>➤ Injury to this nerve can lead to a hoarse voice or difficulty in voice modulation . Testing the patient's ability to speak, particularly in varying pitches , is a direct way to assess the integrity of the external laryngeal nerve.</li><li>➤ Injury</li><li>➤ hoarse voice</li><li>➤ difficulty</li><li>➤ voice modulation</li><li>➤ ability</li><li>➤ speak,</li><li>➤ varying pitches</li><li>➤ integrity</li><li>➤ external laryngeal nerve.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertion (A)-Platysma banding is one of the signs of neck aging and a target of surgical neck rejuvenation. Reasoning (R)-Paralysis of the cervical branch leads to the flaccidity of the platysma muscle.", "options": [{"label": "A", "text": "A and R are both right and R is the correct explanation of A", "correct": false}, {"label": "B", "text": "A and R are both right but R is not the correct explanation of A", "correct": true}, {"label": "C", "text": "A is right but R is wrong", "correct": false}, {"label": "D", "text": "Both A &amp; B are wrong", "correct": false}], "correct_answer": "B. A and R are both right but R is not the correct explanation of A", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture5.jpg"], "explanation": "<p><strong>Ans. B) A and R are both right but R is not the correct explanation of A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Assertion : Platysma banding is one of the signs of neck aging and a target of surgical neck rejuvenation .</li><li>• Assertion</li><li>• Platysma banding is one of the signs of neck aging and a target of surgical neck rejuvenation</li><li>• This statement is correct . Platysma banding refers to the appearance of prominent vertical bands in the neck , often due to changes in the platysma muscle with age. As people age, the platysma muscle can become more lax and separated , leading to visible bands . This is a common aesthetic concern addressed in neck rejuvenation procedures.</li><li>• correct</li><li>• appearance</li><li>• prominent vertical bands</li><li>• neck</li><li>• changes</li><li>• platysma muscle</li><li>• platysma muscle</li><li>• more lax</li><li>• separated</li><li>• visible bands</li><li>• aesthetic</li><li>• neck rejuvenation</li><li>• Reasoning : Paralysis of the cervical branch leads to the flaccidity of the platysma muscle .</li><li>• Reasoning</li><li>• Paralysis of the cervical branch leads to the flaccidity of the platysma muscle</li><li>• This statement is also correct . The cervical branch of the facial nerve innervates the platysma muscle . Paralysis of this branch can lead to weakness or flaccidity of the platysma muscle . When the platysma muscle is flaccid, it does not contract normally, which can affect the appearance of the neck .</li><li>• correct</li><li>• cervical branch</li><li>• facial nerve innervates</li><li>• platysma muscle</li><li>• Paralysis</li><li>• weakness</li><li>• flaccidity</li><li>• platysma muscle</li><li>• flaccid,</li><li>• contract normally,</li><li>• appearance</li><li>• neck</li><li>• Now, let’s discuss the relationship between these two statements:</li><li>• Now, let’s discuss the relationship between these two statements:</li><li>• Option A. While both statements are correct, the reasoning is not the correct explanation for the assertion. Platysma banding as a sign of aging is not primarily due to paralysis of the cervical branch of the facial nerve but is more often related to changes in the muscle and skin due to aging, such as loss of elasticity and muscle tone .</li><li>• Option A.</li><li>• Platysma banding</li><li>• aging</li><li>• primarily</li><li>• paralysis</li><li>• cervical branch</li><li>• facial nerve</li><li>• changes</li><li>• muscle</li><li>• skin</li><li>• aging,</li><li>• loss of elasticity</li><li>• muscle tone</li><li>• Option C. This option is incorrect because both the assertion and the reasoning are correct statements.</li><li>• Option C.</li><li>• incorrect</li><li>• assertion</li><li>• reasoning</li><li>• correct</li><li>• Option D. This option is also incorrect as both A and B are correct in their own right.</li><li>• Option D.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Platysma is a subcutaneous muscle of the neck and is innervated by the cervical branch of the facial nerve . Due to aging , platysma bands can occur. Platysma banding in neck aging is due to changes associated with aging rather than paralysis of the cervical branch of the facial nerve . Platysma manipulation is important in aesthetic neck surgery. The restoration of a youthful cervical contour is a priority in facial rejuvenation procedures , perhaps second only to jowl elimination in terms of importance. A recent study on patients with facial paralysis indicated that there were no platysma bands on the paralyzed side and suggested that denervation of the platysma should be a target in surgical neck rejuvenation .</li><li>➤ Platysma is a subcutaneous muscle of the neck and is innervated by the cervical branch of the facial nerve . Due to aging , platysma bands can occur.</li><li>➤ subcutaneous muscle</li><li>➤ neck</li><li>➤ innervated</li><li>➤ cervical branch</li><li>➤ facial nerve</li><li>➤ aging</li><li>➤ Platysma banding in neck aging is due to changes associated with aging rather than paralysis of the cervical branch of the facial nerve .</li><li>➤ Platysma banding</li><li>➤ changes</li><li>➤ aging</li><li>➤ paralysis</li><li>➤ cervical branch</li><li>➤ facial nerve</li><li>➤ Platysma manipulation is important in aesthetic neck surgery. The restoration of a youthful cervical contour is a priority in facial rejuvenation procedures , perhaps second only to jowl elimination in terms of importance.</li><li>➤ manipulation</li><li>➤ aesthetic neck surgery.</li><li>➤ restoration</li><li>➤ cervical contour</li><li>➤ facial rejuvenation procedures</li><li>➤ second only</li><li>➤ jowl elimination</li><li>➤ A recent study on patients with facial paralysis indicated that there were no platysma bands on the paralyzed side and suggested that denervation of the platysma should be a target in surgical neck rejuvenation .</li><li>➤ facial paralysis</li><li>➤ no platysma bands</li><li>➤ paralyzed side</li><li>➤ denervation</li><li>➤ platysma</li><li>➤ surgical neck rejuvenation</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with a history of recurrent episodes of severe epistaxis. He has a past medical history of hypertension and chronic sinusitis. Physical examination reveals blood originating from the posterior aspect of the nasal cavity. Angiographic studies are considered to manage his condition. Which of the following arteries, if involved, is most likely responsible for his recurrent epistaxis?", "options": [{"label": "A", "text": "First part of Maxillary Artery", "correct": false}, {"label": "B", "text": "Third part of Maxillary Artery", "correct": true}, {"label": "C", "text": "Middle Meningeal Artery", "correct": false}, {"label": "D", "text": "Accessory Meningeal Artery", "correct": false}], "correct_answer": "B. Third part of Maxillary Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture44.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-150454.jpg"], "explanation": "<p><strong>Ans. B) Third part of Maxillary Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The first part of the maxillary artery primarily gives off branches like the deep auricular artery , anterior tympanic artery , middle meningeal artery , accessory meningeal artery , and the inferior alveolar artery. The artery of the pterygoid canal is not a branch of this part of the maxillary artery .</li><li>• Option A.</li><li>• first part</li><li>• maxillary artery</li><li>• deep auricular artery</li><li>• anterior tympanic artery</li><li>• middle meningeal artery</li><li>• accessory meningeal artery</li><li>• inferior alveolar artery.</li><li>• pterygoid canal</li><li>• not</li><li>• maxillary artery</li><li>• Option C. The middle meningeal artery is a branch of the first part of the maxillary artery and is primarily responsible for supplying the meninges of the brain . It does not give off the artery of the pterygoid canal .</li><li>• Option C.</li><li>• middle meningeal artery</li><li>• first part</li><li>• maxillary artery</li><li>• supplying</li><li>• meninges</li><li>• brain</li><li>• not</li><li>• artery</li><li>• pterygoid canal</li><li>• Option D. The accessory meningeal artery, also a branch of the first part of the maxillary artery , primarily supplies the meninges and the trigeminal ganglion . It is not the origin of the artery of the pterygoid canal.</li><li>• Option D.</li><li>• first part</li><li>• maxillary artery</li><li>• supplies</li><li>• meninges</li><li>• trigeminal ganglion</li><li>• not</li><li>• pterygoid canal.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The third part of the maxillary artery gives rise to branches that supply deeper structures within the pterygopalatine fossa and the nasal cavity . This part of the maxillary artery is indeed where the artery of the pterygoid canal originates . It runs along the pterygoid cana l to the nasal cavity and pharynx .</li><li>➤ The third part of the maxillary artery gives rise to branches that supply deeper structures within the pterygopalatine fossa and the nasal cavity .</li><li>➤ third part</li><li>➤ maxillary artery</li><li>➤ branches</li><li>➤ supply deeper structures</li><li>➤ pterygopalatine fossa</li><li>➤ nasal cavity</li><li>➤ This part of the maxillary artery is indeed where the artery of the pterygoid canal originates . It runs along the pterygoid cana l to the nasal cavity and pharynx .</li><li>➤ maxillary artery</li><li>➤ pterygoid canal originates</li><li>➤ pterygoid cana</li><li>➤ nasal cavity</li><li>➤ pharynx</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 313</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The spinal accessory nerve, crucial for motor function, innervates the sternocleidomastoid and trapezius muscles. Damage to this nerve can lead to shoulder weakness, inability to raise the arm above the head, shoulder droop, and difficulty in turning the head to the opposite side. It's often injured due to surgical procedures in the neck or trauma, resulting in characteristic physical findings and requiring targeted therapy for recovery. Spinal accessory nerve related to which of the following triangles: Occipital triangle Subclavian triangle Muscular triangle Carotid triangle Submental triangle", "options": [{"label": "A", "text": "1, 2", "correct": false}, {"label": "B", "text": "2, 4", "correct": false}, {"label": "C", "text": "1, 4", "correct": true}, {"label": "D", "text": "3, 5", "correct": false}], "correct_answer": "C. 1, 4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture45.jpg"], "explanation": "<p><strong>Ans. C) 1, 4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Occipital triangle The occipital triangle is part of the posterior triangle of the neck , bordered by the sternocleidomastoid , trapezius , and the inferior belly of the omohyoid muscle . The spinal accessory nerve travels through this triangle , innervating the sternocleidomastoid muscle from its deep surface before crossing the triangle to reach the trapezius muscle . This makes the occipital triangle relevant to the spinal accessory nerve . Subclavian triangle Also known as the supraclavicular triangle , this is the smaller division of the posterior triangle , located inferior to the occipital triangle . While the spinal accessory nerve runs in close proximity to this area, especially as it travels to the trapezius muscle , its primary course is not within this triangle . Muscular triangle The muscular triangle is a region of the anterior triangle of the neck , containing muscles like the infrahyoid muscles , but it does not include the path of the spinal accessory nerve . The nerve does not travel through this triangle . Carotid triangle The carotid triangle is part of the anterior triangle of the neck . The spinal accessory nerve does not traverse this triangle in its typical anatomical course, but it is located posterior to this triangle. The nerve's relationship to this triangle is clinically significant , particularly in surgeries involving the neck's lateral regions. Submental triangle The submental triangle is another region of the anterior triangle , located under the chin . The spinal accessory nerve does not travel through this area .</li><li>• Occipital triangle The occipital triangle is part of the posterior triangle of the neck , bordered by the sternocleidomastoid , trapezius , and the inferior belly of the omohyoid muscle . The spinal accessory nerve travels through this triangle , innervating the sternocleidomastoid muscle from its deep surface before crossing the triangle to reach the trapezius muscle . This makes the occipital triangle relevant to the spinal accessory nerve .</li><li>• Occipital triangle</li><li>• Occipital triangle</li><li>• The occipital triangle is part of the posterior triangle of the neck , bordered by the sternocleidomastoid , trapezius , and the inferior belly of the omohyoid muscle . The spinal accessory nerve travels through this triangle , innervating the sternocleidomastoid muscle from its deep surface before crossing the triangle to reach the trapezius muscle . This makes the occipital triangle relevant to the spinal accessory nerve .</li><li>• The occipital triangle is part of the posterior triangle of the neck , bordered by the sternocleidomastoid , trapezius , and the inferior belly of the omohyoid muscle . The spinal accessory nerve travels through this triangle , innervating the sternocleidomastoid muscle from its deep surface before crossing the triangle to reach the trapezius muscle . This makes the occipital triangle relevant to the spinal accessory nerve .</li><li>• The occipital triangle is part of the posterior triangle of the neck , bordered by the sternocleidomastoid , trapezius , and the inferior belly of the omohyoid muscle . The spinal accessory nerve travels through this triangle , innervating the sternocleidomastoid muscle from its deep surface before crossing the triangle to reach the trapezius muscle . This makes the occipital triangle relevant to the spinal accessory nerve .</li><li>• posterior triangle</li><li>• neck</li><li>• sternocleidomastoid</li><li>• trapezius</li><li>• inferior belly</li><li>• omohyoid muscle</li><li>• spinal accessory nerve</li><li>• triangle</li><li>• innervating</li><li>• sternocleidomastoid muscle</li><li>• deep surface</li><li>• crossing</li><li>• triangle</li><li>• trapezius muscle</li><li>• occipital triangle</li><li>• spinal accessory nerve</li><li>• Subclavian triangle Also known as the supraclavicular triangle , this is the smaller division of the posterior triangle , located inferior to the occipital triangle . While the spinal accessory nerve runs in close proximity to this area, especially as it travels to the trapezius muscle , its primary course is not within this triangle .</li><li>• Subclavian triangle</li><li>• Subclavian triangle</li><li>• Also known as the supraclavicular triangle , this is the smaller division of the posterior triangle , located inferior to the occipital triangle . While the spinal accessory nerve runs in close proximity to this area, especially as it travels to the trapezius muscle , its primary course is not within this triangle .</li><li>• Also known as the supraclavicular triangle , this is the smaller division of the posterior triangle , located inferior to the occipital triangle . While the spinal accessory nerve runs in close proximity to this area, especially as it travels to the trapezius muscle , its primary course is not within this triangle .</li><li>• Also known as the supraclavicular triangle , this is the smaller division of the posterior triangle , located inferior to the occipital triangle . While the spinal accessory nerve runs in close proximity to this area, especially as it travels to the trapezius muscle , its primary course is not within this triangle .</li><li>• supraclavicular triangle</li><li>• smaller</li><li>• posterior triangle</li><li>• inferior</li><li>• occipital triangle</li><li>• spinal accessory nerve</li><li>• close proximity</li><li>• trapezius muscle</li><li>• primary course</li><li>• not</li><li>• triangle</li><li>• Muscular triangle The muscular triangle is a region of the anterior triangle of the neck , containing muscles like the infrahyoid muscles , but it does not include the path of the spinal accessory nerve . The nerve does not travel through this triangle .</li><li>• Muscular triangle</li><li>• Muscular triangle</li><li>• The muscular triangle is a region of the anterior triangle of the neck , containing muscles like the infrahyoid muscles , but it does not include the path of the spinal accessory nerve . The nerve does not travel through this triangle .</li><li>• The muscular triangle is a region of the anterior triangle of the neck , containing muscles like the infrahyoid muscles , but it does not include the path of the spinal accessory nerve . The nerve does not travel through this triangle .</li><li>• The muscular triangle is a region of the anterior triangle of the neck , containing muscles like the infrahyoid muscles , but it does not include the path of the spinal accessory nerve . The nerve does not travel through this triangle .</li><li>• anterior triangle</li><li>• neck</li><li>• infrahyoid muscles</li><li>• not</li><li>• spinal accessory nerve</li><li>• nerve</li><li>• this triangle</li><li>• Carotid triangle The carotid triangle is part of the anterior triangle of the neck . The spinal accessory nerve does not traverse this triangle in its typical anatomical course, but it is located posterior to this triangle. The nerve's relationship to this triangle is clinically significant , particularly in surgeries involving the neck's lateral regions.</li><li>• Carotid triangle</li><li>• Carotid triangle</li><li>• The carotid triangle is part of the anterior triangle of the neck . The spinal accessory nerve does not traverse this triangle in its typical anatomical course, but it is located posterior to this triangle. The nerve's relationship to this triangle is clinically significant , particularly in surgeries involving the neck's lateral regions.</li><li>• The carotid triangle is part of the anterior triangle of the neck . The spinal accessory nerve does not traverse this triangle in its typical anatomical course, but it is located posterior to this triangle. The nerve's relationship to this triangle is clinically significant , particularly in surgeries involving the neck's lateral regions.</li><li>• The carotid triangle is part of the anterior triangle of the neck . The spinal accessory nerve does not traverse this triangle in its typical anatomical course, but it is located posterior to this triangle. The nerve's relationship to this triangle is clinically significant , particularly in surgeries involving the neck's lateral regions.</li><li>• anterior triangle</li><li>• neck</li><li>• spinal accessory nerve</li><li>• located posterior</li><li>• triangle.</li><li>• nerve's relationship</li><li>• clinically significant</li><li>• surgeries</li><li>• neck's lateral regions.</li><li>• Submental triangle The submental triangle is another region of the anterior triangle , located under the chin . The spinal accessory nerve does not travel through this area .</li><li>• Submental triangle</li><li>• Submental triangle</li><li>• The submental triangle is another region of the anterior triangle , located under the chin . The spinal accessory nerve does not travel through this area .</li><li>• The submental triangle is another region of the anterior triangle , located under the chin . The spinal accessory nerve does not travel through this area .</li><li>• The submental triangle is another region of the anterior triangle , located under the chin . The spinal accessory nerve does not travel through this area .</li><li>• anterior triangle</li><li>• under</li><li>• chin</li><li>• spinal accessory nerve</li><li>• not</li><li>• area</li><li>• Given these relationships, the correct answer is Option C. 1,4 (Occipital triangle and Carotid triangle)</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The spinal accessory nerve is most closely related to the occipital triangle due to its direct course through this area. Spinal accessory nerve is related to carotid triangle ( anterior triangle ) and also occipital triangle ( posterior triangle ).</li><li>➤ The spinal accessory nerve is most closely related to the occipital triangle due to its direct course through this area.</li><li>➤ The spinal accessory nerve is most closely related to the occipital triangle due to its direct course through this area.</li><li>➤ spinal accessory nerve</li><li>➤ occipital triangle</li><li>➤ Spinal accessory nerve is related to carotid triangle ( anterior triangle ) and also occipital triangle ( posterior triangle ).</li><li>➤ Spinal accessory nerve is related to carotid triangle ( anterior triangle ) and also occipital triangle ( posterior triangle ).</li><li>➤ carotid triangle</li><li>➤ anterior triangle</li><li>➤ occipital triangle</li><li>➤ posterior triangle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 408</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the bone in given image forming a crucial part of the auditory ossicles chain for sound transmission?\"", "options": [{"label": "A", "text": "Malleus", "correct": false}, {"label": "B", "text": "Incus", "correct": true}, {"label": "C", "text": "Stapes", "correct": false}, {"label": "D", "text": "Vomer", "correct": false}], "correct_answer": "B. Incus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture49.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture50.jpg"], "explanation": "<p><strong>Ans. B) Incus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. MALLEUS: Head-articulates with body of incus to form saddle synovial joint . Handle - medial surface upper end receives tensor tympani insertion . Handle embedded in fibrous layer of tympanic membrane . Anterior process - anterior ligament of malleus , Lateral process - Anterior and posterior malleolar folds .</li><li>• Option A. MALLEUS:</li><li>• Head-articulates</li><li>• incus</li><li>• saddle synovial joint</li><li>• Handle</li><li>• medial surface</li><li>• upper end</li><li>• tensor tympani insertion</li><li>• Handle embedded</li><li>• fibrous layer</li><li>• tympanic membrane</li><li>• Anterior process</li><li>• anterior ligament</li><li>• malleus</li><li>• Lateral process</li><li>• Anterior</li><li>• posterior</li><li>• malleolar folds</li><li>• Option C. STAPES : Head articulate with incus to form ball and socket joint , Neck - insertion of stapedius and Anterior and posterior limbs connected by footplate of stapes -closes fenestra vestibule .</li><li>• Option C. STAPES</li><li>• Head articulate</li><li>• incus</li><li>• form ball</li><li>• socket joint</li><li>• Neck</li><li>• insertion</li><li>• stapedius</li><li>• Anterior</li><li>• posterior</li><li>• limbs</li><li>• footplate</li><li>• stapes</li><li>• fenestra vestibule</li><li>• Option D. Vomer: It is unpaired bone , contributes to posteroinferior portion of nasal septum .</li><li>• Option D. Vomer:</li><li>• unpaired bone</li><li>• posteroinferior</li><li>• nasal septum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Body forms saddle synovial joint with incus, short process -ligament to fossa incudis and Long process-tip forms ball and socket synovial joint with head of stapes.</li><li>➤ Body forms saddle synovial joint with incus, short process -ligament to fossa incudis and Long process-tip forms ball and socket synovial joint with head of stapes.</li><li>➤ Body forms saddle synovial joint with incus, short process -ligament to fossa incudis and Long process-tip forms ball and socket synovial joint with head of stapes.</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 284</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg 284</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement true regarding the cranial nerve involved for the given image:", "options": [{"label": "A", "text": "It arises from midbrain at level of Inferior Colliculus", "correct": false}, {"label": "B", "text": "Carries Preganglionic Parasympathetic fibres", "correct": true}, {"label": "C", "text": "Has the longest Subarachnoid course", "correct": false}, {"label": "D", "text": "Passes through Dorello’s canal", "correct": false}], "correct_answer": "B. Carries Preganglionic Parasympathetic fibres", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture13.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture53.jpg"], "explanation": "<p><strong>Ans. B) Carries preganglionic parasympathetic fibres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The oculomotor nerve arises from the midbrain , but at the level of the superior colliculus , not the inferior colliculus .</li><li>• Option A.</li><li>• oculomotor nerve</li><li>• midbrain</li><li>• level</li><li>• superior colliculus</li><li>• not</li><li>• inferior colliculus</li><li>• Option C. While the oculomotor nerve does have a significant subarachnoid course , it is not the longest . The trochlear nerve (cranial nerve IV) is often considered to have the longest intradural course of the cranial nerves .</li><li>• Option C.</li><li>• oculomotor nerve</li><li>• subarachnoid course</li><li>• not</li><li>• longest</li><li>• trochlear nerve</li><li>• longest intradural course</li><li>• cranial nerves</li><li>• Option D. It is the abducens nerve (cranial nerve VI) that passes through Dorello’s canal , not the oculomotor nerve. The oculomotor nerve exits the brainstem between the midbrain and pons and passes between the two layers of the tentorium cerebelli .</li><li>• Option D.</li><li>• abducens nerve</li><li>• Dorello’s canal</li><li>• oculomotor nerve</li><li>• exits</li><li>• brainstem</li><li>• midbrain</li><li>• pons</li><li>• passes</li><li>• two layers</li><li>• tentorium cerebelli</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The oculomotor nerve carries preganglionic parasympathetic fibers to the ciliary ganglion . These fibers are responsible for controlling the constrictor muscles of the iris ( pupillary constriction ) and the ciliary muscles of the lens . In oculomotor nerve palsy , these parasympathetic fibers can be affected, leading to pupil dilation ( mydriasis ) and loss of accommodation.</li><li>➤ preganglionic parasympathetic fibers</li><li>➤ ciliary ganglion</li><li>➤ responsible</li><li>➤ controlling</li><li>➤ constrictor muscles</li><li>➤ iris</li><li>➤ pupillary constriction</li><li>➤ ciliary muscles</li><li>➤ lens</li><li>➤ oculomotor nerve palsy</li><li>➤ parasympathetic fibers</li><li>➤ affected,</li><li>➤ pupil dilation</li><li>➤ mydriasis</li><li>➤ loss</li><li>➤ accommodation.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 373</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 373</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the tongue muscle that does not develop from somites:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-15.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture54.jpg"], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The hyoglossus muscle is one of the extrinsic muscles of the tongue. It originates from the hyoid bone and is involved in depressing and retracting the tongue . Like most of the extrinsic tongue muscles , it develops from the first pharyngeal arch , not from somites.</li><li>• Option A.</li><li>• extrinsic muscles</li><li>• tongue.</li><li>• originates</li><li>• hyoid bone</li><li>• depressing</li><li>• retracting the tongue</li><li>• extrinsic tongue muscles</li><li>• first pharyngeal arch</li><li>• Option B: The genioglossus muscle is also an extrinsic muscle of the tongue , originating from the mandible . It is responsible for protruding the tongue . This muscle, too, develops from the first pharyngeal arch and not from somites. Genioglossus also develops from the occipital somites.</li><li>• Option B:</li><li>• extrinsic muscle</li><li>• tongue</li><li>• originating</li><li>• mandible</li><li>• protruding</li><li>• tongue</li><li>• first pharyngeal arch</li><li>• not</li><li>• somites. Genioglossus also develops from the occipital somites.</li><li>• Option D. The styloglossus muscle, another extrinsic muscle of the tongue , originates from the styloid process of the temporal bone . It is involved in retracting and elevating the tongue. Like the hyoglossus and genioglossus , the styloglossus develops from the first pharyngeal arch and not from somites.</li><li>• Option D.</li><li>• extrinsic muscle</li><li>• tongue</li><li>• originates</li><li>• styloid process</li><li>• temporal bone</li><li>• retracting</li><li>• elevating</li><li>• hyoglossus</li><li>• genioglossus</li><li>• styloglossus</li><li>• first pharyngeal arch</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ All muscles of the tongue are innervated by the hypoglossal nerve except the palatoglossus which is innervated by the pharyngeal plexus . All muscles of tongue develop from pre-occipital myotomes of paraxial mesoderm , except palatoglossus which is a derivative of the mesoderm of pharyngeal arc .</li><li>➤ All muscles of the tongue are innervated by the hypoglossal nerve except the palatoglossus which is innervated by the pharyngeal plexus .</li><li>➤ All muscles of the tongue are innervated by the hypoglossal nerve except the palatoglossus which is innervated by the pharyngeal plexus .</li><li>➤ muscles</li><li>➤ tongue</li><li>➤ innervated</li><li>➤ hypoglossal nerve</li><li>➤ except</li><li>➤ palatoglossus</li><li>➤ innervated</li><li>➤ pharyngeal plexus</li><li>➤ All muscles of tongue develop from pre-occipital myotomes of paraxial mesoderm , except palatoglossus which is a derivative of the mesoderm of pharyngeal arc .</li><li>➤ develop</li><li>➤ pre-occipital myotomes</li><li>➤ paraxial mesoderm</li><li>➤ palatoglossus which</li><li>➤ mesoderm of pharyngeal arc</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 142</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the true statement for the pointed structures:", "options": [{"label": "A", "text": "Opens into the floor of mouth into frenulum linguae", "correct": false}, {"label": "B", "text": "It arises from anterior division of mandibular nerve", "correct": false}, {"label": "C", "text": "Belongs to somatic efferent column", "correct": true}, {"label": "D", "text": "It is the first branch from external carotid artery", "correct": false}], "correct_answer": "C. Belongs to somatic efferent column", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture16.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Belongs to somatic efferent column</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Wharton's duct opens into the floor of mouth on sublingual papillae on either side of frenulum linguae .</li><li>• Option A:</li><li>• Wharton's duct</li><li>• floor of mouth</li><li>• sublingual papillae</li><li>• frenulum linguae</li><li>• Option B: Lingual nerve arises from posterior division of mandibular nerve</li><li>• Option B: Lingual nerve</li><li>• posterior division</li><li>• mandibular nerve</li><li>• Option D. Lingual artery course divided by hyoglossus muscle into 3 parts. Superior thyroid artery is the first branch from external carotid artery .</li><li>• Option D. Lingual artery course</li><li>• hyoglossus muscle</li><li>• Superior thyroid</li><li>• artery</li><li>• first branch</li><li>• external carotid artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It is entirely motor ( somatic efferent column ) and supplies all muscles of tongue except Palatoglossus</li><li>➤ entirely motor</li><li>➤ somatic efferent column</li><li>➤ tongue</li><li>➤ Palatoglossus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 149</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 149</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury of which of the following nerve causes of drooping of shoulder?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-110.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture61.jpg"], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Lesser occipital nerve, from ventral of C2 hooks around spinal accessory nerve and ascends to supply upper part of cranial surface of auricle and skin behind auricle .</li><li>• Option A.</li><li>• ventral of C2 hooks</li><li>• spinal accessory nerve</li><li>• ascends</li><li>• supply upper part</li><li>• cranial surface</li><li>• auricle</li><li>• skin</li><li>• auricle</li><li>• Option C. Great auricular nerve supplies skin over angle of mandible , skin over mastoid process and most of the auricle .</li><li>• Option C.</li><li>• skin</li><li>• angle of mandible</li><li>• skin</li><li>• mastoid process</li><li>• auricle</li><li>• Option D. Transverse cervical cutaneous nerve passes deep to external jugular vein to reach anterior border of sternocleidomastoid.</li><li>• Option D.</li><li>• deep</li><li>• external jugular vein</li><li>• anterior border</li><li>• sternocleidomastoid.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Spinal accessory nerve innervates trapezius and sternocleidomastoid . Injury to it results in drooping of shoulder (paralysis of trapezius)</li><li>➤ Spinal accessory nerve innervates trapezius and sternocleidomastoid . Injury to it results in drooping of shoulder (paralysis of trapezius)</li><li>➤ Spinal accessory nerve innervates trapezius and sternocleidomastoid . Injury to it results in drooping of shoulder (paralysis of trapezius)</li><li>➤ trapezius</li><li>➤ sternocleidomastoid</li><li>➤ drooping of shoulder</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 199</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 199</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Injury to which of the following nerve will lead to the hoarseness of voice and stridor?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": true}], "correct_answer": "D. D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-175709.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture62.jpg"], "explanation": "<p><strong>Ans. D) D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Phrenic nerve, from ventral rami of cervical plexus C3 , C4, C5 is motor to the diaphragm and sensory to central part of diaphragmatic pleura , mediastinal pleura and pericardium .</li><li>• Option A.</li><li>• ventral rami</li><li>• cervical plexus C3</li><li>• C4, C5</li><li>• motor</li><li>• diaphragm</li><li>• sensory</li><li>• central part</li><li>• diaphragmatic pleura</li><li>• mediastinal pleura</li><li>• pericardium</li><li>• Option B. Vagus nerve in neck provides superior laryngeal branch , cardiac branches , pharyngeal branch , right recurrent laryngeal nerve .</li><li>• Option B.</li><li>• superior laryngeal branch</li><li>• cardiac branches</li><li>• pharyngeal branch</li><li>• right recurrent laryngeal nerve</li><li>• Option C. Cervical part of sympathetic trunk , superior cervical ganglia lies opposite to C6 vertebra .</li><li>• Option C.</li><li>• sympathetic trunk</li><li>• superior cervical ganglia</li><li>• opposite</li><li>• C6 vertebra</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Right recurrent laryngeal nerve supplies all the muscles of the larynx except cricothyroid and is also sensory to the mucosa of larynx below the level of vocal cords . Injury to this will result in stridor .</li><li>➤ Right recurrent laryngeal nerve supplies all the muscles of the larynx except cricothyroid and is also sensory to the mucosa of larynx below the level of vocal cords .</li><li>➤ muscles</li><li>➤ larynx</li><li>➤ cricothyroid</li><li>➤ sensory</li><li>➤ mucosa</li><li>➤ larynx</li><li>➤ level</li><li>➤ vocal cords</li><li>➤ Injury to this will result in stridor .</li><li>➤ Injury</li><li>➤ stridor</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 244</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the nerve whose injury causes lateral gaze palsy:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": true}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "C. C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture63.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture64.jpg"], "explanation": "<p><strong>Ans. C) C</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Oculomotor nerve lies in the lateral wall of cavernous sinus . It enters the orbit as upper and division through intermediate compartment of superior orbital fissure.</li><li>• Option A.</li><li>• lateral wall</li><li>• cavernous sinus</li><li>• upper</li><li>• division through</li><li>• superior orbital fissure.</li><li>• Option B. Trochlear nerve lies in the lateral wall of cavernous sinus . It enters the orbit through lateral compartment of superior orbital fissure .</li><li>• Option B.</li><li>• lateral wall</li><li>• cavernous sinus</li><li>• lateral compartment</li><li>• superior orbital fissure</li><li>• Option D. Ophthalmic division of trigeminal nerve lies in the lateral wall of cavernous sinus. It divides into lacrimal , frontal and nasociliary branches .</li><li>• Option D.</li><li>• lateral wall</li><li>• cavernous sinus.</li><li>• lacrimal</li><li>• frontal</li><li>• nasociliary branches</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Abducens nerve supplies lateral rectus muscle , injury to which cause lateral gaze palsy . Abducens nerve lies in the floor of cavernous sinus lateral to internal carotid artery .</li><li>• Abducens nerve supplies lateral rectus muscle , injury to which cause lateral gaze palsy .</li><li>• Abducens nerve supplies lateral rectus muscle , injury to which cause lateral gaze palsy .</li><li>• lateral rectus muscle</li><li>• lateral gaze palsy</li><li>• Abducens nerve lies in the floor of cavernous sinus lateral to internal carotid artery .</li><li>• Abducens nerve lies in the floor of cavernous sinus lateral to internal carotid artery .</li><li>• floor of cavernous sinus</li><li>• internal carotid artery</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 377</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg. 377</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure:", "options": [{"label": "A", "text": "Lingual Nerve", "correct": false}, {"label": "B", "text": "Hypoglossal Nerve", "correct": true}, {"label": "C", "text": "Inferior Alveolar Nerve", "correct": false}, {"label": "D", "text": "Nerve to Mylohyoid", "correct": false}], "correct_answer": "B. Hypoglossal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/1.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture13_Ukgr649.jpg"], "explanation": "<p><strong>Ans. B) Hypoglossal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Lingual nerve lies in intimate relation to submandibular duct .</li><li>• Option A</li><li>• Lingual nerve</li><li>• intimate relation</li><li>• submandibular duct</li><li>• Option C . Inferior alveolar nerve from posterior division of mandibular nerve passes through the mandibular foramen .</li><li>• Option C</li><li>• Inferior alveolar nerve</li><li>• posterior division</li><li>• mandibular nerve</li><li>• mandibular foramen</li><li>• Option D . Nerve to mylohyoid arises from inferior alveolar nerve before it enters the mandibular foramen .</li><li>• Option D</li><li>• Nerve to mylohyoid</li><li>• inferior alveolar nerve</li><li>• mandibular foramen</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hypoglossal nerve that lies on the surface of hyoglossus in digastric triangle accompanied by venae comitantes</li><li>➤ Hypoglossal nerve that lies on the surface of hyoglossus in digastric triangle accompanied by venae comitantes</li><li>➤ surface</li><li>➤ hyoglossus</li><li>➤ digastric triangle</li><li>➤ venae comitantes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg No. 89</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg No. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true about the cranial nerve injured in the clinical condition shown in the image:", "options": [{"label": "A", "text": "It is the Cranial Nerve with longest Intradural Course", "correct": false}, {"label": "B", "text": "It has Parasympathetic Component", "correct": false}, {"label": "C", "text": "It undergoes decussation before innervating the target", "correct": true}, {"label": "D", "text": "It has the longest Intraosseous course", "correct": false}], "correct_answer": "C. It undergoes decussation before innervating the target", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture31.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) It undergoes decussation before innervating the target</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Abducens nerve has the longest intradural course and is also involved in raised increased intracranial pressure .</li><li>• Option A</li><li>• Abducens nerve</li><li>• longest intradural course</li><li>• increased intracranial pressure</li><li>• Option B. Cranial nerve with General visceral efferent fibres /preganglionic parasympathetic fibres include- III, VII, IX and X .</li><li>• Option B.</li><li>• Cranial nerve</li><li>• General visceral efferent fibres</li><li>• III, VII, IX</li><li>• X</li><li>• Option D . Facial nerve has the longest intraosseous course.</li><li>• Option D</li><li>• Facial nerve</li><li>• longest intraosseous course.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trochlear nerve is the only cranial nerve that exits from dorsal aspect of brainstem and decussates with nerve of opposite side in the superior medullary velum .</li><li>➤ Trochlear nerve is the only cranial nerve that exits from dorsal aspect of brainstem and decussates with nerve of opposite side in the superior medullary velum .</li><li>➤ Trochlear nerve</li><li>➤ cranial nerve</li><li>➤ dorsal aspect</li><li>➤ brainstem</li><li>➤ decussates</li><li>➤ superior medullary velum</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 376</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 376</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which nerve supplies the marked structure in the given image?", "options": [{"label": "A", "text": "Trochlear Nerve", "correct": false}, {"label": "B", "text": "Upper division of III Nerve", "correct": false}, {"label": "C", "text": "Lower division of III Nerve", "correct": true}, {"label": "D", "text": "Abducens Nerve", "correct": false}], "correct_answer": "C. Lower division of III Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture32_xOBKCci.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lower division of III Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The trochlear nerve ( cranial nerve IV ) innervates the superior oblique muscle , not the medial rectus . The superior oblique muscle turns the eye downward and laterally .</li><li>• Option A.</li><li>• cranial nerve IV</li><li>• superior oblique muscle</li><li>• medial rectus</li><li>• superior oblique muscle</li><li>• eye downward</li><li>• laterally</li><li>• Option B. The upper division of the oculomotor nerve ( cranial nerve III ) innervates the superior rectus and levator palpebrae superioris muscles . The superior rectus muscle elevates the eye , while the levator palpebrae superioris raises the upper eyelid .</li><li>• Option B.</li><li>• upper division</li><li>• oculomotor nerve</li><li>• cranial nerve III</li><li>• superior rectus</li><li>• levator palpebrae superioris muscles</li><li>• superior rectus</li><li>• elevates</li><li>• eye</li><li>• levator palpebrae superioris</li><li>• upper</li><li>• eyelid</li><li>• Option D. The abducens nerve ( cranial nerve VI ) innervates the lateral rectus muscle , which abducts the eye (moves it laterally , away from the nose ).</li><li>• Option D.</li><li>• cranial nerve VI</li><li>• lateral rectus muscle</li><li>• abducts</li><li>• eye</li><li>• laterally</li><li>• away</li><li>• nose</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Medial rectus muscle lies in the medial wall of orbit below the superior oblique muscle . It is innervated by Lower division of III nerve . Lower Division of III Nerve: The lower division of the oculomotor nerve innervates the medial rectus , inferior rectus , and inferior oblique muscles . The medial rectus muscle moves the eye medially ( towards the nose ).</li><li>➤ Medial rectus muscle lies in the medial wall of orbit below the superior oblique muscle . It is innervated by Lower division of III nerve .</li><li>➤ Medial rectus muscle lies in the medial wall of orbit below the superior oblique muscle . It is innervated by Lower division of III nerve .</li><li>➤ Medial rectus muscle</li><li>➤ medial wall</li><li>➤ orbit below</li><li>➤ superior oblique muscle</li><li>➤ Lower division</li><li>➤ III nerve</li><li>➤ Lower Division of III Nerve: The lower division of the oculomotor nerve innervates the medial rectus , inferior rectus , and inferior oblique muscles . The medial rectus muscle moves the eye medially ( towards the nose ).</li><li>➤ Lower Division of III Nerve: The lower division of the oculomotor nerve innervates the medial rectus , inferior rectus , and inferior oblique muscles . The medial rectus muscle moves the eye medially ( towards the nose ).</li><li>➤ lower division</li><li>➤ oculomotor nerve</li><li>➤ medial rectus</li><li>➤ inferior rectus</li><li>➤ inferior oblique muscles</li><li>➤ medial rectus muscle</li><li>➤ eye medially</li><li>➤ towards the nose</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a feature of cranial nerve palsy shown in the image:", "options": [{"label": "A", "text": "Ptosis", "correct": false}, {"label": "B", "text": "Mydriasis", "correct": false}, {"label": "C", "text": "Internal Strabismus", "correct": true}, {"label": "D", "text": "Loss of accommodation", "correct": false}], "correct_answer": "C. Internal Strabismus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture33.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Internal Strabismus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ptosis is a common symptom of oculomotor nerve palsy . The oculomotor nerve innervates the levator palpebrae superioris muscle , which lifts the eyelid . When this nerve is damaged, this muscle fails to function properly, resulting in ptosis.</li><li>• Option A.</li><li>• Ptosis</li><li>• oculomotor nerve palsy</li><li>• oculomotor nerve</li><li>• levator palpebrae superioris muscle</li><li>• lifts</li><li>• eyelid</li><li>• Option B. Mydriasis can occur in oculomotor nerve palsy . The parasympathetic fibers of the oculomotor nerve innervate the sphincter pupillae muscle , which constricts the pupil . Damage to these fibers can lead to an inability to constrict the pupil , causing mydriasis.</li><li>• Option B.</li><li>• Mydriasis</li><li>• oculomotor nerve palsy</li><li>• parasympathetic fibers</li><li>• oculomotor nerve</li><li>• sphincter pupillae muscle</li><li>• constricts</li><li>• pupil</li><li>• inability</li><li>• constrict the pupil</li><li>• Option D. Loss of accommodation is generally not a symptom of oculomotor nerve palsy . The ciliary muscle , responsible for accommodation , is innervated by parasympathetic fibers that travel with the oculomotor nerve . However, these fibers are less commonly affected in oculomotor nerve palsy.</li><li>• Option D.</li><li>• Loss of accommodation</li><li>• oculomotor nerve palsy</li><li>• ciliary muscle</li><li>• accommodation</li><li>• parasympathetic fibers</li><li>• oculomotor nerve</li><li>• less commonly affected</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Internal strabismus , or esotropia , is a condition where one eye turns inward. This cannot be a result of oculomotor nerve palsy . Strabismus is caused by sixth nerve damage ( Abducent nerve ). When these muscles are weakened due to nerve damage, it can cause the eye to deviate inward , resulting in internal strabismus .</li><li>➤ Internal strabismus , or esotropia , is a condition where one eye turns inward.</li><li>➤ Internal strabismus</li><li>➤ esotropia</li><li>➤ one eye turns inward.</li><li>➤ This cannot be a result of oculomotor nerve palsy . Strabismus is caused by sixth nerve damage ( Abducent nerve ). When these muscles are weakened due to nerve damage, it can cause the eye to deviate inward , resulting in internal strabismus .</li><li>➤ oculomotor nerve palsy</li><li>➤ Strabismus</li><li>➤ sixth nerve damage</li><li>➤ Abducent nerve</li><li>➤ eye</li><li>➤ deviate inward</li><li>➤ internal strabismus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256.</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 256.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the muscle which depress the mandible:", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-113.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture65.jpg"], "explanation": "<p><strong>Ans. B) B</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Buccinator muscle is primarily involved in the compression of the cheeks against the teeth and is active during chewing . This action helps to keep the food between the molars for efficient mastication . It also assists in blowing air out of the mouth , as seen when playing wind instruments .</li><li>• Option A.</li><li>• Buccinator muscle</li><li>• compression</li><li>• cheeks</li><li>• teeth</li><li>• active during chewing</li><li>• food between</li><li>• molars</li><li>• efficient mastication</li><li>• blowing air out</li><li>• mouth</li><li>• playing wind instruments</li><li>• Option C. Similar to the Lateral Pterygoid , the Medial Pterygoid muscle is also involved in mastication . Its actions include elevating the mandible and contributing to the side-to-side movements of the jaw . The Medial Pterygoid works in coordination with the Masseter and Temporalis muscles to close the jaw .</li><li>• Option C.</li><li>• Lateral Pterygoid</li><li>• Medial Pterygoid</li><li>• mastication</li><li>• elevating</li><li>• mandible</li><li>• side-to-side movements</li><li>• jaw</li><li>• Masseter</li><li>• Temporalis muscles</li><li>• close</li><li>• jaw</li><li>• Option D . The Superior Constrictor muscle is part of the pharyngeal constrictor muscles , which are not involved in mastication but in the swallowing process . The Superior Constrictor muscle assists in the initial phase of swallowing by constricting the pharyngeal wall , which helps to propel the food bolus from the oropharynx into the esophagus .</li><li>• Option D</li><li>• pharyngeal constrictor muscles</li><li>• not involved</li><li>• mastication</li><li>• swallowing process</li><li>• Superior Constrictor muscle</li><li>• initial phase</li><li>• swallowing</li><li>• constricting</li><li>• pharyngeal wall</li><li>• propel the food</li><li>• bolus</li><li>• oropharynx</li><li>• esophagus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Lateral Pterygoid muscle is involved in the complex movement s of the jaw . It has two main actions: it helps to lower the mandible and assists in protruding the mandible. This muscle plays a crucial role in the side-to-side movement of the jaw , important in the grinding action of chewing .</li><li>➤ Lateral Pterygoid muscle</li><li>➤ complex movement</li><li>➤ jaw</li><li>➤ it helps to lower</li><li>➤ mandible</li><li>➤ protruding the mandible.</li><li>➤ side-to-side movement of the jaw</li><li>➤ grinding action</li><li>➤ chewing</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presents to the clinic with complaints of progressive hoarseness and difficulty swallowing over the past few months. He has a history of smoking and occasional alcohol use. During the Laryngoscopic Examination, the otolaryngologist observes some changes in the structure and mobility of the laryngeal cartilages, which are considered in the differential diagnosis, including possible laryngeal osteoarthritis or ossification-related stiffness, given the patient's age and smoking history. Considering the potential for ossification of laryngeal cartilages with advancing age and its implications for laryngeal function, which of the following laryngeal cartilages does not undergo ossification, and thus, would be less likely to contribute directly to the patient's symptoms?", "options": [{"label": "A", "text": "Thyroid", "correct": false}, {"label": "B", "text": "Cricoid", "correct": false}, {"label": "C", "text": "Cuneiform", "correct": true}, {"label": "D", "text": "Arytenoid Lower Part", "correct": false}], "correct_answer": "C. Cuneiform", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-19-200310.jpg"], "explanation": "<p><strong>Ans. C) Cuneiform</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Thyroid is unpaired laryngeal cartilage made of hyaline cartilage ; hence it undergoes ossification .</li><li>• Option A:</li><li>• unpaired laryngeal cartilage</li><li>• hyaline cartilage</li><li>• undergoes ossification</li><li>• Option B: Cricoid cartilage is unpaired laryngeal cartilage and also made of hyaline and is positioned at C6 vertebral level .</li><li>• Option B:</li><li>• unpaired laryngeal cartilage</li><li>• hyaline</li><li>• positioned</li><li>• C6 vertebral level</li><li>• Option D: Arytenoid are paired cartilages of larynx and made of hyaline cartilage .</li><li>• Option D:</li><li>• paired cartilages</li><li>• larynx</li><li>• hyaline cartilage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The epiglottis and cuneiform are the cartilage of the larynx that typically does not undergo ossification. The epiglottis is a leaf-shaped piece of elastic cartilage that sits above the glottis and is attached to the thyroid cartilage . Its primary function is to seal off the windpipe during eating , so that food is not accidentally inhaled. While most other cartilaginous structures in the larynx , such as the thyroid , cricoid , and arytenoid cartilages , tend to ossify to varying degrees with age , the epiglottis and cuneiform largely retains its cartilaginous structure throughout life . This is due to its composition of elastic cartilage , which is more flexible and less prone to calcification compared to the hyaline cartilage that makes up other laryngeal cartilages .</li><li>➤ The epiglottis and cuneiform are the cartilage of the larynx that typically does not undergo ossification.</li><li>➤ epiglottis</li><li>➤ cuneiform</li><li>➤ cartilage</li><li>➤ larynx</li><li>➤ The epiglottis is a leaf-shaped piece of elastic cartilage that sits above the glottis and is attached to the thyroid cartilage . Its primary function is to seal off the windpipe during eating , so that food is not accidentally inhaled.</li><li>➤ epiglottis</li><li>➤ leaf-shaped piece</li><li>➤ elastic cartilage</li><li>➤ above</li><li>➤ glottis</li><li>➤ attached</li><li>➤ thyroid cartilage</li><li>➤ seal off</li><li>➤ windpipe</li><li>➤ eating</li><li>➤ While most other cartilaginous structures in the larynx , such as the thyroid , cricoid , and arytenoid cartilages , tend to ossify to varying degrees with age , the epiglottis and cuneiform largely retains its cartilaginous structure throughout life .</li><li>➤ cartilaginous structures</li><li>➤ larynx</li><li>➤ thyroid</li><li>➤ cricoid</li><li>➤ arytenoid cartilages</li><li>➤ ossify</li><li>➤ age</li><li>➤ epiglottis</li><li>➤ cuneiform</li><li>➤ cartilaginous structure</li><li>➤ throughout life</li><li>➤ This is due to its composition of elastic cartilage , which is more flexible and less prone to calcification compared to the hyaline cartilage that makes up other laryngeal cartilages .</li><li>➤ elastic cartilage</li><li>➤ flexible</li><li>➤ less prone</li><li>➤ calcification</li><li>➤ hyaline cartilage</li><li>➤ laryngeal cartilages</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 236</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 236</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is correct about the marked structure?", "options": [{"label": "A", "text": "It winds around the second part of Subclavian Artery", "correct": false}, {"label": "B", "text": "It winds around arch of Aorta", "correct": false}, {"label": "C", "text": "It winds around third part of Subclavian Artery", "correct": false}, {"label": "D", "text": "It winds around first part of Subclavian Artery", "correct": true}], "correct_answer": "D. It winds around first part of Subclavian Artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture40.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) It winds around first part of Subclavian Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Right recurrent laryngeal nerve arises from right vagus in neck and ascends in trachea esophageal groove .</li><li>• Option A</li><li>• Right recurrent laryngeal nerve</li><li>• right vagus</li><li>• neck</li><li>• ascends</li><li>• trachea esophageal groove</li><li>• Option B. Left recurrent laryngeal nerve is given off from left vagus in thorax and it winds around arch of aorta .</li><li>• Option B.</li><li>• Left recurrent laryngeal nerve</li><li>• left vagus</li><li>• thorax</li><li>• winds around arch</li><li>• aorta</li><li>• Option C. The third part of subclavian artery is seen in posterior triangle of neck and continues as axillary artery into upper limb .</li><li>• Option C.</li><li>• third part</li><li>• subclavian artery</li><li>• posterior triangle</li><li>• neck</li><li>• continues</li><li>• axillary artery</li><li>• upper limb</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Right recurrent laryngeal nerve winds around the first part of subclavian artery in scaleno vertebral triangle . Right recurrent laryngeal nerve branches off the vagus nerve ( cranial nerve X ) and winds around the right subclavian artery before ascending in the neck to reach the larynx . This anatomical route is specific to the right side of the body . Left recurrent laryngeal nerve has a different pathway. The left recurrent laryngeal nerve branches off the vagus nerve and winds around the aortic arch , specifically around the ligamentum arteriosum , before ascending towards the larynx .</li><li>➤ Right recurrent laryngeal nerve winds around the first part of subclavian artery in scaleno vertebral triangle .</li><li>➤ first part</li><li>➤ subclavian artery</li><li>➤ scaleno vertebral triangle</li><li>➤ Right recurrent laryngeal nerve branches off the vagus nerve ( cranial nerve X ) and winds around the right subclavian artery before ascending in the neck to reach the larynx . This anatomical route is specific to the right side of the body .</li><li>➤ vagus nerve</li><li>➤ cranial nerve X</li><li>➤ right subclavian artery</li><li>➤ ascending</li><li>➤ neck</li><li>➤ larynx</li><li>➤ anatomical route</li><li>➤ right side</li><li>➤ body</li><li>➤ Left recurrent laryngeal nerve has a different pathway. The left recurrent laryngeal nerve branches off the vagus nerve and winds around the aortic arch , specifically around the ligamentum arteriosum , before ascending towards the larynx .</li><li>➤ Left recurrent laryngeal nerve</li><li>➤ vagus nerve</li><li>➤ winds around</li><li>➤ aortic arch</li><li>➤ ligamentum arteriosum</li><li>➤ ascending towards</li><li>➤ larynx</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 410</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 410</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The nerve supply to the muscle which inserts into the pointed area in the given image:", "options": [{"label": "A", "text": "Facial Nerve", "correct": false}, {"label": "B", "text": "Mandibular Nerve", "correct": true}, {"label": "C", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "D", "text": "Vagus Nerve", "correct": false}], "correct_answer": "B. Mandibular Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture41.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture70.jpg"], "explanation": "<p><strong>Ans. B) Mandibular Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Facial nerve innervates stapedius , muscle of middle ear .</li><li>• Option A.</li><li>• Facial nerve</li><li>• stapedius</li><li>• muscle</li><li>• middle ear</li><li>• Option C . Glossopharyngeal nerve innervates stylopharyngeus muscle .</li><li>• Option C</li><li>• Glossopharyngeal nerve</li><li>• stylopharyngeus muscle</li><li>• Option D. Vagus nerve is motor to muscles of soft palate , pharynx and larynx .</li><li>• Option D.</li><li>• Vagus nerve</li><li>• motor</li><li>• muscles</li><li>• soft palate</li><li>• pharynx</li><li>• larynx</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Upper part of handle of malleus which receives insertion of tensor tympani muscle which is innervated by branch from trunk of mandibular division of trigeminal nerve .</li><li>➤ Upper part of handle of malleus which receives insertion of tensor tympani muscle which is innervated by branch from trunk of mandibular division of trigeminal nerve .</li><li>➤ Upper part of handle of malleus</li><li>➤ tensor tympani muscle</li><li>➤ trunk of mandibular division</li><li>➤ trigeminal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg No. 284</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg No. 284</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pointed structure?", "options": [{"label": "A", "text": "It is bounded laterally by Lamina of Thyroid cartilage", "correct": false}, {"label": "B", "text": "It lies Lateral to the Aryepiglottic fold", "correct": false}, {"label": "C", "text": "It lies in the Lateral wall of Larynx", "correct": true}, {"label": "D", "text": "It is traversed by internal Laryngeal Nerve", "correct": false}], "correct_answer": "C. It lies in the Lateral wall of Larynx", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture42_t29BsPG.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/21/picture57.jpg"], "explanation": "<p><strong>Ans. C) It lies in the lateral wall of Larynx</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is true. The pyriform fossa is indeed bounded laterally by the lamina of the thyroid cartilage . The thyroid cartilage provides structural support to the larynx and part of its lamina forms the lateral boundary of the pyriform fossa .</li><li>• Option A.</li><li>• pyriform fossa</li><li>• laterally</li><li>• lamina</li><li>• thyroid cartilage</li><li>• thyroid cartilage</li><li>• structural support</li><li>• larynx</li><li>• lamina forms</li><li>• lateral boundary</li><li>• pyriform fossa</li><li>• Option B. This statement is also true. The aryepiglottic fold is a ridge of mucous membrane that extends from the side of the epiglottis to the arytenoid cartilage , and the pyriform fossa is situated lateral to this fold . The aryepiglottic folds play a role in the closure of the laryngeal inlet during swallowing.</li><li>• Option B.</li><li>• aryepiglottic fold</li><li>• ridge</li><li>• mucous membrane</li><li>• side</li><li>• epiglottis</li><li>• arytenoid cartilage</li><li>• pyriform fossa</li><li>• lateral</li><li>• fold</li><li>• aryepiglottic folds</li><li>• closure</li><li>• laryngeal inlet</li><li>• swallowing.</li><li>• Option D. This statement is true. The internal laryngeal nerve , a branch of the superior laryngeal nerve itself a branch of the vagus nerve ( cranial nerve X ), does traverse the area near the pyriform fossa . It provides sensory innervation to the mucosa above the vocal cords , including the area of the pyriform fossa . The nerve's proximity to the pyriform fossa is clinically significant , particularly during procedures like endotracheal intubation or when assessing for nerve damage .</li><li>• Option D.</li><li>• internal laryngeal nerve</li><li>• branch</li><li>• superior laryngeal nerve</li><li>• branch</li><li>• vagus nerve</li><li>• cranial nerve X</li><li>• traverse</li><li>• pyriform fossa</li><li>• sensory innervation</li><li>• mucosa</li><li>• vocal cords</li><li>• area</li><li>• pyriform fossa</li><li>• nerve's proximity</li><li>• pyriform fossa</li><li>• clinically significant</li><li>• procedures</li><li>• endotracheal intubation</li><li>• assessing</li><li>• nerve damage</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pyriform fossa is located in the lateral wall of the laryngopharynx , not the larynx. The laryngopharynx is the part of the pharynx that lies behind the larynx and extends from the upper border of the epiglottis to the lower border of the cricoid cartilage , where it becomes continuous with the esophagus . The pyriform fossa is indeed an anatomical structure located in the lateral wall of the laryngopharynx , also known as the hypopharynx . There are two pyriform fossae , one on each side of the laryngeal opening . Each pyriform fossa is a pear-shaped recess that plays a significant role in the swallowing mechanism . Here are some key points about the pyriform fossa:</li><li>➤ The pyriform fossa is located in the lateral wall of the laryngopharynx , not the larynx. The laryngopharynx is the part of the pharynx that lies behind the larynx and extends from the upper border of the epiglottis to the lower border of the cricoid cartilage , where it becomes continuous with the esophagus .</li><li>➤ pyriform fossa</li><li>➤ lateral wall</li><li>➤ laryngopharynx</li><li>➤ laryngopharynx</li><li>➤ pharynx</li><li>➤ lies behind</li><li>➤ larynx</li><li>➤ upper border</li><li>➤ epiglottis</li><li>➤ lower border</li><li>➤ cricoid cartilage</li><li>➤ continuous</li><li>➤ esophagus</li><li>➤ The pyriform fossa is indeed an anatomical structure located in the lateral wall of the laryngopharynx , also known as the hypopharynx . There are two pyriform fossae , one on each side of the laryngeal opening . Each pyriform fossa is a pear-shaped recess that plays a significant role in the swallowing mechanism . Here are some key points about the pyriform fossa:</li><li>➤ anatomical structure</li><li>➤ lateral wall</li><li>➤ laryngopharynx</li><li>➤ hypopharynx</li><li>➤ two pyriform fossae</li><li>➤ laryngeal opening</li><li>➤ pear-shaped recess</li><li>➤ swallowing mechanism</li><li>➤ 1. Location: The pyriform fossae are situated on either side of the laryngeal inlet , forming part of the lateral walls of the laryngopharynx . They extend from the level of the hyoid bone to the esophageal inlet .</li><li>➤ Location:</li><li>➤ either side</li><li>➤ laryngeal inlet</li><li>➤ lateral walls</li><li>➤ laryngopharynx</li><li>➤ level</li><li>➤ hyoid bone</li><li>➤ esophageal inlet</li><li>➤ 2. Function: The pyriform fossae are involved in the swallowing process . They act as channels that help direct food and liquid laterally around the laryngeal inlet and into the esophagus , thus protecting the airway during swallowing .</li><li>➤ Function:</li><li>➤ swallowing process</li><li>➤ direct food</li><li>➤ liquid laterally</li><li>➤ laryngeal inlet</li><li>➤ esophagus</li><li>➤ protecting</li><li>➤ airway</li><li>➤ swallowing</li><li>➤ 3 . Clinical Relevance : The pyriform fossa is an important landmark in the field of otolaryngology and head and neck surgery . It is a common site for hypopharyngeal cancers , and its anatomy is crucial for procedures involving the upper airway and esophagus . Foreign bodies can also become lodged in the pyriform fossa, leading to dysphagia (difficulty swallowing) or even aspiration .</li><li>➤ . Clinical Relevance</li><li>➤ pyriform fossa</li><li>➤ important landmark</li><li>➤ otolaryngology</li><li>➤ head and neck surgery</li><li>➤ hypopharyngeal cancers</li><li>➤ upper airway</li><li>➤ esophagus</li><li>➤ Foreign bodies</li><li>➤ lodged</li><li>➤ dysphagia</li><li>➤ even aspiration</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pointed structure?", "options": [{"label": "A", "text": "It intervenes between the Occipital lobes of the Cerebrum and Cerebellum", "correct": false}, {"label": "B", "text": "The midline attachment of Falx Cerebri pulls it upwards", "correct": false}, {"label": "C", "text": "Transverse Sinuses are lodged along its posterior border", "correct": false}, {"label": "D", "text": "The anterior end of its attached margin is fixed to the anterior Clinoid process", "correct": true}], "correct_answer": "D. The anterior end of its attached margin is fixed to the anterior Clinoid process", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture43.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture71.jpg"], "explanation": "<p><strong>Ans. D) The anterior end of its attached margin is fixed to the anterior Clinoid process</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is true . The tentorium cerebelli is an extension of the dura mater that separates the cerebellum from the inferior portion of the occipital lobes of the cerebrum . It acts like a tent over the cerebellum , providing a protective partition .</li><li>• Option A.</li><li>• true</li><li>• tentorium cerebelli</li><li>• extension</li><li>• dura mater</li><li>• separates</li><li>• cerebellum</li><li>• inferior portion</li><li>• occipital lobes</li><li>• cerebrum</li><li>• tent over</li><li>• cerebellum</li><li>• protective partition</li><li>• Option B. This statement is not entirely accurate in the context of how the tentorium cerebelli is structured. The falx cerebri is another dural extension that descends vertically in the longitudinal fissure between the two cerebral hemispheres . While the falx cerebri does have a midline attachment , it doesn't directly pull the tentorium cerebelli upwards . Instead, the tentorium cerebelli is attached at the cranial vault at points that include the internal occipital protuberance and the petrous ridges of the temporal bones , and it is held taut across the top of the cerebellum.</li><li>• Option B.</li><li>• not entirely</li><li>• accurate</li><li>• tentorium cerebelli</li><li>• structured.</li><li>• falx cerebri</li><li>• dural extension</li><li>• descends vertically</li><li>• longitudinal fissure</li><li>• two cerebral hemispheres</li><li>• does have a midline attachment</li><li>• doesn't directly pull</li><li>• tentorium cerebelli upwards</li><li>• tentorium cerebelli</li><li>• cranial vault</li><li>• internal occipital protuberance</li><li>• petrous ridges</li><li>• temporal bones</li><li>• taut</li><li>• top</li><li>• cerebellum.</li><li>• Option C. This statement is true. The transverse sinuses are major dural venous sinuses that run within the posterior border of the tentorium cerebelli . They play a crucial role in venous blood drainage from the brain .</li><li>• Option C.</li><li>• major dural venous sinuses</li><li>• posterior border</li><li>• tentorium cerebelli</li><li>• venous blood drainage</li><li>• brain</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anterior end of the tentorium cerebelli is not attached to the anterior clinoid processes but to the clinoid processes' posterior aspect . The anterior clinoid processes are part of the sphenoid bone , which is located more anteriorly in the skull, whereas the tentorium cerebelli's anterior attachments are at the petrous part of the temporal bones and the dorsum sellae , which are posterior to the clinoid processes .</li><li>➤ anterior end</li><li>➤ tentorium cerebelli</li><li>➤ not attached</li><li>➤ anterior clinoid processes</li><li>➤ clinoid processes'</li><li>➤ posterior aspect</li><li>➤ anterior clinoid processes</li><li>➤ sphenoid bone</li><li>➤ anteriorly</li><li>➤ tentorium cerebelli's</li><li>➤ anterior attachments</li><li>➤ petrous part</li><li>➤ temporal bones</li><li>➤ dorsum sellae</li><li>➤ posterior</li><li>➤ clinoid processes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 162</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 162</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following statements is not true about the pointed structure in the image given below?", "options": [{"label": "A", "text": "It is the dilated posterior end of superior sagittal sinus", "correct": false}, {"label": "B", "text": "It is related below with the occipital sinus", "correct": false}, {"label": "C", "text": "It also receives the inferior sagittal sinus", "correct": true}, {"label": "D", "text": "It is usually continuous with the right transverse sinus", "correct": false}], "correct_answer": "C. It also receives the inferior sagittal sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture44.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture72.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/picture73.jpg"], "explanation": "<p><strong>Ans. C) It also receives the inferior sagittal sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The pointed structure is confluence of sinuses located over internal occipital protuberance .</li><li>• Option A</li><li>• confluence of sinuses</li><li>• internal occipital protuberance</li><li>• Option B . Occipital sinus is the smallest sinus situated along the attached margin of falx cerebri and terminates in the confluence of sinus</li><li>• Option B</li><li>• Occipital sinus</li><li>• smallest sinus</li><li>• attached margin</li><li>• falx cerebri</li><li>• terminates</li><li>• confluence of sinus</li><li>• Option D . It usually lies to the right of the internal occipital crest and is continuous with the right transverse sinus .</li><li>• Option D</li><li>• right</li><li>• internal occipital crest</li><li>• continuous</li><li>• right transverse sinus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The confluence of sinuses, also known as the torcular Herophili , is a large venous structure located at the internal occipital protuberance at the back of the skull . It is where several dural venous sinuses meet , including the superior sagittal sinus , straight sinus , occipital sinus , and the transverse sinuses . However, the statement that the confluence of sinuses receives the inferior sagittal sinus is not accurate.</li><li>➤ torcular Herophili</li><li>➤ large venous structure</li><li>➤ internal occipital protuberance</li><li>➤ back</li><li>➤ skull</li><li>➤ dural venous sinuses meet</li><li>➤ superior sagittal sinus</li><li>➤ straight sinus</li><li>➤ occipital sinus</li><li>➤ transverse sinuses</li><li>➤ The inferior sagittal sinus , which runs along the lower edge of the falx cerebri , does not drain directly into the confluence of sinuses. Instead, it usually joins with the great cerebral vein (also known as the vein of Galen ) to form the straight sinus . The straight sinus then extends posteriorly to drain into the confluence of sinuses .</li><li>➤ inferior sagittal sinus</li><li>➤ lower edge</li><li>➤ falx cerebri</li><li>➤ joins</li><li>➤ great cerebral vein</li><li>➤ vein of Galen</li><li>➤ straight sinus</li><li>➤ straight sinus</li><li>➤ posteriorly</li><li>➤ confluence of sinuses</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 348</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 348</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true about the structure pointed out in the image given below?", "options": [{"label": "A", "text": "Its origin lies above the tip of greater Cornu of Hyoid bone", "correct": false}, {"label": "B", "text": "Its course is divided into 3 parts by Mylohyoid Muscle", "correct": false}, {"label": "C", "text": "Second part of the Artery has a Sublingual course", "correct": false}, {"label": "D", "text": "It terminates by anastomosing with the Artery of the opposite side", "correct": true}], "correct_answer": "D. It terminates by anastomosing with the Artery of the opposite side", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture22_lCLMM3K.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture24.jpg"], "explanation": "<p><strong>Ans. D) It terminates by anastomosing with the Artery of the opposite side</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It arises from external carotid artery opposite the tip of greater cornu of hyoid bone</li><li>• Option A</li><li>• external carotid artery</li><li>• tip</li><li>• greater cornu</li><li>• hyoid bone</li><li>• Option B . Its course is divided into 3 parts by Hyoglossus muscle .</li><li>• Option B</li><li>• divided</li><li>• 3 parts</li><li>• Hyoglossus muscle</li><li>• Option C. The third part of the artery runs beneath the mucus membrane of the undersurface of the tongue on each side of frenulum linguae</li><li>• Option C.</li><li>• third part</li><li>• artery</li><li>• beneath</li><li>• mucus membrane</li><li>• undersurface</li><li>• tongue</li><li>• frenulum linguae</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It is the only branch from external carotid artery to have such a termination by anastomosing with the similar artery of the opposite side at the tip of tongue. The lingual artery , which is a branch of the external carotid artery , primarily supplies blood to the floor of the mouth, the tongue , and other oral structures . It does not terminate by anastomosing with the artery of the opposite side in a direct end-to-end fashion . Instead, the lingual artery travels along the underside of the tongue , giving off several branches like the dorsal lingual arteries , deep lingual artery , and sublingual artery . While there isn't a direct anastomosis of the terminal part of the lingual artery with its counterpart on the opposite side , there is considerable vascular interconnection within the tissues of the tongue . The arteries of the tongue , including branches of the lingual artery , form an extensive network of anastomoses across the midline with the vessels from the opposite side . This network ensures a rich and redundant blood supply to the tongue , allowing for efficient circulation even if one side is compromised.</li><li>➤ It is the only branch from external carotid artery to have such a termination by anastomosing with the similar artery of the opposite side at the tip of tongue.</li><li>➤ only branch</li><li>➤ external carotid artery</li><li>➤ termination</li><li>➤ anastomosing</li><li>➤ artery</li><li>➤ opposite side</li><li>➤ tip of tongue.</li><li>➤ The lingual artery , which is a branch of the external carotid artery , primarily supplies blood to the floor of the mouth, the tongue , and other oral structures . It does not terminate by anastomosing with the artery of the opposite side in a direct end-to-end fashion . Instead, the lingual artery travels along the underside of the tongue , giving off several branches like the dorsal lingual arteries , deep lingual artery , and sublingual artery .</li><li>➤ lingual artery</li><li>➤ branch</li><li>➤ external carotid artery</li><li>➤ blood</li><li>➤ floor of the mouth,</li><li>➤ tongue</li><li>➤ oral structures</li><li>➤ does not</li><li>➤ terminate</li><li>➤ anastomosing</li><li>➤ artery</li><li>➤ opposite side</li><li>➤ direct end-to-end fashion</li><li>➤ lingual artery</li><li>➤ underside</li><li>➤ tongue</li><li>➤ dorsal lingual arteries</li><li>➤ deep lingual artery</li><li>➤ sublingual artery</li><li>➤ While there isn't a direct anastomosis of the terminal part of the lingual artery with its counterpart on the opposite side , there is considerable vascular interconnection within the tissues of the tongue . The arteries of the tongue , including branches of the lingual artery , form an extensive network of anastomoses across the midline with the vessels from the opposite side . This network ensures a rich and redundant blood supply to the tongue , allowing for efficient circulation even if one side is compromised.</li><li>➤ terminal part</li><li>➤ lingual artery</li><li>➤ opposite side</li><li>➤ vascular interconnection</li><li>➤ tissues</li><li>➤ tongue</li><li>➤ arteries</li><li>➤ tongue</li><li>➤ lingual artery</li><li>➤ extensive network</li><li>➤ midline</li><li>➤ vessels</li><li>➤ opposite side</li><li>➤ rich</li><li>➤ redundant blood supply</li><li>➤ tongue</li><li>➤ efficient circulation</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 325</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 325</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The size of opening of the pointed paranasal sinus is reduced by all the following bones except:", "options": [{"label": "A", "text": "Lacrimal Bone", "correct": false}, {"label": "B", "text": "Middle Nasal Concha", "correct": true}, {"label": "C", "text": "Palatine Bone", "correct": false}, {"label": "D", "text": "Ethmoid Bone", "correct": false}], "correct_answer": "B. Middle Nasal Concha", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture51.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Middle Nasal Concha</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The lacrimal bone does not significantly contribute to the size of the opening of the maxillary sinus . It is a small , thin bone that forms part of the medial wall of the orbit . The maxillary sinus opens into the middle meatus of the nasal cavity , and the lacrimal bone is not directly involved in this area .</li><li>• Option A.</li><li>• does not</li><li>• size</li><li>• opening</li><li>• maxillary sinus</li><li>• small</li><li>• thin bone</li><li>• medial wall</li><li>• orbit</li><li>• maxillary sinus</li><li>• middle meatus</li><li>• nasal cavity</li><li>• lacrimal bone</li><li>• not</li><li>• involved</li><li>• area</li><li>• Option C. The palatine bone contributes to the formation of the walls of the nasal cavity and is involved in the structure surrounding the maxillary sinus . However, it does not significantly impact the size of the opening of the maxillary sinus. It forms part of the floor and lateral wall of the nasal cavity but not the area where the sinus drains .</li><li>• Option C.</li><li>• palatine bone</li><li>• formation</li><li>• walls</li><li>• nasal cavity</li><li>• maxillary sinus</li><li>• forms</li><li>• floor</li><li>• lateral wall</li><li>• nasal cavity</li><li>• not</li><li>• sinus drains</li><li>• Option D. The ethmoid bone is indeed involved in the structure around the maxillary sinus , particularly in forming the medial wall of the sinus . It can affect the size of the maxillary sinus opening as it contains the ethmoidal air cells and forms part of the lateral nasal wall adjacent to the sinus opening .</li><li>• Option D.</li><li>• ethmoid bone</li><li>• indeed involved</li><li>• structure</li><li>• maxillary sinus</li><li>• medial wall</li><li>• sinus</li><li>• ethmoidal air</li><li>• lateral nasal wall</li><li>• sinus opening</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The middle nasal concha is not a bone that reduces the size of the opening of the maxillary sinus . In fact, the maxillary sinus opens under the middle nasal concha , specifically into the semilunar hiatus located in the lateral wall of the nasal cavity . The middle nasal concha is part of the ethmoid bone and plays a role in dividing the nasal cavity but does not contribute to the size of the maxillary sinus opening.</li><li>• The middle nasal concha is not a bone that reduces the size of the opening of the maxillary sinus . In fact, the maxillary sinus opens under the middle nasal concha , specifically into the semilunar hiatus located in the lateral wall of the nasal cavity . The middle nasal concha is part of the ethmoid bone and plays a role in dividing the nasal cavity but does not contribute to the size of the maxillary sinus opening.</li><li>• middle nasal concha</li><li>• not a bone</li><li>• reduces</li><li>• size</li><li>• opening</li><li>• maxillary sinus</li><li>• maxillary sinus opens</li><li>• middle nasal concha</li><li>• semilunar hiatus</li><li>• lateral wall</li><li>• nasal cavity</li><li>• middle nasal concha</li><li>• ethmoid bone</li><li>• dividing</li><li>• nasal cavity</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the pointed structure in the given image?", "options": [{"label": "A", "text": "It first passes forward between Mylohyoid &amp; Genioglossus", "correct": true}, {"label": "B", "text": "It then lies between the Sublingual gland &amp; Genioglossus", "correct": false}, {"label": "C", "text": "It presents intimate relation with Lingual Nerve", "correct": false}, {"label": "D", "text": "It opens into the floor of the Mouth", "correct": false}], "correct_answer": "A. It first passes forward between Mylohyoid & Genioglossus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture52.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) It first passes forward between Mylohyoid &amp; Genioglossus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . This statement is true . After emerging from the deep part of the submandibular gland , the duct travels forward and medially , and in its final course , it lies above the mylohyoid muscle , running between the sublingual gland (which lies above it ) and the genioglossus muscle (which is located medially ). This part of its course is superficial and can be located in the floor of the mouth.</li><li>• Option B</li><li>• true</li><li>• emerging</li><li>• deep part</li><li>• submandibular gland</li><li>• duct</li><li>• forward</li><li>• medially</li><li>• final course</li><li>• above</li><li>• mylohyoid muscle</li><li>• sublingual gland</li><li>• above it</li><li>• genioglossus muscle</li><li>• medially</li><li>• superficial</li><li>• floor of the mouth.</li><li>• Option C . This statement is also true . The l ingual nerve , a branch of the mandibular division of the trigeminal nerve ( CN V3 ), initially lies lateral to the submandibular duct . As the duct and nerve approach the tongue, the lingual nerve crosses above the duct from lateral to medial side. This close relationship is clinically significant , especially in dental procedures and surgeries in this region, as there's a risk of nerve injury.</li><li>• Option C</li><li>• true</li><li>• ingual nerve</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• CN V3</li><li>• lateral</li><li>• submandibular duct</li><li>• crosses above</li><li>• lateral</li><li>• medial</li><li>• clinically significant</li><li>• dental procedures</li><li>• surgeries</li><li>• Option D. This is true . The terminal part of the submandibular duct opens into the floor of the mouth at the sublingual papilla , located beside the frenulum of the tongue . This is where the saliva secreted by the submandibular gland is released into the oral cavity .</li><li>• Option D.</li><li>• true</li><li>• terminal part</li><li>• submandibular duct</li><li>• floor</li><li>• mouth</li><li>• sublingual papilla</li><li>• frenulum</li><li>• tongue</li><li>• saliva</li><li>• submandibular gland</li><li>• oral cavity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The submandibular duct does not pass between the mylohyoid and genioglossus muscles . Instead, it originates from the deep part of the submandibular gland , which lies underneath the mylohyoid muscle , and then travels forward . The initial part of its course is deep to the mylohyoid muscle , not between the mylohyoid and genioglossus .</li><li>➤ submandibular duct</li><li>➤ not</li><li>➤ mylohyoid</li><li>➤ genioglossus muscles</li><li>➤ originates</li><li>➤ deep part</li><li>➤ submandibular gland</li><li>➤ underneath</li><li>➤ mylohyoid muscle</li><li>➤ forward</li><li>➤ initial part</li><li>➤ deep</li><li>➤ mylohyoid muscle</li><li>➤ not</li><li>➤ mylohyoid</li><li>➤ genioglossus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 119</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 119</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the image given below?", "options": [{"label": "A", "text": "Hypotympanum medially opens into the Eustachian tube", "correct": true}, {"label": "B", "text": "Mesotympanum is the narrowest part", "correct": false}, {"label": "C", "text": "Epitympanum communicates with the Mastoid Antrum through Aditus", "correct": false}, {"label": "D", "text": "Hypotympanum is the smallest part", "correct": false}], "correct_answer": "A. Hypotympanum medially opens into the Eustachian tube", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/whatsapp-image-2023-06-09-at-182611.jpeg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Hypotympanum medially opens into the Eustachian tube</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Mesotympanum is indeed the narrowest part of the middle ear cavity . It is the central portion of the tympanic cavity , located between the hypotympanum and the epitympanum .</li><li>• Option B</li><li>• Mesotympanum</li><li>• narrowest part</li><li>• middle ear cavity</li><li>• central portion</li><li>• tympanic cavity</li><li>• hypotympanum</li><li>• epitympanum</li><li>• Option C. The epitympanum communicates with the mastoid antrum through a passage called the aditus . The mastoid antrum is a cavity within the mastoid process of the temporal bone , and the epitympanum is the upper portion of the middle ear cavity located above the level of the tympanic membrane .</li><li>• Option C.</li><li>• epitympanum</li><li>• mastoid antrum</li><li>• aditus</li><li>• mastoid antrum</li><li>• mastoid process</li><li>• temporal bone</li><li>• epitympanum</li><li>• upper portion</li><li>• middle ear cavity</li><li>• above</li><li>• level</li><li>• tympanic membrane</li><li>• Option D . The hypotympanum is generally considered the smallest part of the middle ear cavity . It is located inferiorly and posteriorly to the level of the tympanic membrane and is bounded by the tympanic membrane , the jugular fossa , and the bony floor of the middle ear</li><li>• Option D</li><li>• hypotympanum</li><li>• smallest part</li><li>• middle ear cavity</li><li>• inferiorly</li><li>• posteriorly</li><li>• tympanic membrane</li><li>• tympanic membrane</li><li>• jugular fossa</li><li>• bony floor</li><li>• middle ear</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Hypotympanum does not directly open into the Eustachian tube . The Eustachian tube connects the middle ear cavity to the nasopharynx . The hypotympanum is the lowest portion of the tympanic cavity and is located inferiorly to the level of the tympanic membrane . It does not directly open into the Eustachian tube. The Eustachian tube is connected to the anterior wall of the middle ear , not the hypotympanum.</li><li>• Eustachian tube</li><li>• middle ear cavity</li><li>• nasopharynx</li><li>• hypotympanum</li><li>• lowest portion</li><li>• tympanic cavity</li><li>• inferiorly</li><li>• level</li><li>• tympanic membrane</li><li>• anterior wall</li><li>• middle ear</li><li>• Note - Size of Epitympanum is 6mm, Mesotympanum is 2mm &amp; Hypotympanum is 4mm.</li><li>• Note - Size of Epitympanum is 6mm, Mesotympanum is 2mm &amp; Hypotympanum is 4mm.</li><li>• Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 276</li><li>• Ref :</li><li>• IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 276</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is not true about the blood vessels shown in the image given below?", "options": [{"label": "A", "text": "Anterior tympanic artery is a branch from deep auricular artery", "correct": true}, {"label": "B", "text": "Superior tympanic artery is a branch from middle meningeal artery", "correct": false}, {"label": "C", "text": "Inferior tympanic artery is a branch from ascending pharyngeal artery", "correct": false}, {"label": "D", "text": "Posterior tympanic artery is from stylomastoid artery", "correct": false}], "correct_answer": "A. Anterior tympanic artery is a branch from deep auricular artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-122.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) Anterior tympanic artery is a branch from deep auricular artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The superior tympanic artery usually branches off from the middle meningeal artery , which itself is a branch of the maxillary artery . The superior tympanic artery supplies parts of the middle ear , including the tympanic membrane and the ossicles .</li><li>• Option B.</li><li>• middle meningeal artery</li><li>• maxillary artery</li><li>• middle ear</li><li>• tympanic membrane</li><li>• ossicles</li><li>• Option C. The inferior tympanic artery commonly arises from the ascending pharyngeal artery , a branch of the external carotid artery . It contributes to the blood supply of the lower part of the tympanic cavity and the tympanic plexus .</li><li>• Option C.</li><li>• ascending pharyngeal artery</li><li>• external carotid artery</li><li>• blood supply</li><li>• lower part</li><li>• tympanic cavity</li><li>• tympanic plexus</li><li>• Option D . The stylomastoid artery, which is a branch of the posterior auricular artery (itself a branch of the external carotid artery ), primarily supplies the facial nerve and the mastoid cells .</li><li>• Option D</li><li>• posterior auricular artery</li><li>• external carotid artery</li><li>• facial nerve</li><li>• mastoid cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anterior tympanic artery typically arises from the maxillary artery , which is a branch of the external carotid artery . Its primary role is to supply blood to the tympanic membrane (eardrum) and the adjacent parts of the middle ear . The deep auricular artery, also a branch of the maxillary artery , supplies the external acoustic meatus and outer ear but not typically the tympanic membrane.</li><li>➤ The anterior tympanic artery typically arises from the maxillary artery , which is a branch of the external carotid artery . Its primary role is to supply blood to the tympanic membrane (eardrum) and the adjacent parts of the middle ear . The deep auricular artery, also a branch of the maxillary artery , supplies the external acoustic meatus and outer ear but not typically the tympanic membrane.</li><li>➤ maxillary artery</li><li>➤ external carotid artery</li><li>➤ supply blood</li><li>➤ tympanic membrane</li><li>➤ adjacent parts</li><li>➤ middle ear</li><li>➤ deep auricular artery,</li><li>➤ maxillary artery</li><li>➤ external acoustic meatus</li><li>➤ outer ear</li><li>➤ not</li><li>➤ tympanic membrane.</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 276</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 276</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incorrect statement about the pointed structure in the above image:", "options": [{"label": "A", "text": "It begins as a continuation of Sigmoid Sinus", "correct": false}, {"label": "B", "text": "Superior bulb lodges in the Jugular fossa of Temporal bone", "correct": false}, {"label": "C", "text": "Inferior bulb lies beneath the Suprasternal space", "correct": true}, {"label": "D", "text": "Common Carotid Artery lies medial to it", "correct": false}], "correct_answer": "C. Inferior bulb lies beneath the Suprasternal space", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture5_HZqYqyF.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture10_PPmqyEn.jpg"], "explanation": "<p><strong>Ans. C) Inferior bulb lies beneath the Suprasternal space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is correct. The internal jugular vein begins at the base of the skull as a direct continuation of the sigmoid sinus , a dural venous sinus that drains blood from the brain. The transition occurs at the jugular foramen , where the sigmoid sinus becomes the internal jugular vein . It begins in the posterior compartment of jugular foramen .</li><li>• Option A.</li><li>• correct.</li><li>• base of the skull</li><li>• direct continuation</li><li>• sigmoid sinus</li><li>• dural venous</li><li>• sinus</li><li>• brain.</li><li>• jugular foramen</li><li>• sigmoid sinus</li><li>• internal jugular vein</li><li>• posterior compartment</li><li>• jugular foramen</li><li>• Option B. This statement is correct. The superior bulb of the internal jugular vein is an enlarged portion at the vein's origin, and it is located within the jugular fossa of the temporal bone , just as the vein exits the skull through the jugular foramen . At its commencement it presents a dilatation , the superior bulb , related to floor of tympanic cavity.</li><li>• Option B.</li><li>• correct.</li><li>• superior bulb</li><li>• internal jugular vein</li><li>• enlarged portion</li><li>• vein's origin,</li><li>• jugular fossa</li><li>• temporal bone</li><li>• jugular foramen</li><li>• dilatation</li><li>• superior bulb</li><li>• floor of tympanic cavity.</li><li>• Option D. This statement is correct . In the neck, the common carotid artery typically lies medial to the internal jugular vein . The relationship between these two structures is a key anatomical landmark used in medical procedures , such as central venous catheterization . Common carotid artery in the lower part, internal carotid artery in the upper part are related media l to it.</li><li>• Option D.</li><li>• correct</li><li>• common carotid artery</li><li>• medial</li><li>• internal jugular vein</li><li>• relationship</li><li>• two structures</li><li>• anatomical landmark</li><li>• medical procedures</li><li>• central venous catheterization</li><li>• Common carotid artery</li><li>• lower part, internal carotid artery</li><li>• upper part</li><li>• media</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior bulb of the internal jugular vein is not typically described as lying beneath the suprasternal space (the space above the sternum ). The inferior bulb is located near the base of the neck , where the internal jugular vein joins with the subclavian vein to form the brachiocephalic vein . The terminology \" beneath the suprasternal space \" does not accurately describe the anatomical location of the inferior bulb of the internal jugular vein . Close to termination it presents another dilatation inferior bulb , guarded by valves . The inferior bulb lies in the lesser supraclavicular space between the sternal and clavicular head of sternomastoid .</li><li>➤ The inferior bulb of the internal jugular vein is not typically described as lying beneath the suprasternal space (the space above the sternum ). The inferior bulb is located near the base of the neck , where the internal jugular vein joins with the subclavian vein to form the brachiocephalic vein . The terminology \" beneath the suprasternal space \" does not accurately describe the anatomical location of the inferior bulb of the internal jugular vein .</li><li>➤ inferior bulb</li><li>➤ internal jugular vein</li><li>➤ lying beneath</li><li>➤ suprasternal space</li><li>➤ space above the sternum</li><li>➤ inferior bulb</li><li>➤ base</li><li>➤ neck</li><li>➤ internal jugular vein</li><li>➤ subclavian vein</li><li>➤ brachiocephalic vein</li><li>➤ beneath the suprasternal space</li><li>➤ anatomical location</li><li>➤ inferior bulb</li><li>➤ internal jugular vein</li><li>➤ Close to termination it presents another dilatation inferior bulb , guarded by valves . The inferior bulb lies in the lesser supraclavicular space between the sternal and clavicular head of sternomastoid .</li><li>➤ Close to termination</li><li>➤ dilatation inferior bulb</li><li>➤ valves</li><li>➤ lesser supraclavicular space</li><li>➤ sternal</li><li>➤ clavicular head</li><li>➤ sternomastoid</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 341</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 341</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the correct statement pertaining to the pointed structure in the above image:", "options": [{"label": "A", "text": "It is unpaired", "correct": false}, {"label": "B", "text": "Anterior wall presents frontonasal duct", "correct": false}, {"label": "C", "text": "Lymphatics drain into submandibular lymph nodes", "correct": true}, {"label": "D", "text": "It is present in rudimentary form at birth", "correct": false}], "correct_answer": "C. Lymphatics drain into submandibular lymph nodes", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture6_cbwoGMm.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Lymphatics drain into submandibular lymph nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. The frontal sinuses are typically paired , with one sinus located on each side of the midline within the frontal bone . However, there can be variations in size and shape , and in some cases, one sinus may be absent . It consists of two halves , within the two tables of squamous part of frontal bone .</li><li>• Option A.</li><li>• paired</li><li>• one sinus</li><li>• each side</li><li>• midline</li><li>• frontal bone</li><li>• variations</li><li>• size</li><li>• shape</li><li>• one sinus</li><li>• absent</li><li>• two halves</li><li>• two tables</li><li>• squamous</li><li>• frontal bone</li><li>• Option B. The frontal sinuses drain into the nasal cavity , the drainage pathway for the frontal sinus is through the frontal recess , which leads into the ethmoidal infundibulum , and then into the middle meatus of the nasal cavity . The frontonasal duct is present on its floor .</li><li>• Option B.</li><li>• nasal cavity</li><li>• frontal recess</li><li>• ethmoidal infundibulum</li><li>• middle meatus</li><li>• nasal cavity</li><li>• present</li><li>• floor</li><li>• Option D. The frontal sinuses are not fully developed at birth . They begin to develop as outpouchings of the ethmoid sinuses and are usually rudimentary during infancy . The frontal sinuses start to pneumatize ( expand and fill with air ) and become more distinct during childhood , continuing to grow and develop into adolescence and early adulthood . All sinuses are present in rudimentary form at birth except frontal sinus which start development two or three years after birth .</li><li>• Option D.</li><li>• not fully</li><li>• birth</li><li>• outpouchings</li><li>• ethmoid sinuses</li><li>• rudimentary</li><li>• infancy</li><li>• pneumatize</li><li>• expand</li><li>• fill with air</li><li>• childhood</li><li>• grow</li><li>• develop</li><li>• adolescence</li><li>• early adulthood</li><li>• rudimentary form</li><li>• except frontal sinus</li><li>• two</li><li>• three years</li><li>• after birth</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Frontal sinus - arterial supply is from supraorbital artery and venous drainage into the supraorbital and superior ophthalmic vessels . Lymphatics drains into submandibular lymph nodes .</li><li>➤ Frontal sinus - arterial supply is from supraorbital artery and venous drainage into the supraorbital and superior ophthalmic vessels .</li><li>➤ supraorbital artery</li><li>➤ venous drainage</li><li>➤ supraorbital</li><li>➤ superior ophthalmic vessels</li><li>➤ Lymphatics drains into submandibular lymph nodes .</li><li>➤ submandibular lymph nodes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is true about the above image?", "options": [{"label": "A", "text": "B &amp; E are supplied by Mandibular Nerve", "correct": false}, {"label": "B", "text": "D supplies skin over the cheek", "correct": false}, {"label": "C", "text": "A is supplied by Buccal Branch of Mandibular Nerve", "correct": true}, {"label": "D", "text": "E&amp;D causes depression of Mandible", "correct": false}], "correct_answer": "C. A is supplied by Buccal Branch of Mandibular Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/head-and-neck-124.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) A is supplied by Buccal Branch of Mandibular Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Masseter is innervated by mandibular nerve &amp; buccinator by buccal branch of facial nerve .</li><li>• Option A. Masseter</li><li>• innervated</li><li>• mandibular nerve</li><li>• buccinator</li><li>• facial nerve</li><li>• Option B. Upper buccal branch supplies the muscles of upper lip and lower buccal nerve supplies buccinator .</li><li>• Option B. Upper buccal branch</li><li>• upper lip</li><li>• lower buccal nerve</li><li>• buccinator</li><li>• Option D. Masseter causes elevation of mandible at temporomandibular joint</li><li>• Option D. Masseter</li><li>• elevation</li><li>• mandible</li><li>• temporomandibular joint</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Mucous membrane of the vestibule of the mouth. It is innervated by a buccal branch of the mandibular nerve .</li><li>• Mucous membrane of the vestibule of the mouth. It is innervated by a buccal branch of the mandibular nerve .</li><li>• Mucous membrane</li><li>• vestibule</li><li>• mouth.</li><li>• innervated</li><li>• buccal branch</li><li>• mandibular nerve</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 80</li><li>• Ref :</li><li>• IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 80</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the given image the nerve injured is:", "options": [{"label": "A", "text": "Right Lingual Nerve", "correct": false}, {"label": "B", "text": "Left Lingual Nerve", "correct": false}, {"label": "C", "text": "Right Hypoglossal Nerve", "correct": false}, {"label": "D", "text": "Left Hypoglossal Nerve", "correct": true}], "correct_answer": "D. Left Hypoglossal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture7_ww7ClEp.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Left Hypoglossal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Right Lingual nerve is purely sensory to the tongue and arises from posterior division of mandibular division of trigeminal nerve</li><li>• Option A</li><li>• sensory</li><li>• tongue</li><li>• posterior division</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• Option B. Left Lingual nerve carries general sensation from anterior 2/3 tongue</li><li>• Option B.</li><li>• general sensation</li><li>• anterior 2/3 tongue</li><li>• Option C . Hypoglossal nerve innervates all muscles of tongue except palatoglossus .</li><li>• Option C</li><li>• innervates</li><li>• tongue</li><li>• palatoglossus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In hypoglossal nerve injury the tip of the protruded tongue deviates to the paralysed side .</li><li>➤ hypoglossal nerve injury</li><li>➤ tip</li><li>➤ protruded tongue</li><li>➤ paralysed side</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 148</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 148</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following relations mentioned about the pointed structure is correct?", "options": [{"label": "A", "text": "Anteriorly - Frontal Sinus", "correct": false}, {"label": "B", "text": "Inferiorly - Oropharynx", "correct": false}, {"label": "C", "text": "Superiorly - Optic Nerve", "correct": false}, {"label": "D", "text": "Laterally - Cavernous Sinus", "correct": true}], "correct_answer": "D. Laterally - Cavernous Sinus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture11_GxvVpgp.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Laterally: Cavernous Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anteriorly – Frontal Sinus</li><li>• Option A. Anteriorly – Frontal Sinus</li><li>• The frontal sinuses are located above the eyes , in the frontal bone , which forms the forehead . The sphenoid sinuses are not directly in front of the frontal sinuses ; instead, they are situated more posteriorly , deeper within the skull . The ethmoid sinuses would be found between the frontal and sphenoid sinuses .</li><li>• The frontal sinuses are located above the eyes , in the frontal bone , which forms the forehead . The sphenoid sinuses are not directly in front of the frontal sinuses ; instead, they are situated more posteriorly , deeper within the skull . The ethmoid sinuses would be found between the frontal and sphenoid sinuses .</li><li>• above</li><li>• eyes</li><li>• frontal bone</li><li>• forehead</li><li>• sphenoid sinuses</li><li>• front</li><li>• frontal sinuses</li><li>• posteriorly</li><li>• deeper</li><li>• skull</li><li>• ethmoid sinuses</li><li>• frontal</li><li>• sphenoid sinuses</li><li>• Option B. Inferiorly - Oropharynx</li><li>• Option B. Inferiorly - Oropharynx</li><li>• The oropharynx is part of the throat located behind the oral cavity . While the sphenoid sinus is superior to the oropharynx , it is not directly above it in a way that would suggest a direct relationship . The sphenoid sinus is located more superiorly and anteriorly relative to the oropharynx .</li><li>• The oropharynx is part of the throat located behind the oral cavity . While the sphenoid sinus is superior to the oropharynx , it is not directly above it in a way that would suggest a direct relationship . The sphenoid sinus is located more superiorly and anteriorly relative to the oropharynx .</li><li>• throat</li><li>• behind</li><li>• oral cavity</li><li>• sphenoid sinus</li><li>• superior</li><li>• oropharynx</li><li>• direct relationship</li><li>• sphenoid sinus</li><li>• superiorly</li><li>• anteriorly</li><li>• oropharynx</li><li>• Option C. Superiorly - Optic Nerve</li><li>• Option C. Superiorly - Optic Nerve</li><li>• The optic nerve ( cranial nerve II ) runs posteriorly from the eyes to the brain . The sphenoid sinus is located inferiorly to the optic nerve as it passes through the optic canal , which is superior to the sphenoid sinus . This relationship is particularly important because inflammation or expansion of the sphenoid sinus can affect the optic nerve .</li><li>• The optic nerve ( cranial nerve II ) runs posteriorly from the eyes to the brain . The sphenoid sinus is located inferiorly to the optic nerve as it passes through the optic canal , which is superior to the sphenoid sinus . This relationship is particularly important because inflammation or expansion of the sphenoid sinus can affect the optic nerve .</li><li>• cranial nerve II</li><li>• posteriorly</li><li>• eyes</li><li>• brain</li><li>• sphenoid sinus</li><li>• inferiorly</li><li>• optic nerve</li><li>• optic canal</li><li>• superior</li><li>• sphenoid sinus</li><li>• inflammation</li><li>• expansion</li><li>• affect</li><li>• optic nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ On each side it is related to cavernous sinus and internal carotid artery . The cavernous sinuses are large venous channels located on either side of the sella turcica , a saddle-shaped depression in the sphenoid bone that houses the pituitary gland . The lateral walls of the sphenoid sinus are indeed adjacent to the cavernous sinuses . This proximity is clinically significant because infections or other pathologies in the sphenoid sinus can potentially spread to the cavernous sinus , leading to serious complications.</li><li>➤ On each side it is related to cavernous sinus and internal carotid artery .</li><li>➤ cavernous sinus</li><li>➤ internal carotid artery</li><li>➤ The cavernous sinuses are large venous channels located on either side of the sella turcica , a saddle-shaped depression in the sphenoid bone that houses the pituitary gland . The lateral walls of the sphenoid sinus are indeed adjacent to the cavernous sinuses . This proximity is clinically significant because infections or other pathologies in the sphenoid sinus can potentially spread to the cavernous sinus , leading to serious complications.</li><li>➤ large venous channels</li><li>➤ either side</li><li>➤ sella turcica</li><li>➤ saddle-shaped depression</li><li>➤ sphenoid bone</li><li>➤ pituitary gland</li><li>➤ lateral walls</li><li>➤ sphenoid sinus</li><li>➤ adjacent</li><li>➤ cavernous sinuses</li><li>➤ proximity</li><li>➤ clinically significant</li><li>➤ infections</li><li>➤ pathologies</li><li>➤ sphenoid sinus</li><li>➤ cavernous sinus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is the Action of the Marked Muscle in the given Image?", "options": [{"label": "A", "text": "Elevation", "correct": false}, {"label": "B", "text": "Depression", "correct": false}, {"label": "C", "text": "Retraction", "correct": true}, {"label": "D", "text": "Protrusion", "correct": false}], "correct_answer": "C. Retraction", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114930.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115021.jpg"], "explanation": "<p><strong>Ans. C) Retraction</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Masseter, temporalis and medial pterygoid act as elevators of the mandible .</li><li>• Option A:</li><li>• elevators</li><li>• mandible</li><li>• Option B: Depression of mandible produced by lateral pterygoid , and suprahyoid muscles like geniohyoid , digastric and mylohyoid .</li><li>• Option B: Depression</li><li>• lateral pterygoid</li><li>• suprahyoid muscles</li><li>• geniohyoid</li><li>• digastric</li><li>• mylohyoid</li><li>• Option D: Simultaneous action of lateral and medial pterygoid causes protrusion of mandible .</li><li>• Option D:</li><li>• lateral</li><li>• medial pterygoid</li><li>• protrusion</li><li>• mandible</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Temporalis muscle that originates from the temporal fossa of temporal bone and inserts into the coronoid process of the mandible . Its posterior fibres cause retraction of mandible</li><li>➤ Temporalis muscle that originates from the temporal fossa of temporal bone and inserts into the coronoid process of the mandible . Its posterior fibres cause retraction of mandible</li><li>➤ Temporalis muscle</li><li>➤ temporal fossa</li><li>➤ temporal bone</li><li>➤ inserts</li><li>➤ coronoid process</li><li>➤ mandible</li><li>➤ posterior fibres</li><li>➤ retraction</li><li>➤ mandible</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following muscles is not paralysed in the clinical condition shown in the given image?", "options": [{"label": "A", "text": "Levator anguli oris", "correct": false}, {"label": "B", "text": "Buccinator", "correct": false}, {"label": "C", "text": "Mentalis", "correct": false}, {"label": "D", "text": "Levator palpebrae superioris", "correct": true}], "correct_answer": "D. Levator palpebrae superioris", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture14_GUTQ9zM.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Levator palpebrae superioris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Levator anguli oris -muscle of upper lip innervated by upper buccal branch of facial nerve .</li><li>• Option A</li><li>• Levator anguli oris</li><li>• upper lip</li><li>• upper buccal branch</li><li>• facial nerve</li><li>• Option B. Buccinator -muscle of cheek innervated by lower buccal branch of facial nerve .</li><li>• Option B. Buccinator</li><li>• cheek</li><li>• lower buccal branch</li><li>• facial nerve</li><li>• Option C. Mentalis -muscle of chin innervated by marginal mandibular branch of facial nerve .</li><li>• Option C.</li><li>• Mentalis</li><li>• chin</li><li>• marginal mandibular branch</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Levator palpebrae superioris is innervated by upper division oculomotor nerve .</li><li>➤ Levator palpebrae superioris</li><li>➤ upper division oculomotor nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following two are innervated by the same nerve?", "options": [{"label": "A", "text": "A &amp; D", "correct": false}, {"label": "B", "text": "B &amp; C", "correct": false}, {"label": "C", "text": "C &amp; D", "correct": true}, {"label": "D", "text": "D &amp; E", "correct": false}], "correct_answer": "C. C & D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture15_k1D6DFq.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) C &amp; D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Trapezius innervated by spinal accessory nerve . Sternocleidomastoid innervated by spinal accessory nerve Medial pterygoid is innervated by mandibular division of trigeminal nerve Masseter is also supplied by mandibular division of trigeminal nerve .</li><li>• Trapezius innervated by spinal accessory nerve .</li><li>• Trapezius</li><li>• spinal accessory nerve</li><li>• Sternocleidomastoid innervated by spinal accessory nerve</li><li>• Sternocleidomastoid</li><li>• spinal accessory nerve</li><li>• Medial pterygoid is innervated by mandibular division of trigeminal nerve</li><li>• Medial pterygoid</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• Masseter is also supplied by mandibular division of trigeminal nerve .</li><li>• Masseter</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Medial pterygoid &amp; Masseter : Both are innervated by mandibular division of trigeminal nerve .</li><li>• Medial pterygoid &amp; Masseter : Both are innervated by mandibular division of trigeminal nerve .</li><li>• Medial pterygoid &amp; Masseter</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The muscle which has undergone spasm in the below image is:", "options": [{"label": "A", "text": "Right Platysma", "correct": false}, {"label": "B", "text": "Right Deltoid", "correct": false}, {"label": "C", "text": "Left Trapezius", "correct": false}, {"label": "D", "text": "Left Sternocleidomastoid", "correct": true}], "correct_answer": "D. Left Sternocleidomastoid", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture16_PVgQSPA.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture17_lHuqfL0.jpg"], "explanation": "<p><strong>Ans. D) Left Sternocleidomastoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Platysma is subcutaneous muscle of neck it is a remnant of Panniculus carnosus .</li><li>• Option A.</li><li>• Platysma is subcutaneous muscle</li><li>• remnant</li><li>• Panniculus carnosus</li><li>• Option B. Deltoid paralysis will result in loss of round contour of shoulder , inability to abduct and regimental badge of anesthesia .</li><li>• Option B.</li><li>• Deltoid paralysis</li><li>• loss</li><li>• round contour</li><li>• shoulder</li><li>• inability</li><li>• abduct</li><li>• regimental badge</li><li>• anesthesia</li><li>• Option C. Trapezius paralysis will result in difficulty in shrugging the shoulders.</li><li>• Option C.</li><li>• Trapezius paralysis</li><li>• difficulty</li><li>• shrugging</li><li>• shoulders.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In spasm of left sternocleidomastoid , the chin turns to right side and head turns to the same side as the shoulder ( right ).</li><li>➤ In spasm of left sternocleidomastoid , the chin turns to right side and head turns to the same side as the shoulder ( right ).</li><li>➤ spasm</li><li>➤ left sternocleidomastoid</li><li>➤ chin turns</li><li>➤ right side</li><li>➤ head turns</li><li>➤ same side</li><li>➤ shoulder</li><li>➤ right</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 185</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition pg 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Internal laryngeal nerve passes between:", "options": [{"label": "A", "text": "A &amp; B", "correct": false}, {"label": "B", "text": "B &amp; C", "correct": true}, {"label": "C", "text": "C &amp; D", "correct": false}, {"label": "D", "text": "Above A", "correct": false}], "correct_answer": "B. B & C", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture18_CxON5Hh.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) B &amp; C</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . IX nerve and stylopharyngeus muscle will pass in the interval between superior constrictor and middle .</li><li>• Option A</li><li>• IX nerve</li><li>• stylopharyngeus muscle</li><li>• interval</li><li>• superior constrictor</li><li>• middle</li><li>• Option C. The pharyngeal wall is weak between C and D and produces pulsion diverticulum due to neuromuscular incoordination.</li><li>• Option C.</li><li>• pharyngeal wall</li><li>• weak</li><li>• C</li><li>• D</li><li>• pulsion diverticulum</li><li>• neuromuscular</li><li>• Option D. The recurrent laryngeal nerve and inferior laryngeal vessels pass below cricopharyngeus part of inferior constrictor .</li><li>• Option D.</li><li>• recurrent laryngeal nerve</li><li>• inferior laryngeal vessels</li><li>• cricopharyngeus</li><li>• inferior constrictor</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Internal laryngeal nerve passes between B ( Middle constrictor ) and C ( thyropharyngeus part of Inferior constrictor ).</li><li>• Internal laryngeal nerve passes between B ( Middle constrictor ) and C ( thyropharyngeus part of Inferior constrictor ).</li><li>• Internal laryngeal nerve</li><li>• B</li><li>• Middle constrictor</li><li>• C</li><li>• thyropharyngeus part</li><li>• Inferior constrictor</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 233</li><li>• Ref</li><li>• : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 233</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the following nerves innervate the pointed structure except:", "options": [{"label": "A", "text": "X", "correct": false}, {"label": "B", "text": "V", "correct": false}, {"label": "C", "text": "IX", "correct": false}, {"label": "D", "text": "XII", "correct": true}], "correct_answer": "D. XII", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture19_zXd3aG2.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) XII</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . IX, X, XI nerve contributes to the pharyngeal plexus which supplies the soft palate . Vagus is motor</li><li>• Option A</li><li>• IX, X, XI nerve</li><li>• pharyngeal plexus</li><li>• soft palate</li><li>• Vagus is motor</li><li>• Option B. All muscles of soft palate are innervated by pharyngeal plexus except tensor veli palatini which is innervated by trunk of mandibular nerve</li><li>• Option B.</li><li>• soft palate</li><li>• pharyngeal plexus</li><li>• tensor veli</li><li>• palatini</li><li>• trunk of mandibular nerve</li><li>• Option C . IX nerve conveys the sensations from the soft palate.</li><li>• Option C</li><li>• sensations</li><li>• soft palate.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Hypoglossal nerve innervates all the muscles of tongue except palatoglossus</li><li>• Hypoglossal nerve innervates all the muscles of tongue except palatoglossus</li><li>• Hypoglossal nerve innervates all the muscles of tongue except palatoglossus</li><li>• Hypoglossal nerve</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 131</li><li>• Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following nerves transmits from the pointed structure?", "options": [{"label": "A", "text": "Maxillary Nerve", "correct": false}, {"label": "B", "text": "Zygomatic Nerve", "correct": true}, {"label": "C", "text": "Frontal Nerve", "correct": false}, {"label": "D", "text": "Nasociliary Nerve", "correct": false}], "correct_answer": "B. Zygomatic Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture25.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Zygomatic Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Maxillary Nerve, which is the second branch of the trigeminal nerve , indeed passes through the inferior orbital fissure . It enters the pterygopalatine fossa after passing through the fissure and then continues into the orbit through the infraorbital groove and canal to become the infraorbital nerve .</li><li>• Option A:</li><li>• second branch</li><li>• trigeminal nerve</li><li>• inferior orbital fissure</li><li>• enters</li><li>• pterygopalatine fossa</li><li>• fissure</li><li>• continues</li><li>• orbit</li><li>• infraorbital groove</li><li>• canal</li><li>• infraorbital nerve</li><li>• Option C: The frontal nerve does not pass through the inferior orbital fissure. It is a branch of the ophthalmic nerve , the first division of the trigeminal nerve . The frontal nerve enters the orbit through the superior orbital fissure , not the inferior one, and divides into the supraorbital and supratrochlear nerves .</li><li>• Option C:</li><li>• ophthalmic nerve</li><li>• first division</li><li>• trigeminal nerve</li><li>• superior orbital fissure</li><li>• supraorbital</li><li>• supratrochlear nerves</li><li>• Option D: Nasociliary Nerve, another branch of the ophthalmic nerve , also does not pass through the inferior orbital fissure. Like the frontal nerve, it enters the orbit through the superior orbital fissure . The nasociliary nerve provides sensory innervation to the eyeball , eyelids , and nose .</li><li>• Option D:</li><li>• ophthalmic nerve</li><li>• orbit</li><li>• superior orbital fissure</li><li>• sensory innervation</li><li>• eyeball</li><li>• eyelids</li><li>• nose</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior orbital fissure transmits infraorbital vessels and nerve , zygomatic nerve , orbital branch from pterygopalatine ganglion, communications between inferior ophthalmic veins and pterygoid venous plexus .</li><li>➤ Inferior orbital fissure transmits infraorbital vessels and nerve , zygomatic nerve , orbital branch from pterygopalatine ganglion, communications between inferior ophthalmic veins and pterygoid venous plexus .</li><li>➤ Inferior orbital fissure</li><li>➤ infraorbital vessels</li><li>➤ nerve</li><li>➤ zygomatic nerve</li><li>➤ orbital branch</li><li>➤ pterygopalatine ganglion,</li><li>➤ inferior ophthalmic veins</li><li>➤ pterygoid venous plexus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 252</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 252</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures passes through the pointed Foramen?", "options": [{"label": "A", "text": "Greater Petrosal Nerve", "correct": false}, {"label": "B", "text": "Deep Petrosal Nerve", "correct": false}, {"label": "C", "text": "Lesser Petrosal Nerve", "correct": true}, {"label": "D", "text": "Jacobson’s Nerve", "correct": false}], "correct_answer": "C. Lesser Petrosal Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/06/09/picture27_2DhKrOm.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114504.jpg"], "explanation": "<p><strong>Ans. C) Lesser Petrosal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Greater petrosal nerve is a branch from geniculate ganglion . The greater petrosal nerve is a branch of the facial nerve ( cranial nerve VII ) and carries parasympathetic and sensory fibers . It arises from the geniculate ganglion and passes through the middle cranial fossa . The nerve provides parasympathetic innervation to the lacrimal gland (involved in tear production ) and to mucous membranes of the nose and palate . It travels through the foramen lacerum (though not passing entirely through it, as this foramen is mostly filled with cartilage) and enters the pterygoid canal , where it combines with the deep petrosal nerve to form the nerve of the pterygoid canal ( Vidian nerve ).</li><li>• Option A:</li><li>• geniculate ganglion</li><li>• facial nerve</li><li>• cranial nerve VII</li><li>• parasympathetic</li><li>• sensory fibers</li><li>• geniculate ganglion</li><li>• middle cranial fossa</li><li>• parasympathetic innervation</li><li>• lacrimal gland</li><li>• tear production</li><li>• mucous membranes</li><li>• nose</li><li>• palate</li><li>• foramen lacerum</li><li>• pterygoid canal</li><li>• deep petrosal nerve</li><li>• nerve</li><li>• pterygoid canal</li><li>• Vidian nerve</li><li>• Option B: Deep petrosal nerve arises from plexus around internal carotid artery . The deep petrosal nerve carries postganglionic sympathetic fibers from the carotid plexus . It does not contain sensory or parasympathetic fibers. The deep petrosal nerve passes through the carotid canal alongside the internal carotid artery and then through the foramen lacerum , though it does not exit the skull through this foramen. It joins with the greater petrosal nerve to form the nerve of the pterygoid canal , which then passes through the pterygoid canal to reach the pterygopalatine ganglion .</li><li>• Option B:</li><li>• plexus</li><li>• internal carotid artery</li><li>• postganglionic sympathetic fibers</li><li>• carotid plexus</li><li>• carotid canal</li><li>• internal carotid artery</li><li>• foramen lacerum</li><li>• greater petrosal nerve</li><li>• nerve</li><li>• pterygoid canal</li><li>• pterygoid canal</li><li>• reach</li><li>• pterygopalatine ganglion</li><li>• Option D: Jacobson’s nerve is tympanic branch of glossopharyngeal nerve . It enters the middle ear cavity through a small canal called the tympanic canaliculus , which is located near the jugular fossa . The nerve contributes to the formation of the tympanic plexus on the promontory of the middle ear . The tympanic plexus gives rise to the lesser petrosal nerve . Jacobson's nerve is involved in providing sensory innervation to the mucosa of the middle ear , the mastoid antrum , and the auditory tube .</li><li>• Option D:</li><li>• Jacobson’s nerve</li><li>• tympanic branch</li><li>• glossopharyngeal nerve</li><li>• enters</li><li>• middle ear cavity</li><li>• small canal</li><li>• tympanic canaliculus</li><li>• jugular fossa</li><li>• formation</li><li>• tympanic plexus</li><li>• promontory</li><li>• middle ear</li><li>• rise</li><li>• lesser petrosal nerve</li><li>• Jacobson's nerve</li><li>• sensory innervation</li><li>• mucosa</li><li>• middle ear</li><li>• mastoid antrum</li><li>• auditory tube</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Foramen Ovale: Structures traversing - mandibular nerve , accessory meningeal artery , lesser petrosal nerve , emissary vein . The lesser petrosal nerve is a parasympathetic nerve that originates from the tympanic plexus , which is formed by the tympanic nerve (a branch of the glossopharyngeal nerve, cranial nerve IX) and branches from the carotid plexus . The lesser petrosal nerve exits the skull through the foramen ovale (or sometimes through a small canal adjacent to it) and carries parasympathetic fibers to the otic ganglion , after which postganglionic fibers innervate the parotid gland to stimulate saliva production .</li><li>➤ Foramen Ovale: Structures traversing - mandibular nerve , accessory meningeal artery , lesser petrosal nerve , emissary vein .</li><li>➤ Foramen Ovale:</li><li>➤ mandibular nerve</li><li>➤ accessory meningeal artery</li><li>➤ lesser petrosal nerve</li><li>➤ emissary vein</li><li>➤ The lesser petrosal nerve is a parasympathetic nerve that originates from the tympanic plexus , which is formed by the tympanic nerve (a branch of the glossopharyngeal nerve, cranial nerve IX) and branches from the carotid plexus . The lesser petrosal nerve exits the skull through the foramen ovale (or sometimes through a small canal adjacent to it) and carries parasympathetic fibers to the otic ganglion , after which postganglionic fibers innervate the parotid gland to stimulate saliva production .</li><li>➤ lesser petrosal nerve</li><li>➤ parasympathetic nerve</li><li>➤ tympanic plexus</li><li>➤ tympanic nerve</li><li>➤ carotid plexus</li><li>➤ exits</li><li>➤ skull</li><li>➤ foramen ovale</li><li>➤ parasympathetic fibers</li><li>➤ otic ganglion</li><li>➤ postganglionic fibers</li><li>➤ parotid gland</li><li>➤ saliva production</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 40</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 40</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure?", "options": [{"label": "A", "text": "Langley’s Ganglion", "correct": false}, {"label": "B", "text": "Meckel’s Ganglion", "correct": false}, {"label": "C", "text": "Geniculate Ganglion", "correct": false}, {"label": "D", "text": "Gasserian Ganglion", "correct": true}], "correct_answer": "D. Gasserian Ganglion", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114828.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114845.jpg"], "explanation": "<p><strong>Ans. D) Gasserian Ganglion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Langley’s ganglia is the other name for submandibular ganglia . Langley's ganglion isn't a widely recognized term in standard anatomical nomenclature. It could potentially be a less common name for a specific ganglion, possibly related to the work of John Newport Langley , an English physiologist who made significant contributions to the understanding of the autonomic nervous system .</li><li>• Option A: Langley’s ganglia</li><li>• submandibular ganglia</li><li>• work</li><li>• John Newport</li><li>• Langley</li><li>• understanding</li><li>• autonomic nervous system</li><li>• Option B: Meckel’s ganglia is the other name for pterygopalatine ganglion , is located in the pterygopalatine fossa , near the maxillary nerve . It is a parasympathetic ganglion that plays a crucial role in innervating the lacrimal glands (contributing to tear production ) and various glands in the nasal cavity and palate . It involves functions such as nasal secretion and dilation of blood vessels in the nasal cavity .</li><li>• Option B: Meckel’s ganglia</li><li>• pterygopalatine ganglion</li><li>• pterygopalatine fossa</li><li>• maxillary nerve</li><li>• parasympathetic ganglion</li><li>• lacrimal glands</li><li>• tear production</li><li>• glands</li><li>• nasal cavity</li><li>• palate</li><li>• nasal secretion</li><li>• dilation</li><li>• blood vessels</li><li>• nasal cavity</li><li>• Option C: Geniculate ganglion is located at the external genu of facial nerve . The geniculate ganglion is a sensory ganglion of the facial nerve ( cranial nerve VII ) located in the facial canal . It contains the cell bodies of sensory neurons that bring taste sensations from the anterior two-thirds of the tongue and cutaneous sensations from the external ear . It is also involved in the sensory pathway for the facial nerve .</li><li>• Option C: Geniculate ganglion</li><li>• external genu</li><li>• facial nerve</li><li>• sensory ganglion</li><li>• facial nerve</li><li>• cranial nerve VII</li><li>• facial canal</li><li>• cell bodies</li><li>• sensory neurons</li><li>• taste sensations</li><li>• anterior two-thirds</li><li>• tongue</li><li>• cutaneous sensations</li><li>• external ear</li><li>• sensory pathway</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Gasserian ganglion, more commonly known as the trigeminal ganglion , is part of the trigeminal nerve ( cranial nerve V ), the largest of the cranial nerves . It is located in a cavity called Meckel's cave , part of the temporal bone . This ganglion contains the cell bodies of sensory neurons that carry information from the face , including touch , pain , and temperature sensations . The trigeminal nerve has three major branches : the ophthalmic , maxillary , and mandibular nerves , which innervate different regions of the face .</li><li>➤ trigeminal ganglion</li><li>➤ trigeminal nerve</li><li>➤ cranial nerve V</li><li>➤ largest</li><li>➤ cranial nerves</li><li>➤ cavity</li><li>➤ Meckel's cave</li><li>➤ temporal bone</li><li>➤ cell bodies</li><li>➤ sensory neurons</li><li>➤ face</li><li>➤ touch</li><li>➤ pain</li><li>➤ temperature sensations</li><li>➤ three major branches</li><li>➤ ophthalmic</li><li>➤ maxillary</li><li>➤ mandibular nerves</li><li>➤ different</li><li>➤ regions</li><li>➤ face</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg380</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg380</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man presents to the clinic with complaints of a persistent dull throat pain that radiates to his left ear. He mentions that the pain worsens when he turns his head or swallows. The patient also reports a sensation of a foreign body in his throat. His past medical history is unremarkable, and he denies any recent trauma or infection. On physical examination, palpation of the tonsillar fossa elicits the pain and reproduces the sensation he has been complaining about. On examination pointed structure was involved. Name the syndrome related to the pointed structure?", "options": [{"label": "A", "text": "Gradenigo Syndrome", "correct": false}, {"label": "B", "text": "Eagle Syndrome", "correct": true}, {"label": "C", "text": "Vernet Syndrome", "correct": false}, {"label": "D", "text": "Villaret's Syndrome", "correct": false}], "correct_answer": "B. Eagle Syndrome", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114858.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-114911.jpg"], "explanation": "<p><strong>Ans. B) Eagle Syndrome</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Gradenigo`s Triad is characterized by 5th Cranial Nerve Involvement (Retro-orbital Pain, Paraesthesia over Face), 6th Cranial Nerve Involvement (Diplopia) and Persistent Ear Discharge</li><li>• Option A:</li><li>• Gradenigo`s Triad</li><li>• 5th Cranial Nerve Involvement (Retro-orbital Pain, Paraesthesia over Face), 6th Cranial Nerve Involvement (Diplopia) and Persistent Ear Discharge</li><li>• Option C: Vernet syndrome refers to paralysis of IX , X , XI cranial nerves traversing through posterior compartment of jugular foramen .</li><li>• Option C:</li><li>• paralysis</li><li>• IX</li><li>• X</li><li>• XI cranial nerves</li><li>• posterior compartment</li><li>• jugular foramen</li><li>• Option D: Villaret syndrome involves IX, X, XI, XII and cervical sympathetic fibres . It is also called retropharyngeal space syndrome .</li><li>• Option D:</li><li>• IX, X, XI, XII</li><li>• cervical sympathetic fibres</li><li>• retropharyngeal space syndrome</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Styloid process of temporal bone: An abnormally elongated styloid process can damage the glossopharyngeal nerve , which is closely related to it producing otalgia , odynophagia , facial pain when turning the head .</li><li>➤ Styloid process of temporal bone: An abnormally elongated styloid process can damage the glossopharyngeal nerve , which is closely related to it producing otalgia , odynophagia , facial pain when turning the head .</li><li>➤ abnormally</li><li>➤ elongated styloid process</li><li>➤ glossopharyngeal nerve</li><li>➤ otalgia</li><li>➤ odynophagia</li><li>➤ facial pain</li><li>➤ turning</li><li>➤ head</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 27</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Cranial Nerve involved in this syndrome is:", "options": [{"label": "A", "text": "V", "correct": false}, {"label": "B", "text": "VII", "correct": true}, {"label": "C", "text": "VIII", "correct": false}, {"label": "D", "text": "IX", "correct": false}], "correct_answer": "B. VII", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115304.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115327.jpg"], "explanation": "<p><strong>Ans. B) VII</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Auriculotemporal nerve , branch from posterior division of mandibular nerve from trigeminal nerve supplies the auricle -part of tragus , helix , antihelix .</li><li>• Option A: Auriculotemporal nerve</li><li>• posterior division</li><li>• mandibular nerve</li><li>• trigeminal nerve</li><li>• auricle</li><li>• tragus</li><li>• helix</li><li>• antihelix</li><li>• Option C: Vestibulocochlear nerve enters through internal acoustic meatus and is concerned with equilibrium and hearing .</li><li>• Option C:</li><li>• Vestibulocochlear nerve</li><li>• internal acoustic meatus</li><li>• equilibrium</li><li>• hearing</li><li>• Option D: Glossopharyngeal nerve through its tympanic branch supplies middle ear .</li><li>• Option D:</li><li>• Glossopharyngeal nerve</li><li>• tympanic branch</li><li>• middle ear</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ramsay Hunt syndrome which is characterised by vesicles over conchal region of the auricle and Bell’s palsy due to reactivation of varicella zoster virus in geniculate ganglion of facial nerve . Facial nerve has no direct cutaneous branch but through its communications with the vagus nerve - Alderman’s nerve -the only cutaneous branch of vagus .</li><li>➤ Ramsay Hunt syndrome which is characterised by vesicles over conchal region of the auricle and Bell’s palsy due to reactivation of varicella zoster virus in geniculate ganglion of facial nerve .</li><li>➤ Ramsay Hunt syndrome</li><li>➤ vesicles</li><li>➤ conchal region</li><li>➤ auricle</li><li>➤ Bell’s palsy</li><li>➤ reactivation</li><li>➤ varicella zoster virus</li><li>➤ geniculate ganglion</li><li>➤ facial nerve</li><li>➤ Facial nerve has no direct cutaneous branch but through its communications with the vagus nerve - Alderman’s nerve -the only cutaneous branch of vagus .</li><li>➤ communications</li><li>➤ vagus nerve</li><li>➤ Alderman’s nerve</li><li>➤ only cutaneous branch</li><li>➤ vagus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the pointed structure:", "options": [{"label": "A", "text": "Vagus Nerve", "correct": false}, {"label": "B", "text": "Cervical Part of Sympathetic Trunk", "correct": false}, {"label": "C", "text": "Recurrent Laryngeal Nerve", "correct": false}, {"label": "D", "text": "Phrenic Nerve", "correct": true}], "correct_answer": "D. Phrenic Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115348.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115359.jpg"], "explanation": "<p><strong>Ans. D) Phrenic Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Vagus nerve lies within the carotid sheath between the internal carotid artery and internal jugular vein in carotid triangle .</li><li>• Option A:</li><li>• carotid sheath</li><li>• internal carotid artery</li><li>• internal jugular vein</li><li>• carotid triangle</li><li>• Option B: Cervical part of the sympathetic trunk has three cervical ganglia - superior , middle and inferior . Sometimes inferior cervical ganglia fuses with the superior thoracic ganglia and forms the stellate ganglion .</li><li>• Option B:</li><li>• three cervical ganglia</li><li>• superior</li><li>• middle</li><li>• inferior</li><li>• inferior cervical ganglia</li><li>• superior thoracic ganglia</li><li>• stellate ganglion</li><li>• Option C: Recurrent laryngeal nerve on the right side arises from vagus in root of neck and winds around first part of subclavian artery . Left side it arises in the thorax and winds around arch of aorta . Recurrent laryngeal nerve runs in the tracheoesophageal groove .</li><li>• Option C:</li><li>• right side</li><li>• vagus</li><li>• root</li><li>• neck</li><li>• winds</li><li>• first part</li><li>• subclavian artery</li><li>• Left side</li><li>• arises</li><li>• thorax</li><li>• winds</li><li>• arch of aorta</li><li>• Recurrent laryngeal nerve</li><li>• tracheoesophageal groove</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Phrenic nerve C3 C4 C5 from cervical plexus: It is found over the anterior surface of scalenus anterior over the root of the neck , crosses anterior to hilum of lungs .</li><li>➤ Phrenic nerve C3 C4 C5 from cervical plexus: It is found over the anterior surface of scalenus anterior over the root of the neck , crosses anterior to hilum of lungs .</li><li>➤ Phrenic nerve C3 C4 C5</li><li>➤ cervical plexus:</li><li>➤ anterior surface</li><li>➤ scalenus anterior</li><li>➤ root</li><li>➤ neck</li><li>➤ crosses</li><li>➤ anterior</li><li>➤ hilum</li><li>➤ lungs</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following marked structures forms the Superior Boundary for Piriform Fossa?", "options": [{"label": "A", "text": "A", "correct": true}, {"label": "B", "text": "B", "correct": false}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "A. A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115427_AkyMAXC.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. A) A</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Palatoglossal arch has the palatoglossus muscle covered by the mucosa and forms the anterior boundary for tonsillar fossa .</li><li>• Option B:</li><li>• Palatoglossal arch</li><li>• palatoglossus muscle</li><li>• mucosa</li><li>• anterior boundary</li><li>• tonsillar fossa</li><li>• Option C: Vallecula the depression between medial and lateral glossoepiglottic folds .</li><li>• Option C:</li><li>• Vallecula</li><li>• depression</li><li>• medial</li><li>• lateral glossoepiglottic folds</li><li>• Option D: Palatopharyngeal arch containing the palatopharyngeus muscle .</li><li>• Option D:</li><li>• Palatopharyngeal arch</li><li>• palatopharyngeus muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The piriform fossa , an important anatomical structure in the throat , is part of the hypopharynx . It is located on either side of the laryngeal opening . The boundaries of the piriform fossa are as follows: Medial Boundary: The medial boundary of the piriform fossa is the aryepiglottic fold . This fold is a mucosal structure that extends from the side of the epiglottis to the arytenoid cartilage of the larynx . Lateral Boundary: The lateral boundary is formed by the thyroid cartilage and the thyrohyoid membrane . This area is significant as it provides a surface against which food is directed during swallowing. Anterior Boundary: Anteriorly , the boundary is the posterior surface of the thyroid cartilage and the cricothyroid joint . This area is directly adjacent to the laryngeal inlet . Posterior Boundary: Posteriorly , the piriform fossa is bounded by the mucosa covering the cervical vertebrae . This area forms the posterior wall of the hypopharynx . Inferior Boundary: Inferiorly , the piriform fossa extends to the level where the hypopharynx joins the esophagus .</li><li>➤ The piriform fossa , an important anatomical structure in the throat , is part of the hypopharynx . It is located on either side of the laryngeal opening . The boundaries of the piriform fossa are as follows: Medial Boundary: The medial boundary of the piriform fossa is the aryepiglottic fold . This fold is a mucosal structure that extends from the side of the epiglottis to the arytenoid cartilage of the larynx . Lateral Boundary: The lateral boundary is formed by the thyroid cartilage and the thyrohyoid membrane . This area is significant as it provides a surface against which food is directed during swallowing. Anterior Boundary: Anteriorly , the boundary is the posterior surface of the thyroid cartilage and the cricothyroid joint . This area is directly adjacent to the laryngeal inlet . Posterior Boundary: Posteriorly , the piriform fossa is bounded by the mucosa covering the cervical vertebrae . This area forms the posterior wall of the hypopharynx . Inferior Boundary: Inferiorly , the piriform fossa extends to the level where the hypopharynx joins the esophagus .</li><li>➤ piriform fossa</li><li>➤ throat</li><li>➤ hypopharynx</li><li>➤ either side</li><li>➤ laryngeal opening</li><li>➤ Medial Boundary: The medial boundary of the piriform fossa is the aryepiglottic fold . This fold is a mucosal structure that extends from the side of the epiglottis to the arytenoid cartilage of the larynx . Lateral Boundary: The lateral boundary is formed by the thyroid cartilage and the thyrohyoid membrane . This area is significant as it provides a surface against which food is directed during swallowing. Anterior Boundary: Anteriorly , the boundary is the posterior surface of the thyroid cartilage and the cricothyroid joint . This area is directly adjacent to the laryngeal inlet . Posterior Boundary: Posteriorly , the piriform fossa is bounded by the mucosa covering the cervical vertebrae . This area forms the posterior wall of the hypopharynx . Inferior Boundary: Inferiorly , the piriform fossa extends to the level where the hypopharynx joins the esophagus .</li><li>➤ Medial Boundary: The medial boundary of the piriform fossa is the aryepiglottic fold . This fold is a mucosal structure that extends from the side of the epiglottis to the arytenoid cartilage of the larynx .</li><li>➤ Medial Boundary:</li><li>➤ aryepiglottic fold</li><li>➤ mucosal structure</li><li>➤ extends</li><li>➤ side</li><li>➤ epiglottis</li><li>➤ arytenoid cartilage</li><li>➤ larynx</li><li>➤ Lateral Boundary: The lateral boundary is formed by the thyroid cartilage and the thyrohyoid membrane . This area is significant as it provides a surface against which food is directed during swallowing.</li><li>➤ Lateral Boundary:</li><li>➤ thyroid cartilage</li><li>➤ thyrohyoid membrane</li><li>➤ Anterior Boundary: Anteriorly , the boundary is the posterior surface of the thyroid cartilage and the cricothyroid joint . This area is directly adjacent to the laryngeal inlet .</li><li>➤ Anterior Boundary: Anteriorly</li><li>➤ posterior surface</li><li>➤ thyroid cartilage</li><li>➤ cricothyroid joint</li><li>➤ adjacent</li><li>➤ laryngeal inlet</li><li>➤ Posterior Boundary: Posteriorly , the piriform fossa is bounded by the mucosa covering the cervical vertebrae . This area forms the posterior wall of the hypopharynx .</li><li>➤ Posterior Boundary: Posteriorly</li><li>➤ mucosa</li><li>➤ cervical vertebrae</li><li>➤ posterior wall</li><li>➤ hypopharynx</li><li>➤ Inferior Boundary: Inferiorly , the piriform fossa extends to the level where the hypopharynx joins the esophagus .</li><li>➤ Inferior Boundary: Inferiorly</li><li>➤ hypopharynx</li><li>➤ esophagus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following arteries does not provide blood supply to the structure indicated by the pointed arrow?", "options": [{"label": "A", "text": "Ophthalmic Artery", "correct": false}, {"label": "B", "text": "Lingual Artery", "correct": true}, {"label": "C", "text": "Facial Artery", "correct": false}, {"label": "D", "text": "Maxillary Artery", "correct": false}], "correct_answer": "B. Lingual Artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115446.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lingual Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A: Anterior ethmoidal branch - Ophthalmic artery - Internal carotid artery .</li><li>• Option A:</li><li>• Anterior ethmoidal branch</li><li>• Internal carotid artery</li><li>• Option C: Septal branch of Facial artery : External carotid artery .</li><li>• Option C:</li><li>• Septal branch</li><li>• Facial artery</li><li>• External carotid artery</li><li>• Option D: Greater palatine artery , Sphenopalatine artery - maxillary artery - External carotid artery .</li><li>• Option D: Greater palatine artery</li><li>• Sphenopalatine artery</li><li>• maxillary artery</li><li>• External carotid artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Little's area , also known as Kiesselbach's plexus , is a region in the anterior part of the nasal septum that is prone to epistaxis . The blood supply to Little's area is quite rich and comes from several arteries, which form an anastomosis in this region. These arteries include:</li><li>➤ Little's area</li><li>➤ Kiesselbach's plexus</li><li>➤ anterior part</li><li>➤ nasal septum</li><li>➤ epistaxis</li><li>➤ blood supply</li><li>➤ Little's area</li><li>➤ rich</li><li>➤ anastomosis</li><li>➤ Anterior Ethmoidal Artery is a branch of the ophthalmic artery , which itself is a branch of the internal carotid artery . It supplies the anterior and superior parts of the nasal septum . Posterior Ethmoidal Artery: Although its contribution is less significant than the anterior ethmoidal artery, the posterior ethmoidal artery also supplies blood to this region. It's another branch of the ophthalmic artery. Sphenopalatine Artery is the terminal branch of the maxillary artery , which is a branch of the external carotid artery . It enters the nasal cavity through the sphenopalatine foramen and supplies the posterior and superior parts of the nasal septum . Greater Palatine Artery , another branch of the maxillary artery , ascends to the nasal cavity through the incisive canal and contributes to the blood supply of the anterior part of the nasal septum . Superior Labial Artery: A branch of the facial artery (from the external carotid artery ), the superior labial artery supplies the anterior part of the nasal septum near the nostrils .</li><li>➤ Anterior Ethmoidal Artery is a branch of the ophthalmic artery , which itself is a branch of the internal carotid artery . It supplies the anterior and superior parts of the nasal septum .</li><li>➤ Anterior Ethmoidal Artery</li><li>➤ ophthalmic artery</li><li>➤ branch</li><li>➤ internal carotid artery</li><li>➤ supplies</li><li>➤ anterior</li><li>➤ superior parts</li><li>➤ nasal septum</li><li>➤ Posterior Ethmoidal Artery: Although its contribution is less significant than the anterior ethmoidal artery, the posterior ethmoidal artery also supplies blood to this region. It's another branch of the ophthalmic artery.</li><li>➤ Posterior Ethmoidal Artery:</li><li>➤ supplies</li><li>➤ blood</li><li>➤ Sphenopalatine Artery is the terminal branch of the maxillary artery , which is a branch of the external carotid artery . It enters the nasal cavity through the sphenopalatine foramen and supplies the posterior and superior parts of the nasal septum .</li><li>➤ Sphenopalatine Artery</li><li>➤ terminal branch</li><li>➤ maxillary artery</li><li>➤ external carotid artery</li><li>➤ enters</li><li>➤ nasal cavity</li><li>➤ sphenopalatine foramen</li><li>➤ supplies</li><li>➤ posterior</li><li>➤ superior parts</li><li>➤ nasal septum</li><li>➤ Greater Palatine Artery , another branch of the maxillary artery , ascends to the nasal cavity through the incisive canal and contributes to the blood supply of the anterior part of the nasal septum .</li><li>➤ Greater Palatine Artery</li><li>➤ maxillary artery</li><li>➤ ascends</li><li>➤ nasal cavity</li><li>➤ incisive canal</li><li>➤ blood supply</li><li>➤ anterior part</li><li>➤ nasal septum</li><li>➤ Superior Labial Artery: A branch of the facial artery (from the external carotid artery ), the superior labial artery supplies the anterior part of the nasal septum near the nostrils .</li><li>➤ Superior Labial Artery:</li><li>➤ facial artery</li><li>➤ external carotid artery</li><li>➤ anterior part</li><li>➤ nasal septum</li><li>➤ nostrils</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 218</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 218</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Into which lymph nodes does the lymphatic drainage primarily occur for the structure indicated by the pointed arrow?", "options": [{"label": "A", "text": "Submandibular Nodes", "correct": false}, {"label": "B", "text": "Submental Nodes", "correct": false}, {"label": "C", "text": "Jugulo-Omohyoid Nodes", "correct": false}, {"label": "D", "text": "Jugulodigastric Node", "correct": true}], "correct_answer": "D. Jugulodigastric Node", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/17/screenshot-2024-02-17-115500.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Jugulodigastric Node</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Submandibular nodes are located in a digastric triangle beneath deep cervical fascia . It is crossed superficially by marginal mandibular nerve .</li><li>• Option A:</li><li>• digastric triangle</li><li>• deep cervical fascia</li><li>• superficially</li><li>• marginal mandibular nerve</li><li>• Option B: Submental nodes receive from tip of tongue , central part of lower lip , floor of mouth , lingual and labial gums opposite lower incisor teeth .</li><li>• Option B:</li><li>• tip of tongue</li><li>• central part</li><li>• lower lip</li><li>• floor of mouth</li><li>• lingual</li><li>• lower incisor teeth</li><li>• Option C: Jugulo-Omoyoid nodes lie on IJV above the intermediate tendon of omohyoid .</li><li>• Option C:</li><li>• IJV above</li><li>• intermediate tendon</li><li>• omohyoid</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lymphatics from palatine tonsil mainly drain into jugulodigastric nodes . Jugulodigastric nodes receive lymph also from posterior 1/3 tongue</li><li>➤ Lymphatics from palatine tonsil mainly drain into jugulodigastric nodes .</li><li>➤ palatine tonsil</li><li>➤ drain</li><li>➤ jugulodigastric nodes</li><li>➤ Jugulodigastric nodes receive lymph also from posterior 1/3 tongue</li><li>➤ receive lymph</li><li>➤ posterior 1/3 tongue</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Hypoglossal Nerve is related to which of the following triangles?", "options": [{"label": "A", "text": "Carotid &amp; Muscular Triangles", "correct": false}, {"label": "B", "text": "Muscular &amp; Submental Triangles", "correct": false}, {"label": "C", "text": "Submental &amp; Digastric Triangles", "correct": false}, {"label": "D", "text": "Digastric &amp; Carotid Triangles", "correct": true}], "correct_answer": "D. Digastric & Carotid Triangles", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Digastric &amp; Carotid Triangles</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Nerves present in the carotid triangle include spinal part of accessory nerve , loop of hypoglossal nerve , vagus nerve and cervical part of sympathetic trunk .</li><li>• Option A:</li><li>• carotid triangle</li><li>• spinal part</li><li>• accessory nerve</li><li>• loop</li><li>• hypoglossal nerve</li><li>• vagus nerve</li><li>• cervical part</li><li>• sympathetic trunk</li><li>• Option B: Submental triangle lies in midline and unpaired , its content include – submental lymph node and commencement of anterior jugular veins .</li><li>• Option B:</li><li>• unpaired</li><li>• submental lymph node</li><li>• anterior jugular veins</li><li>• Option C: Digastric triangle has the mylohyoid vessels and nerves which pierces the sphenomandibular ligament to supply mylohyoid and anterior belly of digastric .</li><li>• Option C:</li><li>• mylohyoid vessels</li><li>• nerves</li><li>• pierces</li><li>• sphenomandibular ligament</li><li>• supply</li><li>• mylohyoid</li><li>• anterior belly</li><li>• digastric</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hypoglossal nerve in carotid triangle - Loop of hypoglossal nerve winds forward around lower sternomastoid branch of occipital artery and crosses superficial to internal and external carotid and first part of lingual artery . It gives two branches in the carotid triangle - descendens hypoglossi and nerve to thyrohyoid .</li><li>➤ Hypoglossal nerve</li><li>➤ carotid triangle</li><li>➤ Loop</li><li>➤ hypoglossal nerve</li><li>➤ forward</li><li>➤ lower sternomastoid branch</li><li>➤ occipital artery</li><li>➤ superficial</li><li>➤ internal</li><li>➤ external carotid</li><li>➤ first part</li><li>➤ lingual artery</li><li>➤ two branches</li><li>➤ carotid triangle</li><li>➤ descendens hypoglossi</li><li>➤ nerve</li><li>➤ thyrohyoid</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 201</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Oral diaphragm is formed by:", "options": [{"label": "A", "text": "Mylohyoid", "correct": true}, {"label": "B", "text": "Genioglossus", "correct": false}, {"label": "C", "text": "Hyoglossus", "correct": false}, {"label": "D", "text": "Buccinator", "correct": false}], "correct_answer": "A. Mylohyoid", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Mylohyoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Genioglossus arises from the superior genial tubercles of mandible and form the bulk of tongue inserting into it from root to its apex . The genioglossus is responsible for protruding and retracting the tongue . While it plays a crucial role in tongue movement and speech , it is not part of the oral diaphragm.</li><li>• Option B:</li><li>• superior genial tubercles</li><li>• mandible</li><li>• bulk of tongue</li><li>• root</li><li>• apex</li><li>• protruding</li><li>• retracting</li><li>• tongue</li><li>• tongue movement</li><li>• speech</li><li>• Option C: Hyoglossus muscles divides the lingual artery into three parts . The hyoglossus is involved in tongue movement . It assists in depressing and retracting the tongue . Like the genioglossus, it is not part of the oral diaphragm.</li><li>• Option C:</li><li>• lingual artery</li><li>• three parts</li><li>• tongue movement</li><li>• depressing</li><li>• retracting</li><li>• tongue</li><li>• Option D: The buccinator muscle is located in the cheek and plays a role in compressing the cheeks against the teeth , aiding in actions like blowing air and keeping food in the mouth . It is not part of the oral diaphragm. Buccinator is a muscle of the cheek innervated by facial nerve</li><li>• Option D:</li><li>• cheek</li><li>• compressing</li><li>• cheeks</li><li>• against</li><li>• teeth</li><li>• aiding</li><li>• blowing air</li><li>• keeping food</li><li>• mouth</li><li>• Buccinator</li><li>• muscle</li><li>• cheek</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Mylohyoid muscle originates from the mylohyoid line of mandible and inserts . The fibers slope downward and medially , posterior 1/4 th fibres is inserted into body of hyoid bone and anterior 3/4 th fibres interdigitate in a median fibrous raphe . The mylohyoid muscle of both sides form a gutter shaped floor of the mouth and support the weight of the tongue , hence called diaphragm a orris. It divides the submandibular gland into a superficial and deep part.</li><li>➤ Mylohyoid muscle</li><li>➤ mylohyoid line</li><li>➤ mandible</li><li>➤ inserts</li><li>➤ downward</li><li>➤ medially</li><li>➤ posterior 1/4 th fibres</li><li>➤ body</li><li>➤ hyoid bone</li><li>➤ anterior 3/4 th fibres</li><li>➤ median fibrous raphe</li><li>➤ both sides</li><li>➤ gutter shaped floor</li><li>➤ mouth</li><li>➤ support</li><li>➤ weight</li><li>➤ tongue</li><li>➤ diaphragm</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a Remnant of Panniculus Carnosus?", "options": [{"label": "A", "text": "Dartos", "correct": false}, {"label": "B", "text": "Palmaris Longus", "correct": true}, {"label": "C", "text": "Occipitofrontalis", "correct": false}, {"label": "D", "text": "Auricularis Anterior", "correct": false}], "correct_answer": "B. Palmaris Longus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Palmaris Longus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Dartos is a subcutaneous smooth muscle present beneath the skin of scrotum , innervated by sympathetic fibres .</li><li>• Option A:</li><li>• subcutaneous smooth muscle</li><li>• beneath</li><li>• skin</li><li>• scrotum</li><li>• sympathetic fibres</li><li>• Option C: Occipitofrontalis subcutaneous muscle of the scalp innervated by facial nerve , its contraction moves the scalp forwards and backwards . The frontal belly of the occipitofrontalis is innervated by temporal branch of facial nerve . Occipital belly by posterior auricular branch of facial nerve</li><li>• Option C:</li><li>• subcutaneous muscle</li><li>• scalp</li><li>• facial nerve</li><li>• contraction</li><li>• scalp</li><li>• forwards</li><li>• backwards</li><li>• frontal belly</li><li>• occipitofrontalis</li><li>• temporal branch</li><li>• facial nerve</li><li>• Occipital belly</li><li>• posterior auricular branch</li><li>• facial nerve</li><li>• Option D: Auricularis anterior subcutaneous muscle of the auricle is innervated by temporal branch of facial nerve .</li><li>• Option D:</li><li>• subcutaneous muscle</li><li>• auricle</li><li>• temporal branch</li><li>• facial nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Palmaris longus muscle is present beneath deep fascia over the flexor surface of forearm and its tendon expands to form the palmar aponeurosis in hand . Palmaris brevis present subcutaneously over the hypothenar eminence is a remnant of panniculus carnosus .</li><li>➤ beneath deep fascia</li><li>➤ flexor surface</li><li>➤ forearm</li><li>➤ tendon</li><li>➤ palmar aponeurosis</li><li>➤ hand</li><li>➤ subcutaneously</li><li>➤ over</li><li>➤ hypothenar eminence</li><li>➤ panniculus carnosus</li><li>➤ Ref: IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li><li>➤ Ref: IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 77</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Facial Nerve enters through which compartment of Internal Acoustic Meatus?", "options": [{"label": "A", "text": "Anteroinferior", "correct": false}, {"label": "B", "text": "Posteroinferior", "correct": false}, {"label": "C", "text": "Posterosuperior", "correct": false}, {"label": "D", "text": "Anterosuperior", "correct": true}], "correct_answer": "D. Anterosuperior", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Anterosuperior</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The anteroinferior quadrant presents tractus spiralis foraminous for transmission of cochlear nerve fibres .</li><li>• Option A:</li><li>• tractus spiralis foraminous</li><li>• cochlear nerve fibres</li><li>• Option B: Posteroinferior quadrant presents the inferior vestibular area for the inferior division of vestibular nerve . A foramen singular lies behind and below the inferior vestibular area for passage of a twig of vestibular nerve to reach the ampulla of the posterior semicircular duct .</li><li>• Option B:</li><li>• inferior vestibular area</li><li>• inferior division</li><li>• vestibular nerve</li><li>• behind</li><li>• below</li><li>• inferior vestibular area</li><li>• twig</li><li>• vestibular nerve</li><li>• ampulla</li><li>• posterior semicircular</li><li>• duct</li><li>• Option C: Posterosuperior quadrant presents superior vestibular area for superior division of vestibular nerve .</li><li>• Option C:</li><li>• superior vestibular area</li><li>• superior division</li><li>• vestibular nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Structures traversing internal acoustic meats include – Facial nerve , Vestibulocochlear Nerve and Labyrinthine Artery . The facial nerve passes through the anterosuperior quadrant .</li><li>➤ internal acoustic meats</li><li>➤ Facial nerve</li><li>➤ Vestibulocochlear Nerve</li><li>➤ Labyrinthine Artery</li><li>➤ anterosuperior quadrant</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 293</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 293</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following nucleus is not related to the Facial Nerve?", "options": [{"label": "A", "text": "Nucleus Tractus Solitarius", "correct": false}, {"label": "B", "text": "Inferior Salivatory Nucleus", "correct": true}, {"label": "C", "text": "Spinal Nucleus of Trigeminal Nerve", "correct": false}, {"label": "D", "text": "Lacrimatory Nucleus", "correct": false}], "correct_answer": "B. Inferior Salivatory Nucleus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Inferior Salivatory Nucleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The nucleus tractus solitarius is related to multiple cranial nerves , including the Facial nerve . It is involved in processing visceral sensory information and is associated with various functions, including taste perception , which is transmitted by the Facial nerve . It receives afferents from VII, IX and X</li><li>• Option A:</li><li>• multiple cranial</li><li>• nerves</li><li>• Facial nerve</li><li>• visceral sensory information</li><li>• taste perception</li><li>• Facial nerve</li><li>• afferents</li><li>• VII, IX</li><li>• X</li><li>• Option C: Spinal nucleus of trigeminal nerve receives pain temperature sensation from face . Alderman's nerve , the only cutaneous branch of Vagus communicates with facial nerve and through this communication facial nerve receives cutaneous sensation from auricle and relays in upper part of spinal nucleus of trigeminal nerve .</li><li>• Option C:</li><li>• pain temperature</li><li>• sensation</li><li>• face</li><li>• Alderman's nerve</li><li>• only cutaneous branch</li><li>• Vagus communicates</li><li>• facial nerve</li><li>• cutaneous sensation</li><li>• auricle</li><li>• relays</li><li>• upper part</li><li>• spinal nucleus</li><li>• trigeminal nerve</li><li>• Option D: Lacrimatory nucleus of facial nerve provides the preganglionic parasympathetic fibres for lacrimal gland . It is involved in controlling lacrimation ( tear production ) and salivation through parasympathetic pathways.</li><li>• Option D:</li><li>• preganglionic parasympathetic fibres</li><li>• lacrimal gland</li><li>• lacrimation</li><li>• tear production</li><li>• salivation</li><li>• parasympathetic pathways.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The inferior salivatory nucleus is related to the Glossopharyngeal nerve ( cranial nerve IX ), not the Facial nerve. It is responsible for parasympathetic innervation of the parotid gland .</li><li>➤ inferior salivatory nucleus</li><li>➤ Glossopharyngeal nerve</li><li>➤ cranial nerve IX</li><li>➤ parasympathetic innervation</li><li>➤ parotid gland</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 393</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the incorrect statement about the Intrapetrous Course of Facial Nerve?", "options": [{"label": "A", "text": "Passes Above the Vestibule of Inner Ear", "correct": false}, {"label": "B", "text": "Oblique Course over Medial Wall of Middle Ear", "correct": false}, {"label": "C", "text": "Vertical Course over Posterior Wall of Middle Ear", "correct": false}, {"label": "D", "text": "Horizontal Course over Anterior Wall of Middle Ear", "correct": true}], "correct_answer": "D. Horizontal Course over Anterior Wall of Middle Ear", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-131735.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-131758.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-131908.jpg"], "explanation": "<p><strong>Ans. D) Horizontal Course over Anterior Wall of Middle Ear</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: At the bottom of internal acoustic meatus the two roots of facial nerve unite to form a trunk which enters the bony facial canal and passes laterally above the vestibule of inner ear .</li><li>• Option A:</li><li>• bottom</li><li>• internal acoustic meatus</li><li>• two roots</li><li>• facial nerve</li><li>• trunk</li><li>• enters</li><li>• bony facial canal</li><li>• laterally</li><li>• above</li><li>• vestibule</li><li>• inner ear</li><li>• Option B: Facial nerve reaches the medial wall of epitympanic part of middle ear where it forms the external genu and presents geniculate ganglion .</li><li>• Option B:</li><li>• medial wall</li><li>• epitympanic part</li><li>• middle ear</li><li>• external genu</li><li>• geniculate ganglion</li><li>• Option C: From the genu facial nerve passes backward and downward lodging in the bony canal above the promontory and fenestra vestibuli . Then it descends vertically along the posterior wall of the tympanic cavity and exits through stylomastoid foramen .</li><li>• Option C:</li><li>• genu facial nerve</li><li>• backward</li><li>• downward</li><li>• bony canal</li><li>• above</li><li>• promontory</li><li>• fenestra vestibuli</li><li>• descends vertically</li><li>• posterior wall</li><li>• tympanic cavity</li><li>• exits</li><li>• stylomastoid foramen</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ After entering the temporal bone through the internal acoustic meatus , the facial nerve (CN VII) traverses the petrous part of the temporal bone in a complex path divided into segments:</li><li>➤ After entering</li><li>➤ temporal bone</li><li>➤ internal acoustic meatus</li><li>➤ facial nerve</li><li>➤ petrous part</li><li>➤ temporal bone</li><li>➤ Labyrinthine Segment: The shortest and narrowest part , which is located between the internal acoustic meatus and the geniculate ganglion . Tympanic Segment (Horizontal Segment): After the geniculate ganglion, the nerve turns sharply backward (at the first genu) to run horizontally in a bone canal called the facial canal . This segment is indeed above the oval window and crosses the medial (internal) wall of the tympanic cavity (middle ear ) horizontally. It is at this point that the nerve is closest to the middle ear cavity , making it vulnerable during middle ear surgeries . Mastoid Segment (Vertical Segment): After the horizontal segment, the nerve makes a second sharp turn (at the second genu ) to descend vertically in the posterior part of the temporal bone , heading toward the stylomastoid foramen , from where it exits the skull .</li><li>➤ Labyrinthine Segment: The shortest and narrowest part , which is located between the internal acoustic meatus and the geniculate ganglion .</li><li>➤ Labyrinthine Segment:</li><li>➤ shortest</li><li>➤ narrowest part</li><li>➤ internal acoustic meatus</li><li>➤ geniculate ganglion</li><li>➤ Tympanic Segment (Horizontal Segment): After the geniculate ganglion, the nerve turns sharply backward (at the first genu) to run horizontally in a bone canal called the facial canal . This segment is indeed above the oval window and crosses the medial (internal) wall of the tympanic cavity (middle ear ) horizontally. It is at this point that the nerve is closest to the middle ear cavity , making it vulnerable during middle ear surgeries .</li><li>➤ Tympanic Segment (Horizontal Segment):</li><li>➤ sharply backward</li><li>➤ horizontally</li><li>➤ facial canal</li><li>➤ above</li><li>➤ oval window</li><li>➤ crosses</li><li>➤ medial</li><li>➤ wall</li><li>➤ tympanic cavity</li><li>➤ )</li><li>➤ horizontally.</li><li>➤ closest</li><li>➤ middle ear cavity</li><li>➤ vulnerable</li><li>➤ middle ear surgeries</li><li>➤ Mastoid Segment (Vertical Segment): After the horizontal segment, the nerve makes a second sharp turn (at the second genu ) to descend vertically in the posterior part of the temporal bone , heading toward the stylomastoid foramen , from where it exits the skull .</li><li>➤ Mastoid Segment (Vertical Segment):</li><li>➤ second sharp turn</li><li>➤ second genu</li><li>➤ descend vertically</li><li>➤ posterior part</li><li>➤ temporal bone</li><li>➤ stylomastoid foramen</li><li>➤ exits</li><li>➤ skull</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 395</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 395</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with a painful rash on her right ear, right-sided facial weakness, and a sensation of spinning when moving her head. She also reports a decrease in hearing on the affected side and a metallic taste in her mouth. On examination, vesicular lesions are noted on the ear, and she is unable to close her right eye or lift her right corner of the mouth. The diagnosis of Ramsay Hunt syndrome is considered. Given the patient's presentation, in which part of the pinna of the ear are the vesicular lesions most likely to be found in Ramsay Hunt syndrome?", "options": [{"label": "A", "text": "Lobule", "correct": false}, {"label": "B", "text": "Anterior Wall of External Meatus", "correct": false}, {"label": "C", "text": "Tragus", "correct": false}, {"label": "D", "text": "Conchae", "correct": true}], "correct_answer": "D. Conchae", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-131946.jpg"], "explanation": "<p><strong>Ans. D) Conchae</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Lobule , Helix , Antihelix , Posterior part of Lateral Surface and most of cranial surface of auricle is innervated by Great auricular nerve .</li><li>• Option A:</li><li>• Lobule</li><li>• Helix</li><li>• Antihelix</li><li>• Posterior part</li><li>• Lateral Surface</li><li>• cranial surface</li><li>• auricle</li><li>• Great auricular nerve</li><li>• Option B: Anterior wall and roof of external meatus is innervated by auriculotemporal nerve.</li><li>• Option B:</li><li>• Anterior wall</li><li>• roof</li><li>• external meatus</li><li>• auriculotemporal nerve.</li><li>• Option C: Tragus , crus of helix and adjoining area of helix is innervated by auriculotemporal nerve.</li><li>• Option C:</li><li>• Tragus</li><li>• crus of</li><li>• helix</li><li>• adjoining area</li><li>• helix</li><li>• auriculotemporal nerve.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Conchae of the auricle and the posterior wall and roof of external auditory canal is innervated by the auricular branch of vagus nerve which communicates with facial nerve .</li><li>➤ Conchae</li><li>➤ auricle</li><li>➤ posterior wall</li><li>➤ roof</li><li>➤ external auditory canal</li><li>➤ auricular branch</li><li>➤ vagus nerve</li><li>➤ facial nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old man comes to the clinic complaining of a sudden loss of taste on the front two-thirds of his tongue. He denies any facial weakness, ear pain, or changes in his ability to produce tears when he yawns or eats. He has no history of recent illness, trauma, or ear infections. Physical examination does not reveal any facial asymmetry or abnormality in lacrimation. Given these findings, you consider the anatomy of the facial nerve and its branches that convey taste sensation from the anterior two-thirds of the tongue.", "options": [{"label": "A", "text": "Below Stylomastoid Foramen", "correct": false}, {"label": "B", "text": "At Geniculate Ganglion", "correct": false}, {"label": "C", "text": "At Internal Auditory Canal", "correct": false}, {"label": "D", "text": "Between Genu and Pyramidal Eminence", "correct": true}], "correct_answer": "D. Between Genu and Pyramidal Eminence", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132007.jpg"], "explanation": "<p><strong>Ans. D) Between Genu and Pyramidal Eminence</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The facial nerve exits the skull through the stylomastoid foramen , which is located between the styloid and mastoid processes of the temporal bone . This is where the facial nerve becomes vulnerable to compression or injury , leading to facial paralysis or other facial nerve-related symptoms . However, in this scenario, the patient does not present with facial weakness, so this option is less likely.</li><li>• Option A:</li><li>• facial nerve</li><li>• stylomastoid foramen</li><li>• styloid</li><li>• mastoid processes</li><li>• temporal bone</li><li>• vulnerable</li><li>• compression</li><li>• injury</li><li>• facial paralysis</li><li>• facial nerve-related symptoms</li><li>• Option B: The geniculate ganglion is a swelling on the facial nerve located within the facial canal . It contains the cell bodies of the sensory fibers responsible for taste sensation from the anterior two-thirds of the tongue . Damage to this ganglion could result in loss of taste sensation on the affected side of the tongue . However, the patient's symptoms of sudden taste loss suggest a more distal lesion along the course of the nerve</li><li>• Option B:</li><li>• geniculate ganglion</li><li>• swelling</li><li>• facial nerve</li><li>• facial canal</li><li>• cell bodies</li><li>• sensory fibers</li><li>• taste sensation</li><li>• anterior two-thirds</li><li>• tongue</li><li>• Damage</li><li>• ganglion</li><li>• loss</li><li>• taste sensation</li><li>• affected side</li><li>• tongue</li><li>• Option C: The internal auditory canal is where the facial nerve enters the temporal bone alongside the vestibulocochlear nerve ( cranial nerve VIII ). Lesions at this site typically present with symptoms related to both the facial nerve (such as facial weakness ) and the vestibulocochlear nerve (such as hearing loss or vertigo ). Since the patient does not have any other symptoms suggestive of vestibulocochlear nerve involvement, this option is less likely.</li><li>• Option C:</li><li>• internal auditory canal</li><li>• facial nerve</li><li>• temporal bone</li><li>• vestibulocochlear nerve</li><li>• cranial nerve VIII</li><li>• facial weakness</li><li>• vestibulocochlear nerve</li><li>• hearing loss</li><li>• vertigo</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The genu of the facial nerve is a sharp bend in its course as it passes around the medial side of the middle ear cavity . The pyramidal eminence is a bony prominence on the medial wall of the middle ear . Lesions between these two landmarks can affect the chorda tympani branch of the facial nerve , which carries taste sensation from the anterior two-thirds of the tongue . Damage to this branch could result in sudden loss of taste without affecting other functions of the facial nerve , such as facial movement or lacrimation . Therefore, lesion between genunand pyramidal eminence is the most likely explanation for the patient's symptoms.</li><li>➤ genu</li><li>➤ facial nerve</li><li>➤ sharp bend</li><li>➤ medial side</li><li>➤ middle ear cavity</li><li>➤ pyramidal eminence</li><li>➤ bony prominence</li><li>➤ medial wall</li><li>➤ middle ear</li><li>➤ chorda tympani</li><li>➤ facial nerve</li><li>➤ taste sensation</li><li>➤ anterior two-thirds</li><li>➤ tongue</li><li>➤ Damage</li><li>➤ branch</li><li>➤ sudden loss</li><li>➤ taste</li><li>➤ without affecting</li><li>➤ functions</li><li>➤ facial nerve</li><li>➤ facial movement</li><li>➤ lacrimation</li><li>➤ genunand pyramidal</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th Edition Pg 401</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Incorrect statement about Investing Layer of Deep Cervical Fascia:", "options": [{"label": "A", "text": "Encloses Sternocleidomastoid", "correct": false}, {"label": "B", "text": "Forms Sphenomandibular Ligament", "correct": true}, {"label": "C", "text": "Forms Roof for Posterior Triangle", "correct": false}, {"label": "D", "text": "Encloses Submandibular Gland", "correct": false}], "correct_answer": "B. Forms Sphenomandibular Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132035.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132048.jpg"], "explanation": "<p><strong>Ans. B) Forms Sphenomandibular Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Investing layer of deep cervical fascia splits to enclose sternocleidomastoid and trapezius .</li><li>• Option A:</li><li>• Investing layer</li><li>• deep cervical fascia</li><li>• enclose sternocleidomastoid</li><li>• trapezius</li><li>• Option C: Investing layer of deep cervical fascia forms the roof of anterior and posterior triangle .</li><li>• Option C:</li><li>• roof</li><li>• anterior</li><li>• posterior triangle</li><li>• Option D: Investing layer of deep cervical fascia splits to enclose submandibular and parotid salivary glands .</li><li>• Option D:</li><li>• submandibular</li><li>• parotid salivary glands</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The investing layer of deep cervical fascia thickens to form the stylomandibular ligament that separates the submandibular and parotid salivary gland . The sphenomandibular ligament is a remnant of Meckel's cartilage of the first pharyngeal arch .</li><li>➤ The investing layer of deep cervical fascia thickens to form the stylomandibular ligament that separates the submandibular and parotid salivary gland .</li><li>➤ thickens</li><li>➤ stylomandibular ligament</li><li>➤ separates</li><li>➤ submandibular</li><li>➤ parotid salivary gland</li><li>➤ The sphenomandibular ligament is a remnant of Meckel's cartilage of the first pharyngeal arch .</li><li>➤ remnant</li><li>➤ Meckel's</li><li>➤ cartilage</li><li>➤ first pharyngeal arch</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Danger Space of Neck lies between:", "options": [{"label": "A", "text": "Buccopharyngeal Fascia and Alar Fascia", "correct": false}, {"label": "B", "text": "Alar Fascia and Posterior Layer of Prevertebral Fascia", "correct": true}, {"label": "C", "text": "Pretracheal and Prevertebral Fascia", "correct": false}, {"label": "D", "text": "Pharyngobasilar Fascia and Buccopharyngeal Fascia", "correct": false}], "correct_answer": "B. Alar Fascia and Posterior Layer of Prevertebral Fascia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132146.jpg"], "explanation": "<p><strong>Ans. B) Alar Fascia and Posterior Layer of Prevertebral Fascia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Retropharyngeal space lies between buccopharyngeal fascia ( anteriorly ) and alar fascia ( posteriorly ) and is laterally related to the carotid sheath . Above-base of skull, below-superior mediastinum . It is found on either side of midline .</li><li>• Option A:</li><li>• Retropharyngeal space</li><li>• buccopharyngeal fascia</li><li>• anteriorly</li><li>• alar fascia</li><li>• posteriorly</li><li>• carotid sheath</li><li>• Above-base</li><li>• below-superior mediastinum</li><li>• either side</li><li>• midline</li><li>• Option C: Pretracheal fascia invests the larynx , trachea and splits to enclose thyroid gland .</li><li>• Option C:</li><li>• Pretracheal fascia</li><li>• larynx</li><li>• trachea</li><li>• splits</li><li>• thyroid gland</li><li>• Option D: Buccopharyngeal fascia covers the outer aspect of the constrictor muscles of pharynx and also extends to cover the outer surface of buccinator muscle .</li><li>• Option D:</li><li>• Buccopharyngeal fascia</li><li>• outer aspect</li><li>• constrictor muscles</li><li>• pharynx</li><li>• outer surface</li><li>• buccinator muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The danger space of the neck lies between the anterior layer ( alar fascia ) and posterior layer of prevertebral fascia . Superiorly it extends to the base of the skull and inferiorly to the posterior mediastinum since the posterior layer of the prevertebral layer fuses with anterior longitudinal ligament of the T1-T3 vertebra . It is unpaired and present in midline .</li><li>➤ The danger space of the neck lies between the anterior layer ( alar fascia ) and posterior layer of prevertebral fascia .</li><li>➤ danger space</li><li>➤ anterior layer</li><li>➤ alar fascia</li><li>➤ posterior layer</li><li>➤ prevertebral fascia</li><li>➤ Superiorly it extends to the base of the skull and inferiorly to the posterior mediastinum since the posterior layer of the prevertebral layer fuses with anterior longitudinal ligament of the T1-T3 vertebra . It is unpaired and present in midline .</li><li>➤ extends</li><li>➤ base</li><li>➤ skull</li><li>➤ inferiorly</li><li>➤ posterior mediastinum</li><li>➤ posterior layer</li><li>➤ prevertebral layer</li><li>➤ fuses</li><li>➤ anterior longitudinal ligament</li><li>➤ T1-T3 vertebra</li><li>➤ unpaired</li><li>➤ present</li><li>➤ midline</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 181-183</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 181-183</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old man with a history of hypertension and diabetes presents to the clinic with a pulsatile mass in his right neck that he noticed a few weeks ago. He denies any trauma, pain, or previous surgery in the area. On examination, a bruit is audible over the mass with auscultation. The mass is located in the right carotid triangle, defined by the anterior border of the sternocleidomastoid, the posterior belly of the digastric muscle, and the superior belly of the omohyoid muscle. Imaging studies are planned to further evaluate the mass and its vascular connections, particularly with the branches of the external carotid artery that traverse this region. Considering the location of the mass in the carotid triangle, which of the following branches of the external carotid artery is least likely to be involved in this clinical scenario?", "options": [{"label": "A", "text": "Ascending Pharyngeal Artery", "correct": false}, {"label": "B", "text": "Posterior Auricular Artery", "correct": true}, {"label": "C", "text": "Occipital Artery", "correct": false}, {"label": "D", "text": "Facial Artery", "correct": false}], "correct_answer": "B. Posterior Auricular Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132448.jpg"], "explanation": "<p><strong>Ans. B) Posterior Auricular Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Ascending pharyngeal artery ascends along the wall of the pharynx and reaches the base of the skull . Palatine branch of ascending pharyngeal artery passes through sinus of Morgagni .</li><li>• Option A:</li><li>• wall</li><li>• pharynx</li><li>• reaches</li><li>• base</li><li>• skull</li><li>• Palatine branch</li><li>• ascending pharyngeal artery</li><li>• sinus of Morgagni</li><li>• Option C: Occipital artery provides sternomastoid branches , mastoid , meningeal and muscular branches .</li><li>• Option C:</li><li>• sternomastoid branches</li><li>• mastoid</li><li>• meningeal</li><li>• muscular branches</li><li>• Option D: Facial artery in the cervical region provides ascending palatine , glandular , submental and inferior tonsillar branches .</li><li>• Option D:</li><li>• cervical region</li><li>• ascending palatine</li><li>• glandular</li><li>• submental</li><li>• inferior tonsillar branches</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the carotid triangle five branches of the external carotid artery are given off . It includes superior thyroid artery , ascending pharyngeal artery , lingual artery , facial artery and occipital artery .</li><li>➤ In the carotid triangle five branches of the external carotid artery are given off .</li><li>➤ carotid triangle</li><li>➤ five branches</li><li>➤ external carotid artery</li><li>➤ given off</li><li>➤ It includes superior thyroid artery , ascending pharyngeal artery , lingual artery , facial artery and occipital artery .</li><li>➤ superior thyroid artery</li><li>➤ ascending pharyngeal artery</li><li>➤ lingual artery</li><li>➤ facial artery</li><li>➤ occipital artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 322</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 322</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a Routine Physical Examination, a 45-Year-Old Woman is noted to have a palpable nodule on her thyroid gland. She reports no symptoms of hyperthyroidism or hypothyroidism, and her thyroid function tests are within normal limits. Given the presence of the thyroid nodule, further evaluation including ultrasound and fine-needle aspiration is planned. In preparation for potential surgical intervention, the surgical team reviews the vascular anatomy of the thyroid gland, focusing on the venous drainage, to minimize the risk of intraoperative bleeding. Understanding the venous drainage of the thyroid gland is crucial for thyroidectomy procedures. Which of the following veins is responsible for draining the middle thyroid vein?", "options": [{"label": "A", "text": "External Jugular Vein", "correct": false}, {"label": "B", "text": "Anterior Jugular Vein", "correct": false}, {"label": "C", "text": "Internal Jugular Vein", "correct": true}, {"label": "D", "text": "Oblique Jugular Vein", "correct": false}], "correct_answer": "C. Internal Jugular Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132646.jpg"], "explanation": "<p><strong>Ans. C) Internal Jugular Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: External jugular vein is present over the roof of the posterior triangle of neck and drains into subclavian vein .</li><li>• Option A:</li><li>• roof</li><li>• posterior triangle</li><li>• neck</li><li>• drains</li><li>• subclavian vein</li><li>• Option B: Anterior jugular vein runs near the anterior median line of neck and drains into external jugular vein .</li><li>• Option B:</li><li>• anterior median line</li><li>• neck</li><li>• external jugular vein</li><li>• Option D: Oblique jugular vein communicates internal jugular vein with the external jugular vein in the upper part of neck .</li><li>• Option D:</li><li>• internal jugular</li><li>• vein</li><li>• external jugular vein</li><li>• upper part</li><li>• neck</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior thyroid vein , middle thyroid vein and vein of kocher if present drains into the internal jugular vein . The inferior thyroid veins drain into left brachiocephalic vein .</li><li>➤ The superior thyroid vein , middle thyroid vein and vein of kocher if present drains into the internal jugular vein .</li><li>➤ The superior thyroid vein , middle thyroid vein and vein of kocher if present drains into the internal jugular vein .</li><li>➤ superior thyroid vein</li><li>➤ middle thyroid vein</li><li>➤ vein of kocher</li><li>➤ drains</li><li>➤ internal jugular vein</li><li>➤ The inferior thyroid veins drain into left brachiocephalic vein .</li><li>➤ The inferior thyroid veins drain into left brachiocephalic vein .</li><li>➤ left brachiocephalic vein</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 307</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 307</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Chief Source of Blood Supply to Parathyroid Glands is from:", "options": [{"label": "A", "text": "Superior Thyroid Artery", "correct": false}, {"label": "B", "text": "Superior Laryngeal Artery", "correct": false}, {"label": "C", "text": "Inferior Thyroid Artery", "correct": true}, {"label": "D", "text": "Cricothyroid Artery", "correct": false}], "correct_answer": "C. Inferior Thyroid Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132702.jpg"], "explanation": "<p><strong>Ans. C) Inferior Thyroid Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior thyroid artery gives rise to infrahyoid , cricothyroid , sternomastoid, superior laryngeal and glandular branches .</li><li>• Option A:</li><li>• infrahyoid</li><li>• cricothyroid</li><li>• sternomastoid,</li><li>• superior laryngeal</li><li>• glandular branches</li><li>• Option B: Superior laryngeal artery pierces thyrohyoid membrane along with internal laryngeal nerve .</li><li>• Option B:</li><li>• thyrohyoid membrane</li><li>• internal laryngeal</li><li>• nerve</li><li>• Option D: Cricothyroid artery arises from superior thyroid artery and passes across cricothyroid ligament to anastomose with artery of opposite side .</li><li>• Option D:</li><li>• superior thyroid artery</li><li>• cricothyroid ligament</li><li>• anastomose</li><li>• artery</li><li>• opposite side</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior thyroid artery that arises from thyrocervical trunk of first part of subclavian artery provides chief source of blood supply to parathyroid glands and also provides branches to supply trachea , oesophagus and pharynx .</li><li>➤ arises</li><li>➤ thyrocervical trunk</li><li>➤ first part</li><li>➤ subclavian artery</li><li>➤ chief source</li><li>➤ blood supply</li><li>➤ parathyroid glands</li><li>➤ branches</li><li>➤ supply trachea</li><li>➤ oesophagus</li><li>➤ pharynx</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 308</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 308</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 2-day-old newborn is brought to the pediatric clinic by concerned parents due to a noticeable, well-defined swelling on the right side of the head, which was not present at birth but developed a few hours after delivery. The baby was delivered vaginally with the assistance of vacuum extraction due to prolonged labor. The swelling does not cross suture lines and is non-tender on palpation. The rest of the physical examination is unremarkable, and the baby appears to be feeding well and is otherwise healthy. Given the clinical presentation and the history of vacuum-assisted delivery, which of the following best describes the location of bleeding in cephalhematoma, as observed in this newborn?", "options": [{"label": "A", "text": "Between First and Second Layer", "correct": false}, {"label": "B", "text": "Between Second and Third Layer", "correct": false}, {"label": "C", "text": "Between Third and Fourth Layer", "correct": false}, {"label": "D", "text": "Between Fifth Layer and Skull", "correct": true}], "correct_answer": "D. Between Fifth Layer and Skull", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132723.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132801.jpg"], "explanation": "<p><strong>Ans. D) Between Fifth Layer and Skull</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: First layer of scalp is provided with numerous sebaceous glands and is common site of sebaceous cysts .</li><li>• Option A:</li><li>• First layer</li><li>• scalp</li><li>• numerous sebaceous glands</li><li>• common site</li><li>• sebaceous cysts</li><li>• Option B: Second layer of scalp is made of dense connective tissue to which the walls of blood vessels are adhered and if cut results in profuse bleeding .</li><li>• Option B:</li><li>• Second layer</li><li>• scalp</li><li>• dense connective tissue</li><li>• walls</li><li>• blood vessels</li><li>• adhered</li><li>• cut results</li><li>• profuse bleeding</li><li>• Option C: Third layer of scalp is the aponeurotic layer with occipitofrontalis muscle , the fibres of gale aponeurotica if cut transversely will result in gaping of wounds . The fourth layer is made of loose connective tissue and is called dangerous layer of scalp .</li><li>• Option C:</li><li>• Third layer</li><li>• scalp</li><li>• aponeurotic layer</li><li>• occipitofrontalis muscle</li><li>• fibres</li><li>• gale aponeurotica</li><li>• gaping</li><li>• wounds</li><li>• fourth layer</li><li>• loose connective tissue</li><li>• dangerous layer of scalp</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cephalohematoma is a condition where bleeding occurs underneath the skin , over one or several cranial bones, in newborns. This hematoma is specifically found between the periosteum (the outer covering of the bone) and the skull bone itself . The periosteum can be considered as part of the \" fifth layer \" when enumerating the scalp layers , which include: Skin , Connective tissue , Aponeurosis (galea aponeurotica), Loose connective tissue and Periosteum (Pericranium). Cephalohematoma is confined by the sutures of the skull because the periosteum is tightly adhered to the bone at the sutures . This means the bleeding does not cross suture lines, distinguishing cephalohematomas from other types of swelling or bleeding, such as caput succedaneum, which can cross suture lines.</li><li>➤ Cephalohematoma is a condition where bleeding occurs underneath the skin , over one or several cranial bones, in newborns. This hematoma is specifically found between the periosteum (the outer covering of the bone) and the skull bone itself . The periosteum can be considered as part of the \" fifth layer \" when enumerating the scalp layers , which include: Skin , Connective tissue , Aponeurosis (galea aponeurotica), Loose connective tissue and Periosteum (Pericranium).</li><li>➤ Cephalohematoma is a condition where bleeding occurs underneath the skin , over one or several cranial bones, in newborns. This hematoma is specifically found between the periosteum (the outer covering of the bone) and the skull bone itself . The periosteum can be considered as part of the \" fifth layer \" when enumerating the scalp layers , which include: Skin , Connective tissue , Aponeurosis (galea aponeurotica), Loose connective tissue and Periosteum (Pericranium).</li><li>➤ Cephalohematoma</li><li>➤ bleeding</li><li>➤ underneath</li><li>➤ skin</li><li>➤ specifically found</li><li>➤ periosteum</li><li>➤ outer covering</li><li>➤ skull bone itself</li><li>➤ periosteum</li><li>➤ fifth layer</li><li>➤ enumerating</li><li>➤ scalp layers</li><li>➤ Skin</li><li>➤ Connective tissue</li><li>➤ Aponeurosis</li><li>➤ Loose connective tissue</li><li>➤ Periosteum</li><li>➤ Cephalohematoma is confined by the sutures of the skull because the periosteum is tightly adhered to the bone at the sutures . This means the bleeding does not cross suture lines, distinguishing cephalohematomas from other types of swelling or bleeding, such as caput succedaneum, which can cross suture lines.</li><li>➤ Cephalohematoma is confined by the sutures of the skull because the periosteum is tightly adhered to the bone at the sutures . This means the bleeding does not cross suture lines, distinguishing cephalohematomas from other types of swelling or bleeding, such as caput succedaneum, which can cross suture lines.</li><li>➤ sutures</li><li>➤ skull</li><li>➤ periosteum</li><li>➤ tightly adhered</li><li>➤ bone</li><li>➤ sutures</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 68</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 68</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Least Vascular Part of Intra Articular Disc of Temporomandibular Joint is:", "options": [{"label": "A", "text": "Anterior Extension", "correct": false}, {"label": "B", "text": "Anterior Band", "correct": false}, {"label": "C", "text": "Intermediate Zone", "correct": true}, {"label": "D", "text": "Posterior Band", "correct": false}], "correct_answer": "C. Intermediate Zone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-132819.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-133110.jpg"], "explanation": "<p><strong>Ans. C) Intermediate Zone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The intra articular disc is made of five zones from before backwards anterior extension , anterior thick band , intermediate zone , posterior thick band and bilamellar region</li><li>• Option A:</li><li>• intra articular disc</li><li>• five zones</li><li>• before backwards</li><li>• anterior extension</li><li>• anterior thick band</li><li>• intermediate zone</li><li>• posterior thick</li><li>• band</li><li>• bilamellar region</li><li>• Option B: Lateral pterygoid muscle inserts into the capsule of temporomandibular joint and the intra articular disc is considered to be a morphologic remnant of lateral pterygoid muscle .</li><li>• Option B:</li><li>• Lateral pterygoid muscle</li><li>• capsule</li><li>• temporomandibular joint</li><li>• intra articular disc</li><li>• morphologic remnant</li><li>• lateral pterygoid muscle</li><li>• Option C: The intra articular disc divides the joint cavity into two compartments and posteriorly the disc is split into upper and lower lamellae by venous plexus .</li><li>• Option C:</li><li>• intra articular disc</li><li>• joint cavity</li><li>• two compartments</li><li>• posteriorly</li><li>• disc</li><li>• split</li><li>• upper</li><li>• lower lamellae</li><li>• venous plexus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Intra-Articular Disc of the Temporo-Mandibular Joint (TMJ) is a fibrocartilaginous structure that divides the joint into two compartments . The disc has a biconcave , or saddle-shaped , configuration and is thicker at its periphery than at its center . The vascularity of the TMJ disc varies across its structure, with the peripheral regions having more blood supply compared to the central areas . The central portion of the TMJ disc , particularly the intermediate zone , is the least vascular part . This area is designed to withstand high compressive forces during jaw movements , such as chewing and speaking , and consists mainly of dense fibrous connective tissue with very few or no blood vessels. The lack of vascularity in this area contributes to the disc's ability to distribute mechanical stress without undergoing significant deformation or damage .</li><li>➤ The Intra-Articular Disc of the Temporo-Mandibular Joint (TMJ) is a fibrocartilaginous structure that divides the joint into two compartments . The disc has a biconcave , or saddle-shaped , configuration and is thicker at its periphery than at its center . The vascularity of the TMJ disc varies across its structure, with the peripheral regions having more blood supply compared to the central areas .</li><li>➤ Intra-Articular Disc</li><li>➤ Temporo-Mandibular Joint (TMJ)</li><li>➤ fibrocartilaginous structure</li><li>➤ two compartments</li><li>➤ biconcave</li><li>➤ saddle-shaped</li><li>➤ configuration</li><li>➤ thicker</li><li>➤ periphery</li><li>➤ center</li><li>➤ vascularity</li><li>➤ TMJ disc</li><li>➤ peripheral</li><li>➤ blood supply</li><li>➤ central areas</li><li>➤ The central portion of the TMJ disc , particularly the intermediate zone , is the least vascular part . This area is designed to withstand high compressive forces during jaw movements , such as chewing and speaking , and consists mainly of dense fibrous connective tissue with very few or no blood vessels. The lack of vascularity in this area contributes to the disc's ability to distribute mechanical stress without undergoing significant deformation or damage .</li><li>➤ central portion</li><li>➤ TMJ disc</li><li>➤ intermediate zone</li><li>➤ least vascular part</li><li>➤ withstand high compressive forces</li><li>➤ jaw movements</li><li>➤ chewing</li><li>➤ speaking</li><li>➤ dense fibrous connective tissue</li><li>➤ lack</li><li>➤ vascularity</li><li>➤ contributes</li><li>➤ disc's ability</li><li>➤ distribute mechanical stress</li><li>➤ without</li><li>➤ deformation</li><li>➤ damage</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 111</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 111</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Skin over Angle of Mandible innervated by:", "options": [{"label": "A", "text": "Mandibular Nerve", "correct": false}, {"label": "B", "text": "Maxillary Nerve", "correct": false}, {"label": "C", "text": "Great Auricular Nerve", "correct": true}, {"label": "D", "text": "Infratrochlear Nerve", "correct": false}], "correct_answer": "C. Great Auricular Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-133130.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-133143.jpg"], "explanation": "<p><strong>Ans. C) Great Auricular Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Mandibular division of trigeminal nerve supplies the skin over lower lip , chin , over mandible excluding its Angle , part of Pinna , External Acoustic Meatus and most of the temple .</li><li>• Option A:</li><li>• trigeminal nerve</li><li>• skin</li><li>• lower lip</li><li>• chin</li><li>• over mandible</li><li>• Angle</li><li>• part of Pinna</li><li>• External Acoustic Meatus</li><li>• most</li><li>• temple</li><li>• Option B: Maxillary division of trigeminal nerve supplies the skin over upper lip , part of the side of nose , lower eyelid , lower eyelid , malar prominence and small portion of temple .</li><li>• Option B:</li><li>• trigeminal nerve</li><li>• skin</li><li>• upper lip</li><li>• part</li><li>• side of nose</li><li>• lower eyelid</li><li>• lower eyelid</li><li>• malar prominence</li><li>• small portion</li><li>• temple</li><li>• Option D: Infratrochlear nerve, branch of ophthalmic nerve which supplies skin over tip and side of nose , upper eyelid and forehead.</li><li>• Option D:</li><li>• ophthalmic nerve</li><li>• skin</li><li>• tip</li><li>• side of nose</li><li>• upper eyelid</li><li>• forehead.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The skin over the angle of mandible is primarily innervated by the great auricular nerve . The great auricular nerve is a branch of the cervical plexus , arising from the ventral rami of C2 and C3 spinal nerves . It ascends along the sternocleidomastoid muscle , then curves around its posterior border to reach the skin over the parotid gland , the angle of the mandible , and the area around the ear .</li><li>➤ The skin over the angle of mandible is primarily innervated by the great auricular nerve .</li><li>➤ The skin over the angle of mandible is primarily innervated by the great auricular nerve .</li><li>➤ skin</li><li>➤ angle</li><li>➤ mandible</li><li>➤ great auricular nerve</li><li>➤ The great auricular nerve is a branch of the cervical plexus , arising from the ventral rami of C2 and C3 spinal nerves . It ascends along the sternocleidomastoid muscle , then curves around its posterior border to reach the skin over the parotid gland , the angle of the mandible , and the area around the ear .</li><li>➤ The great auricular nerve is a branch of the cervical plexus , arising from the ventral rami of C2 and C3 spinal nerves . It ascends along the sternocleidomastoid muscle , then curves around its posterior border to reach the skin over the parotid gland , the angle of the mandible , and the area around the ear .</li><li>➤ cervical plexus</li><li>➤ ventral rami</li><li>➤ C2</li><li>➤ C3 spinal nerves</li><li>➤ ascends</li><li>➤ sternocleidomastoid muscle</li><li>➤ curves</li><li>➤ posterior border</li><li>➤ reach</li><li>➤ skin</li><li>➤ parotid gland</li><li>➤ angle</li><li>➤ mandible</li><li>➤ area</li><li>➤ ear</li><li>➤ This nerve provides sensory innervation to the skin in these areas , making it responsible for the sensation over the angle of the mandible .</li><li>➤ This nerve provides sensory innervation to the skin in these areas , making it responsible for the sensation over the angle of the mandible .</li><li>➤ This nerve provides sensory innervation to the skin in these areas , making it responsible for the sensation over the angle of the mandible .</li><li>➤ sensory innervation</li><li>➤ skin</li><li>➤ areas</li><li>➤ responsible</li><li>➤ sensation</li><li>➤ over</li><li>➤ angle</li><li>➤ mandible</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 85</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 85</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle of Mastication innervated by Trunk of Mandibular Nerve:", "options": [{"label": "A", "text": "Masseter", "correct": false}, {"label": "B", "text": "Medial Pterygoid", "correct": true}, {"label": "C", "text": "Lateral Pterygoid", "correct": false}, {"label": "D", "text": "Temporalis", "correct": false}], "correct_answer": "B. Medial Pterygoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-17-133202.jpg"], "explanation": "<p><strong>Ans. B) Medial Pterygoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A : Masseter is innervated by the anterior division of mandibular nerve and is strong elevator of mandible .</li><li>• Option A</li><li>• anterior division</li><li>• mandibular nerve</li><li>• strong</li><li>• elevator</li><li>• mandible</li><li>• Option C: Lateral Pterygoid is innervated by the anterior division of mandibular nerve and is a depressor of mandible .</li><li>• Option C:</li><li>• anterior division</li><li>• mandibular nerve</li><li>• depressor</li><li>• mandible</li><li>• Option D: Temporalis is innervated by the anterior division of mandibular nerve and its posterior fibres are retractors of mandible .</li><li>• Option D:</li><li>• anterior division</li><li>• mandibular nerve</li><li>• posterior fibres</li><li>• retractors</li><li>• mandible</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The trunk of the mandibular nerve gives rise to nerve to medial pterygoid that innervates medial pterygoid and also tensor tympani , tensor palatini . Nervous spinosus also arises from the trunk .</li><li>➤ The trunk of the mandibular nerve gives rise to nerve to medial pterygoid that innervates medial pterygoid and also tensor tympani , tensor palatini .</li><li>➤ trunk</li><li>➤ mandibular nerve</li><li>➤ rise</li><li>➤ nerve</li><li>➤ medial pterygoid</li><li>➤ medial pterygoid</li><li>➤ tensor tympani</li><li>➤ tensor palatini</li><li>➤ Nervous spinosus also arises from the trunk .</li><li>➤ arises</li><li>➤ trunk</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 102</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures is not affected during tonsillectomy procedures?", "options": [{"label": "A", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "B", "text": "External Carotid Artery", "correct": true}, {"label": "C", "text": "Internal Carotid Artery", "correct": false}, {"label": "D", "text": "Paratonsillar Vein", "correct": false}], "correct_answer": "B. External Carotid Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-144833.jpg"], "explanation": "<p><strong>Ans. B) External Carotid Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Glossopharyngeal nerve- Styloglossus muscle along with IX nerve is related to the anteroinferior 1/3 of lateral wall of tonsil .</li><li>• Option A:</li><li>• Styloglossus muscle</li><li>• IX nerve</li><li>• anteroinferior 1/3</li><li>• lateral wall</li><li>• tonsil</li><li>• Option C: Internal carotid artery lies 2.5cm behind and lateral to tonsillar sinus .</li><li>• Option C:</li><li>• 2.5cm behind</li><li>• lateral</li><li>• tonsillar sinus</li><li>• Option D: Paratonsillar vein lies in the loose areolar tissue along the lateral aspect of the tonsil . The facial artery , its ascending palatine branch and its tonsillar branches , ascending pharyngeal artery also form its lateral relations for palatine tonsil .</li><li>• Option D:</li><li>• loose areolar tissue</li><li>• lateral aspect</li><li>• tonsil</li><li>• facial artery</li><li>• ascending palatine branch</li><li>• tonsillar branches</li><li>• ascending pharyngeal artery</li><li>• lateral relations</li><li>• palatine tonsil</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ During a tonsillectomy, which is the surgical removal of the palatine tonsils , the external carotid artery is not typically affected . The palatine tonsils are located in the tonsillar fossa between the palatoglossal and palatopharyngeal arches . While there are several structures in close proximity to the tonsils that could potentially be affected during surgery , such as the glossopharyngeal nerve ( CN IX ), the tonsillar branches of the facial artery , and the lingual artery , the external carotid artery itself is located more deeply and laterally relative to the tonsil and is not directly involved in a standard tonsillectomy procedure. Therefore, it is generally not at risk during this surgery.</li><li>➤ During a tonsillectomy, which is the surgical removal of the palatine tonsils , the external carotid artery is not typically affected .</li><li>➤ surgical removal</li><li>➤ palatine tonsils</li><li>➤ external carotid artery</li><li>➤ not</li><li>➤ affected</li><li>➤ The palatine tonsils are located in the tonsillar fossa between the palatoglossal and palatopharyngeal arches .</li><li>➤ palatine tonsils</li><li>➤ tonsillar fossa</li><li>➤ palatoglossal</li><li>➤ palatopharyngeal arches</li><li>➤ While there are several structures in close proximity to the tonsils that could potentially be affected during surgery , such as the glossopharyngeal nerve ( CN IX ), the tonsillar branches of the facial artery , and the lingual artery , the external carotid artery itself is located more deeply and laterally relative to the tonsil and is not directly involved in a standard tonsillectomy procedure. Therefore, it is generally not at risk during this surgery.</li><li>➤ tonsils</li><li>➤ potentially</li><li>➤ affected</li><li>➤ surgery</li><li>➤ glossopharyngeal nerve</li><li>➤ CN IX</li><li>➤ tonsillar branches</li><li>➤ facial artery</li><li>➤ lingual artery</li><li>➤ external carotid artery</li><li>➤ deeply</li><li>➤ laterally</li><li>➤ tonsil</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Trigeminal Nerve supplies all of the following muscles except:", "options": [{"label": "A", "text": "Tensor Tympani", "correct": false}, {"label": "B", "text": "Tensor Veli Palatini", "correct": false}, {"label": "C", "text": "Levatorveli Palatini", "correct": true}, {"label": "D", "text": "Anterior Belly of Digastric", "correct": false}], "correct_answer": "C. Levatorveli Palatini", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-144901.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/whatsapp-image-2024-02-20-at-150457.jpeg"], "explanation": "<p><strong>Ans. C) Levatorveli Palatine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Tensor tympani-muscle of middle ear , derivative of first pharyngeal arch innervated by mandibular division of trigeminal nerve . The tensor tympani muscle, which dampens sounds , such as those produced by chewing , is innervated by the mandibular branch of the trigeminal nerve ( V3 ).</li><li>• Option A:</li><li>• middle ear</li><li>• first pharyngeal arch</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• dampens</li><li>• sounds</li><li>• chewing</li><li>• mandibular branch</li><li>• trigeminal nerve</li><li>• V3</li><li>• Option B: Tensor veli palatini tendon expands to form palatine aponeurosis , it's also called dilator tubae muscle and is innervated by trunk of mandibular division of trigeminal nerve . The tensor veli palatini muscle, which helps open the Eustachian tube during swallowing and yawning , is also innervated by the mandibular branch of the trigeminal nerve ( V3 ).</li><li>• Option B:</li><li>• palatine aponeurosis</li><li>• dilator tubae muscle</li><li>• trunk</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• open</li><li>• Eustachian tube</li><li>• swallowing</li><li>• yawning</li><li>• mandibular branch</li><li>• trigeminal nerve</li><li>• V3</li><li>• Option D: Anterior belly of digastric- innervated by nerve to mylohyoid , a branch of inferior alveolar nerve that arises from mandibular division of trigeminal nerve . The anterior belly of the digastric muscle , which aids in depressing the mandible , is innervated by the mylohyoid nerve , a branch of the mandibular branch of the trigeminal nerve ( V3 ).</li><li>• Option D:</li><li>• nerve</li><li>• mylohyoid</li><li>• inferior alveolar nerve</li><li>• arises</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• anterior belly</li><li>• digastric muscle</li><li>• depressing</li><li>• mandible</li><li>• mylohyoid nerve</li><li>• mandibular branch</li><li>• trigeminal nerve</li><li>• V3</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The levator veli palatini muscle, responsible for elevating the soft palate during swallowing and speaking , is not innervated by the trigeminal nerve. Instead, it is innervated by the pharyngeal plexus , with contributions mainly from the vagus nerve ( CN X ).</li><li>➤ elevating</li><li>➤ soft palate</li><li>➤ swallowing</li><li>➤ speaking</li><li>➤ innervated</li><li>➤ pharyngeal plexus</li><li>➤ vagus nerve</li><li>➤ CN X</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 109</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 109</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nasal Septum is formed by ALL except:", "options": [{"label": "A", "text": "Perpendicular Plate of Palatine Bone", "correct": true}, {"label": "B", "text": "Ethmoid", "correct": false}, {"label": "C", "text": "Vomer", "correct": false}, {"label": "D", "text": "Sphenoid", "correct": false}], "correct_answer": "A. Perpendicular Plate of Palatine Bone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/screenshot-2024-02-20-144941.jpg"], "explanation": "<p><strong>Ans. A) Perpendicular Plate of Palatine Bone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Perpendicular plate of ethmoid contributes to the anterosuperior portion of nasal septum .</li><li>• Option B:</li><li>• ethmoid</li><li>• anterosuperior portion</li><li>• nasal septum</li><li>• Option C: Vomer, the unpaired bone contributes to the posteroinferior portion of nasal septum .</li><li>• Option C:</li><li>• unpaired bone</li><li>• posteroinferior portion</li><li>• nasal septum</li><li>• Option D: Minor contribution to the septum in its posterosuperior portion comes from the sphenoidal crest .</li><li>• Option D:</li><li>• posterosuperior portion</li><li>• sphenoidal crest</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The nasal septum is the structure that divides the nasal cavity into two nostrils (or nasal passages ). It is composed of both bone and cartilage . The nasal septum is formed by:</li><li>➤ nasal septum</li><li>➤ divides</li><li>➤ nasal cavity</li><li>➤ two nostrils</li><li>➤ nasal passages</li><li>➤ both bone</li><li>➤ cartilage</li><li>➤ Perpendicular Plate of the Ethmoid Bone: This is a thin , vertical bone that forms the superior part of the nasal septum . The ethmoid bone is one of the cranial bones and contributes significantly to the structure of the nasal cavity . Vomer Bone: The vomer is a thin , plow-shaped bone that forms the inferior and posterior parts of the nasal septum . It articulates above with the perpendicular plate of the ethmoid bone and below with the maxillary and palatine bones . Septal Cartilage (Quadrangular Cartilage): This is a flexible cartilage that fills in the anterior part of the nasal septum . It extends from the nasal bones in the roof of the nose down to the maxillary bones in the floor .</li><li>➤ Perpendicular Plate of the Ethmoid Bone: This is a thin , vertical bone that forms the superior part of the nasal septum . The ethmoid bone is one of the cranial bones and contributes significantly to the structure of the nasal cavity .</li><li>➤ Perpendicular Plate of the Ethmoid Bone:</li><li>➤ thin</li><li>➤ vertical bone</li><li>➤ superior part</li><li>➤ nasal septum</li><li>➤ cranial bones</li><li>➤ nasal cavity</li><li>➤ Vomer Bone: The vomer is a thin , plow-shaped bone that forms the inferior and posterior parts of the nasal septum . It articulates above with the perpendicular plate of the ethmoid bone and below with the maxillary and palatine bones .</li><li>➤ Vomer Bone:</li><li>➤ thin</li><li>➤ plow-shaped bone</li><li>➤ forms</li><li>➤ inferior</li><li>➤ posterior parts</li><li>➤ nasal septum</li><li>➤ perpendicular plate</li><li>➤ ethmoid bone</li><li>➤ below</li><li>➤ maxillary</li><li>➤ palatine bones</li><li>➤ Septal Cartilage (Quadrangular Cartilage): This is a flexible cartilage that fills in the anterior part of the nasal septum . It extends from the nasal bones in the roof of the nose down to the maxillary bones in the floor .</li><li>➤ Septal Cartilage (Quadrangular Cartilage):</li><li>➤ flexible cartilage</li><li>➤ fills</li><li>➤ anterior part</li><li>➤ nasal septum</li><li>➤ nasal bones</li><li>➤ roof</li><li>➤ nose</li><li>➤ down</li><li>➤ maxillary bones</li><li>➤ floor</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 20</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 20</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Cavernous sinus receives input from:", "options": [{"label": "A", "text": "Superior Petrosal Sinus", "correct": false}, {"label": "B", "text": "Inferior Petrosal Sinus", "correct": false}, {"label": "C", "text": "Deep Middle Cerebral Vein", "correct": false}, {"label": "D", "text": "Superficial Middle Cerebral Vein", "correct": true}], "correct_answer": "D. Superficial Middle Cerebral Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture71.jpg"], "explanation": "<p><strong>Ans. D) Superficial Middle Cerebral Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A &amp; B: Superior and inferior petrosal sinus are the outgoing channels of cavernous sinus. Cavernous sinus communicates with transverse sinus via superior petrosal sinus and with internal jugular vein via inferior petrosal sinus .</li><li>• Option A &amp; B:</li><li>• Superior</li><li>• inferior petrosal sinus</li><li>• transverse sinus</li><li>• superior petrosal sinus</li><li>• internal jugular vein</li><li>• inferior petrosal sinus</li><li>• Option C: Deep middle cerebral vein unites with anterior cerebral vein and striate veins to form the basal vein .</li><li>• Option C:</li><li>• Deep middle cerebral vein</li><li>• anterior cerebral vein</li><li>• striate veins</li><li>• basal vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Superficial middle cerebral vein lies over the posterior ramus of the lateral sulcus and drains the superolateral surface of the cerebral hemisphere into cavernous sinus .</li><li>➤ Superficial middle cerebral</li><li>➤ posterior ramus</li><li>➤ lateral sulcus</li><li>➤ superolateral surface</li><li>➤ cerebral hemisphere</li><li>➤ cavernous sinus</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 351</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 351</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man presents to the emergency department with severe pain in the left side of his face, fever, and difficulty swallowing. He has a history of poorly controlled diabetes mellitus. On examination, there is noticeable swelling and tenderness over the left parotid region, and trismus is present. Imaging studies reveal an abscess in the deep lobe of the left parotid gland with extension into the adjacent parapharyngeal space. The patient is started on intravenous antibiotics and is being evaluated for possible surgical drainage. In the context of this patient's presentation and the anatomical considerations of parotid gland abscesses, which of the following statements is correct?", "options": [{"label": "A", "text": "Stenson's Duct opens into Vestibule of Mouth opposite Upper Third Molar", "correct": false}, {"label": "B", "text": "External Carotid Artery pierces the Posterior Border to enter the Gland", "correct": false}, {"label": "C", "text": "Majority of Lymph Nodes are embedded in Deep Lobe", "correct": false}, {"label": "D", "text": "Deep Lobe Abscess can extend into Parapharyngeal Space", "correct": true}], "correct_answer": "D. Deep Lobe Abscess can extend into Parapharyngeal Space", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture70.jpg"], "explanation": "<p><strong>Ans. D) Deep Lobe Abscess can extend into Parapharyngeal Space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Stenson's duct opens into vestibule of mouth opposite upper second molar .</li><li>• Option A:</li><li>• upper second molar</li><li>• Option B: External carotid artery pierces the posteromedial surface to enter the gland.</li><li>• Option B:</li><li>• posteromedial surface</li><li>• Option C: The facio venous plane of Patey divides the gland into superficial and deep lobe . The parotid lymph nodes lie over the superficial surface .</li><li>• Option C:</li><li>• superficial</li><li>• deep lobe</li><li>• superficial</li><li>• surface</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The parapharyngeal space is bounded posterolaterally by parotid gland hence spread of abscess from parotid gland into this space and its further spread can result in Ludwig’s angina .</li><li>➤ posterolaterally</li><li>➤ parotid gland</li><li>➤ spread</li><li>➤ abscess</li><li>➤ parotid gland</li><li>➤ space</li><li>➤ Ludwig’s angina</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 96</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 96</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Component of Inner Waldeyer Ring are ALL Except:", "options": [{"label": "A", "text": "Upper Deep Cervical Nodes", "correct": true}, {"label": "B", "text": "Tubal Tonsil", "correct": false}, {"label": "C", "text": "Palatine Tonsil", "correct": false}, {"label": "D", "text": "Lymphatic Tissue over Posterior 1/3 Tongue", "correct": false}], "correct_answer": "A. Upper Deep Cervical Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture69.jpg"], "explanation": "<p><strong>Ans. A) Upper Deep Cervical Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Tubal tonsil -part of waldeyer ring found in lateral wall of nasopharynx overlying tubal elevation .</li><li>• Option B:</li><li>• waldeyer ring</li><li>• lateral wall</li><li>• nasopharynx</li><li>• tubal elevation</li><li>• Option C: Palatine tonsil part of waldeyer ring found in lateral wall of oropharynx .</li><li>• Option C:</li><li>• waldeyer ring</li><li>• lateral wall</li><li>• oropharynx</li><li>• Option D: Lymphatic tissue over posterior 1/3 tongue contribute to Lingual tonsil and part of waldeyer ring .</li><li>• Option D:</li><li>• Lingual tonsil</li><li>• waldeyer ring</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Waldeyer's ring is a ring of lymphoid tissue located in the throat and nasopharynx . It forms part of the body's immune system by encircling the entrance to the pharynx and providing a defense against inhaled and ingested pathogens . The Waldeyer's ring includes both outer and inner components .</li><li>➤ The Waldeyer's ring is a ring of lymphoid tissue located in the throat and nasopharynx .</li><li>➤ throat</li><li>➤ nasopharynx</li><li>➤ It forms part of the body's immune system by encircling the entrance to the pharynx and providing a defense against inhaled and ingested pathogens .</li><li>➤ body's immune system</li><li>➤ encircling</li><li>➤ entrance</li><li>➤ pharynx</li><li>➤ defense against inhaled</li><li>➤ ingested pathogens</li><li>➤ The Waldeyer's ring includes both outer and inner components .</li><li>➤ Waldeyer's ring</li><li>➤ both outer</li><li>➤ inner components</li><li>➤ The inner components of the Waldeyer's ring typically refer to the lymphoid tissues that are situated more deeply or posteriorly in the nasopharynx and oropharynx . These include:</li><li>➤ lymphoid tissues</li><li>➤ deeply</li><li>➤ posteriorly</li><li>➤ nasopharynx</li><li>➤ oropharynx</li><li>➤ Pharyngeal Tonsil (Adenoids): Located in the roof of the nasopharynx , the pharyngeal tonsil enlarges during childhood and tends to atrophy with age . It is a significant part of the body's immune defense , especially in children . Tubal Tonsils: These are located near the openings of the Eustachian tubes in the nasopharynx . The tubal tonsils are smaller lymphoid tissues that, along with the adenoids and other components, form the ring of lymphoid tissue . Lingual Tonsil: Situated at the base of the tongue , the lingual tonsil is part of the Waldeyer's ring , contributing to the immune defense at the entrance of the oropharynx and laryngopharynx .</li><li>➤ Pharyngeal Tonsil (Adenoids): Located in the roof of the nasopharynx , the pharyngeal tonsil enlarges during childhood and tends to atrophy with age . It is a significant part of the body's immune defense , especially in children .</li><li>➤ Pharyngeal Tonsil (Adenoids):</li><li>➤ roof</li><li>➤ nasopharynx</li><li>➤ pharyngeal tonsil</li><li>➤ childhood</li><li>➤ atrophy</li><li>➤ age</li><li>➤ body's immune defense</li><li>➤ children</li><li>➤ Tubal Tonsils: These are located near the openings of the Eustachian tubes in the nasopharynx . The tubal tonsils are smaller lymphoid tissues that, along with the adenoids and other components, form the ring of lymphoid tissue .</li><li>➤ Tubal Tonsils:</li><li>➤ openings</li><li>➤ Eustachian tubes</li><li>➤ nasopharynx</li><li>➤ smaller lymphoid tissues</li><li>➤ adenoids</li><li>➤ ring</li><li>➤ lymphoid tissue</li><li>➤ Lingual Tonsil: Situated at the base of the tongue , the lingual tonsil is part of the Waldeyer's ring , contributing to the immune defense at the entrance of the oropharynx and laryngopharynx .</li><li>➤ Lingual Tonsil:</li><li>➤ base</li><li>➤ tongue</li><li>➤ lingual tonsil</li><li>➤ Waldeyer's ring</li><li>➤ immune defense</li><li>➤ entrance</li><li>➤ oropharynx</li><li>➤ laryngopharynx</li><li>➤ The outer components typically refer to the more anteriorly placed palatine tonsils , which are located at the sides of the throat , and sometimes the palatoglossal and palatopharyngeal arches , which are muscular folds adjacent to the palatine tonsils .</li><li>➤ anteriorly</li><li>➤ palatine tonsils</li><li>➤ sides</li><li>➤ throat</li><li>➤ palatoglossal</li><li>➤ palatopharyngeal arches</li><li>➤ muscular folds</li><li>➤ palatine tonsils</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is incorrect about Pterygopalatine Fossa:", "options": [{"label": "A", "text": "Contains Third Part of Maxillary Artery", "correct": false}, {"label": "B", "text": "Medially communicates with Infratemporal Fossa", "correct": true}, {"label": "C", "text": "Communicates with Middle through Foramen Rotundum", "correct": false}, {"label": "D", "text": "Vidian Nerve Canal opens into it", "correct": false}], "correct_answer": "B. Medially communicates with Infratemporal Fossa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture60.jpg"], "explanation": "<p><strong>Ans. B) Medially communicates with Infratemporal Fossa.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Maxillary artery divided by lateral pterygoid muscle into 3 parts . The first and second part lie in infratemporal fossa .</li><li>• Option A:</li><li>• lateral pterygoid muscle</li><li>• 3</li><li>• parts</li><li>• first</li><li>• second part</li><li>• infratemporal fossa</li><li>• Option C: Maxillary division of trigeminal nerve reaches pterygopalatine fossa via foramen rotundum .</li><li>• Option C:</li><li>• Maxillary division</li><li>• trigeminal nerve</li><li>• pterygopalatine fossa</li><li>• foramen rotundum</li><li>• Option D: Nerve of pterygoid canal reaches pterygopalatine fossa from middle cranial fossa via vidain nerve canal .</li><li>• Option D:</li><li>• Nerve of pterygoid canal</li><li>• pterygopalatine fossa</li><li>• middle cranial fossa</li><li>• vidain nerve canal</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pterygopalatine fossa medially related to perpendicular plate of palatine bone and laterally communicates with infratemporal fossa .</li><li>➤ Pterygopalatine fossa</li><li>➤ medially</li><li>➤ perpendicular plate</li><li>➤ palatine bone</li><li>➤ laterally</li><li>➤ infratemporal fossa</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 110</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 110</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Fish Bone Area Sensory Supply:", "options": [{"label": "A", "text": "External Laryngeal Nerve", "correct": false}, {"label": "B", "text": "Glossopharyngeal Nerve", "correct": false}, {"label": "C", "text": "Recurrent Laryngeal Nerve", "correct": false}, {"label": "D", "text": "Internal Laryngeal Nerve", "correct": true}], "correct_answer": "D. Internal Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture59.jpg"], "explanation": "<p><strong>Ans. D) Internal Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: External laryngeal nerve ELN is entirely motor and supplies cricothyroid muscle which is a tensor of vocal cord .</li><li>• Option A:</li><li>• motor</li><li>• supplies</li><li>• cricothyroid muscle</li><li>• tensor</li><li>• vocal cord</li><li>• Option B: Glossopharyngeal nerve carries general sensation from pharynx , tonsils , fauces and posterior 1/3 tongue .</li><li>• Option B:</li><li>• general sensation</li><li>• pharynx</li><li>• tonsils</li><li>• fauces</li><li>• posterior 1/3 tongue</li><li>• Option C: Recurrent laryngeal nerve supplies all muscles of the larynx except cricothyroid and is also sensory to mucosa of larynx below the level of vocal cords .</li><li>• Option C:</li><li>• all muscles</li><li>• larynx</li><li>• except</li><li>• cricothyroid</li><li>• sensory</li><li>• mucosa</li><li>• larynx</li><li>• below</li><li>• vocal cords</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sensory supply to the piriform fossa primarily comes from the internal branch of the superior laryngeal nerve , which is a branch of the vagus nerve ( cranial nerve X ). The internal laryngeal nerve enters the larynx through the thyrohyoid membrane and provides sensory innervation to the mucosa of the larynx above the vocal cords , including the piriform fossa . The piriform fossa is a pear-shaped depression located on either side of the laryngeal inlet , between the aryepiglottic fold and the thyroid cartilage . It is an important anatomical region for swallowing , as it helps to direct food and liquids away from the airway and towards the esophagus . The sensory innervation provided by the internal laryngeal nerve is crucial for triggering the swallowing reflex and protecting the airway during ingestion .</li><li>➤ The sensory supply to the piriform fossa primarily comes from the internal branch of the superior laryngeal nerve , which is a branch of the vagus nerve ( cranial nerve X ). The internal laryngeal nerve enters the larynx through the thyrohyoid membrane and provides sensory innervation to the mucosa of the larynx above the vocal cords , including the piriform fossa .</li><li>➤ sensory supply</li><li>➤ piriform fossa</li><li>➤ internal branch</li><li>➤ superior laryngeal nerve</li><li>➤ branch</li><li>➤ vagus nerve</li><li>➤ cranial nerve X</li><li>➤ internal laryngeal nerve</li><li>➤ larynx</li><li>➤ thyrohyoid membrane</li><li>➤ sensory innervation</li><li>➤ mucosa</li><li>➤ larynx above</li><li>➤ vocal cords</li><li>➤ piriform fossa</li><li>➤ The piriform fossa is a pear-shaped depression located on either side of the laryngeal inlet , between the aryepiglottic fold and the thyroid cartilage . It is an important anatomical region for swallowing , as it helps to direct food and liquids away from the airway and towards the esophagus . The sensory innervation provided by the internal laryngeal nerve is crucial for triggering the swallowing reflex and protecting the airway during ingestion .</li><li>➤ pear-shaped depression</li><li>➤ either side</li><li>➤ laryngeal inlet</li><li>➤ aryepiglottic fold</li><li>➤ thyroid cartilage</li><li>➤ swallowing</li><li>➤ direct food</li><li>➤ liquids away</li><li>➤ airway</li><li>➤ towards</li><li>➤ esophagus</li><li>➤ internal laryngeal nerve</li><li>➤ triggering</li><li>➤ swallowing reflex</li><li>➤ protecting</li><li>➤ airway during ingestion</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 230</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old woman presents to the clinic with complaints of double vision and difficulty looking downward, especially when navigating stairs. She reports a sensation of heaviness in her right eye and occasional pain behind the eye when attempting to read. On examination, there is a noticeable limitation in the downward movement of the right eye. The rest of the cranial nerve examination is within normal limits. Which of the following anatomical structures is most likely involved in the pathophysiology of this patient's symptoms?", "options": [{"label": "A", "text": "Superior Oblique and Superior Rectus", "correct": false}, {"label": "B", "text": "Medial and Lateral Rectus", "correct": false}, {"label": "C", "text": "Inferior Rectus and Inferior Oblique", "correct": true}, {"label": "D", "text": "LPS and Superior Rectus", "correct": false}], "correct_answer": "C. Inferior Rectus and Inferior Oblique", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture57.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture58.jpg"], "explanation": "<p><strong>Ans. C) Inferior Rectus and Inferior Oblique</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: This option is incorrect . The superior oblique and superior rectus muscles are located in the upper part of the orbital cavity and are not primarily supported by Lockwood's ligament. The superior oblique muscle is involved in downward and outward eye movements , while the superior rectus elevates the eye . Lockwood's ligament is more associated with the structures of the inferior orbit . Suspensory ligament suspends the eyeball from below .</li><li>• Option A:</li><li>• incorrect</li><li>• upper part</li><li>• orbital cavity</li><li>• superior oblique muscle</li><li>• downward</li><li>• outward eye movements</li><li>• superior rectus elevates</li><li>• eye</li><li>• Lockwood's ligament</li><li>• structures</li><li>• inferior orbit</li><li>• Suspensory ligament</li><li>• suspends</li><li>• eyeball</li><li>• below</li><li>• Option B: This option is also incorrect . The medial and lateral rectus muscles are responsible for moving the eye medially and laterally , respectively. While these muscles are important for horizontal eye movements , they are not the primary structures supported by Lockwood's ligament. Suspensory ligament connects the medial check ligament of medial rectus with the lateral check ligament of lateral rectus .</li><li>• Option B:</li><li>• incorrect</li><li>• moving</li><li>• eye medially</li><li>• laterally</li><li>• horizontal eye movements</li><li>• connects</li><li>• medial check ligament</li><li>• medial rectus</li><li>• lateral check ligament</li><li>• lateral rectus</li><li>• Option D: This option is incorrect . The Levator Palpebrae Superioris (LPS) is responsible for elevating the upper eyelid , and the superior rectus , as mentioned, elevates the eye . Both these structures are located superiorly in the orbit and are not primarily supported by the suspensory ligament of Lockwood, which is more concerned with the inferior orbital structures . Whitnall's tubercle on the lateral wall of the orbit receives the attachment of suspensory ligament .</li><li>• Option D:</li><li>• incorrect</li><li>• Levator Palpebrae Superioris (LPS)</li><li>• elevating</li><li>• upper eyelid</li><li>• superior rectus</li><li>• elevates</li><li>• eye</li><li>• superiorly</li><li>• orbit</li><li>• inferior orbital</li><li>• structures</li><li>• Whitnall's</li><li>• tubercle</li><li>• lateral wall</li><li>• orbit</li><li>• receives</li><li>• attachment</li><li>• suspensory ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The suspensory ligament of Lockwood forms a hammock-like support that helps to cradle the eyeball , particularly influencing the position and function of the inferior rectus and inferior oblique muscles . The inferior rectus muscle depresses the eye , while the inferior oblique muscle is involved in elevating the eye and rotating it outward . Lockwood's ligament provides support to these muscles and the lower part of the eyeball , contributing to the stability of the eye within the orbit and ensuring proper functioning of these muscles .</li><li>➤ The suspensory ligament of Lockwood forms a hammock-like support that helps to cradle the eyeball , particularly influencing the position and function of the inferior rectus and inferior oblique muscles .</li><li>➤ suspensory ligament</li><li>➤ Lockwood</li><li>➤ hammock-like support</li><li>➤ cradle</li><li>➤ eyeball</li><li>➤ influencing</li><li>➤ position</li><li>➤ function</li><li>➤ inferior rectus</li><li>➤ inferior oblique muscles</li><li>➤ The inferior rectus muscle depresses the eye , while the inferior oblique muscle is involved in elevating the eye and rotating it outward .</li><li>➤ depresses</li><li>➤ eye</li><li>➤ inferior oblique muscle</li><li>➤ elevating</li><li>➤ eye</li><li>➤ rotating</li><li>➤ outward</li><li>➤ Lockwood's ligament provides support to these muscles and the lower part of the eyeball , contributing to the stability of the eye within the orbit and ensuring proper functioning of these muscles .</li><li>➤ lower part</li><li>➤ eyeball</li><li>➤ stability</li><li>➤ eye</li><li>➤ orbit</li><li>➤ ensuring proper</li><li>➤ muscles</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 263</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All will occur in damage to Oculomotor Nerve except:", "options": [{"label": "A", "text": "Lateral and Upward Deviation", "correct": true}, {"label": "B", "text": "Loss of Accommodation Reflex", "correct": false}, {"label": "C", "text": "Dilated Pupil", "correct": false}, {"label": "D", "text": "Ptosis", "correct": false}], "correct_answer": "A. Lateral and Upward Deviation", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture56.jpg"], "explanation": "<p><strong>Ans. A) Lateral and Upward Deviation</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The accommodation reflex involves changes in the lens of the eye to focus on near objects , and the oculomotor nerve provides the parasympathetic innervation necessary for this process. Damage to the oculomotor nerve would impair the ability to constrict the pupil and change the shape of the lens for near vision , leading to loss of accommodation .</li><li>• Option B:</li><li>• changes</li><li>• lens</li><li>• eye</li><li>• focus</li><li>• near objects</li><li>• oculomotor nerve</li><li>• parasympathetic innervation</li><li>• Damage</li><li>• oculomotor nerve</li><li>• impair</li><li>• ability</li><li>• constrict</li><li>• pupil</li><li>• change</li><li>• shape</li><li>• lens</li><li>• near vision</li><li>• loss</li><li>• accommodation</li><li>• Option C: The parasympathetic fibers of the oculomotor nerve innervate the sphincter pupillae muscle , which constricts the pupil . Damage to the oculomotor nerve can lead to a lack of parasympathetic input , resulting in a dilated pupil ( mydriasis ) due to unopposed sympathetic activity .</li><li>• Option C:</li><li>• parasympathetic fibers</li><li>• oculomotor nerve</li><li>• sphincter pupillae muscle</li><li>• constricts</li><li>• pupil</li><li>• Damage</li><li>• oculomotor nerve</li><li>• lead</li><li>• lack</li><li>• parasympathetic input</li><li>• dilated pupil</li><li>• mydriasis</li><li>• unopposed sympathetic activity</li><li>• Option D: The oculomotor nerve innervates the levator palpebrae superioris muscle , which is responsible for elevating the upper eyelid . Damage to this nerve would result in ptosis , or drooping of the upper eyelid , due to paralysis of the levator muscle . Paralysis of levatorpalapabrae superioris results in ptosis .</li><li>• Option D:</li><li>• oculomotor nerve</li><li>• levator palpebrae superioris</li><li>• muscle</li><li>• elevating</li><li>• upper eyelid</li><li>• ptosis</li><li>• drooping</li><li>• upper eyelid</li><li>• paralysis</li><li>• levator muscle</li><li>• Paralysis</li><li>• levatorpalapabrae superioris</li><li>• ptosis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Damage to the oculomotor nerve ( cranial nerve III ) can lead to several ocular deficits , as this nerve innervates the majority of the extraocular muscles , the levator palpebrae superioris muscle (which elevates the upper eyelid ) and provides parasympathetic innervation to the pupil and lens . In oculomotor nerve palsy , the eye tends to deviate \" down and out ,\" not lateral and upward. This is due to unopposed action of the lateral rectus (innervated by the abducens nerve , CN VI ) and superior oblique (innervated by the trochlear nerve , CN IV ) muscles . The lateral rectus muscle abducts the eye , and the superior oblique muscle helps in intorsion and depression of the eye when it is in an abducted position . Therefore, damage to the oculomotor nerve typically results in the eye looking downward and outward , not lateral and upward.</li><li>➤ Damage to the oculomotor nerve ( cranial nerve III ) can lead to several ocular deficits , as this nerve innervates the majority of the extraocular muscles , the levator palpebrae superioris muscle (which elevates the upper eyelid ) and provides parasympathetic innervation to the pupil and lens .</li><li>➤ Damage to the oculomotor nerve ( cranial nerve III ) can lead to several ocular deficits , as this nerve innervates the majority of the extraocular muscles , the levator palpebrae superioris muscle (which elevates the upper eyelid ) and provides parasympathetic innervation to the pupil and lens .</li><li>➤ Damage</li><li>➤ oculomotor nerve</li><li>➤ cranial nerve III</li><li>➤ several ocular deficits</li><li>➤ innervates</li><li>➤ majority</li><li>➤ extraocular muscles</li><li>➤ levator palpebrae superioris muscle</li><li>➤ elevates</li><li>➤ upper eyelid</li><li>➤ parasympathetic innervation</li><li>➤ pupil</li><li>➤ lens</li><li>➤ In oculomotor nerve palsy , the eye tends to deviate \" down and out ,\" not lateral and upward. This is due to unopposed action of the lateral rectus (innervated by the abducens nerve , CN VI ) and superior oblique (innervated by the trochlear nerve , CN IV ) muscles . The lateral rectus muscle abducts the eye , and the superior oblique muscle helps in intorsion and depression of the eye when it is in an abducted position . Therefore, damage to the oculomotor nerve typically results in the eye looking downward and outward , not lateral and upward.</li><li>➤ In oculomotor nerve palsy , the eye tends to deviate \" down and out ,\" not lateral and upward. This is due to unopposed action of the lateral rectus (innervated by the abducens nerve , CN VI ) and superior oblique (innervated by the trochlear nerve , CN IV ) muscles . The lateral rectus muscle abducts the eye , and the superior oblique muscle helps in intorsion and depression of the eye when it is in an abducted position . Therefore, damage to the oculomotor nerve typically results in the eye looking downward and outward , not lateral and upward.</li><li>➤ oculomotor nerve palsy</li><li>➤ deviate</li><li>➤ down and out</li><li>➤ unopposed action</li><li>➤ lateral rectus</li><li>➤ abducens nerve</li><li>➤ VI</li><li>➤ superior oblique</li><li>➤ trochlear nerve</li><li>➤ IV</li><li>➤ muscles</li><li>➤ lateral rectus muscle</li><li>➤ abducts</li><li>➤ eye</li><li>➤ superior oblique muscle</li><li>➤ intorsion</li><li>➤ depression</li><li>➤ eye</li><li>➤ abducted position</li><li>➤ damage</li><li>➤ oculomotor nerve</li><li>➤ eye</li><li>➤ downward</li><li>➤ outward</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 256</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Upper Premolars are supplied by:", "options": [{"label": "A", "text": "Anterior Superior Alveolar Nerve", "correct": false}, {"label": "B", "text": "Middle Superior Alveolar Nerve", "correct": true}, {"label": "C", "text": "Posterior Superior Alveolar Nerve", "correct": false}, {"label": "D", "text": "Inferior Alveolar Nerve", "correct": false}], "correct_answer": "B. Middle Superior Alveolar Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture48.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture49.jpg"], "explanation": "<p><strong>Ans. B) Middle superior alveolar nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Canine and incisors of upper jaw - anterior superior alveolar nerve from infraorbital nerve , branch from maxillary division of trigeminal nerve .</li><li>• Option A:</li><li>• Canine</li><li>• incisors</li><li>• upper jaw</li><li>• anterior superior alveolar nerve</li><li>• infraorbital nerve</li><li>• maxillary division</li><li>• trigeminal nerve</li><li>• Option C: Molars of upper jaw - posterior superior alveolar nerve from maxillary division of trigeminal nerve</li><li>• Option C:</li><li>• Molars of upper jaw</li><li>• posterior superior alveolar nerve</li><li>• maxillary division</li><li>• trigeminal nerve</li><li>• Option D: Lower jaw dentition - inferior alveolar nerve from mandibular division of trigeminal nerve</li><li>• Option D:</li><li>• Lower jaw dentition</li><li>• inferior alveolar nerve</li><li>• mandibular division</li><li>• trigeminal nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Upper premolars are supplied by branches of the maxillary division of the trigeminal nerve (CN V2 ). Specifically, the innervation to the upper premolars comes from the middle superior alveolar nerve , a branch of the infraorbital nerve , which itself is a branch of the maxillary nerve . The first upper premolar may also receive some innervation from the anterior superior alveolar nerve , another branch of the infraorbital nerve . Additionally, the blood supply to the upper premolars is primarily from the posterior superior alveolar artery , which is a branch of the maxillary artery . The maxillary artery is one of the two terminal branches of the external carotid artery .</li><li>➤ Upper premolars are supplied by branches of the maxillary division of the trigeminal nerve (CN V2 ). Specifically, the innervation to the upper premolars comes from the middle superior alveolar nerve , a branch of the infraorbital nerve , which itself is a branch of the maxillary nerve .</li><li>➤ branches</li><li>➤ maxillary division</li><li>➤ trigeminal nerve</li><li>➤ V2</li><li>➤ innervation</li><li>➤ upper premolars</li><li>➤ middle superior alveolar nerve</li><li>➤ branch</li><li>➤ infraorbital nerve</li><li>➤ maxillary nerve</li><li>➤ The first upper premolar may also receive some innervation from the anterior superior alveolar nerve , another branch of the infraorbital nerve .</li><li>➤ first upper premolar</li><li>➤ receive</li><li>➤ innervation</li><li>➤ anterior superior alveolar nerve</li><li>➤ infraorbital nerve</li><li>➤ Additionally, the blood supply to the upper premolars is primarily from the posterior superior alveolar artery , which is a branch of the maxillary artery . The maxillary artery is one of the two terminal branches of the external carotid artery .</li><li>➤ blood supply</li><li>➤ upper premolars</li><li>➤ posterior superior alveolar artery</li><li>➤ maxillary artery</li><li>➤ two terminal branches</li><li>➤ external carotid artery</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with a chronic headache localized to the forehead and behind the eyes. He also reports a decreased sense of smell and episodes of nasal congestion not relieved by over-the-counter medications. Imaging studies, including a CT scan of the sinuses, show opacification of the sphenoidal sinuses with bone remodeling. Given the location of his sinus disease, which of the following structures is most at risk of being affected by the pathology in this patient?", "options": [{"label": "A", "text": "Vidian Nerve", "correct": true}, {"label": "B", "text": "Mandibular Nerve", "correct": false}, {"label": "C", "text": "Greater Petrosal Nerve", "correct": false}, {"label": "D", "text": "Maxillary Nerve", "correct": false}], "correct_answer": "A. Vidian Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture47.jpg"], "explanation": "<p><strong>Ans. A) Vidian Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Mandibular nerve passes through foramen ovale in middle cranial fossa to enter infratemporal fossa .</li><li>• Option B:</li><li>• foramen ovale</li><li>• middle cranial fossa</li><li>• infratemporal fossa</li><li>• Option C: Greater petrosal nerve arises from geniculate ganglion pierces roof of middle ear lies over the groove on it.</li><li>• Option C:</li><li>• geniculate ganglion</li><li>• roof</li><li>• middle ear lies</li><li>• groove</li><li>• Option D: Maxillary nerve passes through foramen rotundum of middle cranial fossa to reach pterygopalatine fossa .</li><li>• Option D:</li><li>• foramen rotundum</li><li>• middle cranial fossa</li><li>• pterygopalatine fossa</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Vidian nerve , also known as the nerve of the pterygoid canal , does not lie directly over the floor of the sphenoidal sinus. The structure that lies directly over the floor of the sphenoidal sinus is typically the sphenoid bone itself, which forms the roof of the nasopharynx . The Vidian nerve runs in the pterygoid canal , which is situated more laterally , in the base of the skull , connecting the foramen lacerum to the pterygopalatine fossa . The Vidian nerve is formed by the union of the greater petrosal nerve , carrying parasympathetic fibers , and the deep petrosal nerve , carrying sympathetic fibers . This nerve travels through the pterygoid canal and ends in the pterygopalatine ganglion . While it is an important neural structure in the vicinity , it doesn't directly overlay the sphenoidal sinus floor but is rather related to the lateral and posterior aspects of the sphenoidal sinus within the deeper parts of the skull base .</li><li>➤ The Vidian nerve , also known as the nerve of the pterygoid canal , does not lie directly over the floor of the sphenoidal sinus.</li><li>➤ Vidian nerve</li><li>➤ nerve</li><li>➤ pterygoid canal</li><li>➤ The structure that lies directly over the floor of the sphenoidal sinus is typically the sphenoid bone itself, which forms the roof of the nasopharynx .</li><li>➤ directly</li><li>➤ floor</li><li>➤ sphenoidal sinus</li><li>➤ sphenoid bone</li><li>➤ forms</li><li>➤ roof</li><li>➤ nasopharynx</li><li>➤ The Vidian nerve runs in the pterygoid canal , which is situated more laterally , in the base of the skull , connecting the foramen lacerum to the pterygopalatine fossa .</li><li>➤ pterygoid canal</li><li>➤ laterally</li><li>➤ base</li><li>➤ skull</li><li>➤ foramen lacerum</li><li>➤ pterygopalatine fossa</li><li>➤ The Vidian nerve is formed by the union of the greater petrosal nerve , carrying parasympathetic fibers , and the deep petrosal nerve , carrying sympathetic fibers .</li><li>➤ union</li><li>➤ greater petrosal nerve</li><li>➤ parasympathetic fibers</li><li>➤ deep petrosal nerve</li><li>➤ sympathetic fibers</li><li>➤ This nerve travels through the pterygoid canal and ends in the pterygopalatine ganglion .</li><li>➤ pterygoid canal</li><li>➤ ends</li><li>➤ pterygopalatine ganglion</li><li>➤ While it is an important neural structure in the vicinity , it doesn't directly overlay the sphenoidal sinus floor but is rather related to the lateral and posterior aspects of the sphenoidal sinus within the deeper parts of the skull base .</li><li>➤ neural structure</li><li>➤ vicinity</li><li>➤ lateral</li><li>➤ posterior aspects</li><li>➤ sphenoidal sinus</li><li>➤ deeper parts</li><li>➤ skull base</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 220</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 220</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Maxillary Bone does not articulate with:", "options": [{"label": "A", "text": "Ethmoid", "correct": false}, {"label": "B", "text": "Sphenoid", "correct": true}, {"label": "C", "text": "Lacrimal", "correct": false}, {"label": "D", "text": "Frontal", "correct": false}], "correct_answer": "B. Sphenoid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture46.jpg"], "explanation": "<p><strong>Ans. B) Sphenoid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Medially , the maxilla articulates with the ethmoid bone , specifically at the ethmoidal sinuses and the middle nasal concha .</li><li>• Option A: Medially</li><li>• maxilla</li><li>• articulates</li><li>• ethmoid bone</li><li>• ethmoidal sinuses</li><li>• middle nasal concha</li><li>• Option C: The maxilla articulates anteriorly with the lacrimal bone , contributing to the medial wall of the orbit .</li><li>• Option C:</li><li>• anteriorly</li><li>• lacrimal bone</li><li>• medial wall</li><li>• orbit</li><li>• Option D: Frontal Bone articulates superiorly with the frontal bone , contributing to the formation of the floor of the orbit and the lateral walls and floor of the nasal cavity .</li><li>• Option D:</li><li>• superiorly</li><li>• frontal bone</li><li>• formation</li><li>• floor</li><li>• orbit</li><li>• lateral walls</li><li>• floor</li><li>• nasal cavity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The maxillary bone , also known as the maxilla , articulates with several bones in the skull , including frontal , lacrimal , ethmoid and</li><li>➤ maxillary bone</li><li>➤ maxilla</li><li>➤ articulates</li><li>➤ bones</li><li>➤ skull</li><li>➤ frontal</li><li>➤ lacrimal</li><li>➤ ethmoid</li><li>➤ Inferior Nasal Concha: The maxilla articulates with the inferior nasal concha , which is part of the lateral wall of the nasal cavity . Palatine Bone: Posteriorly , the maxilla articulates with the horizontal plate of the palatine bone, helping to form the hard palate . Zygomatic Bone: Laterally , the maxilla articulates with the zygomatic bone , contributing to the prominence of the cheek and the lateral wall and floor of the orbit . Vomer: The maxilla also articulates with the vomer bone along its posterior aspect , particularly at the nasal septum . Nasal Bones: The maxilla articulates with the two nasal bones at the bridge of the nose , contributing to the upper part of the nasal septum and the lateral walls of the nasal cavity .</li><li>➤ Inferior Nasal Concha: The maxilla articulates with the inferior nasal concha , which is part of the lateral wall of the nasal cavity .</li><li>➤ Inferior Nasal Concha: The maxilla articulates with the inferior nasal concha , which is part of the lateral wall of the nasal cavity .</li><li>➤ Inferior Nasal Concha:</li><li>➤ inferior nasal concha</li><li>➤ lateral wall</li><li>➤ nasal cavity</li><li>➤ Palatine Bone: Posteriorly , the maxilla articulates with the horizontal plate of the palatine bone, helping to form the hard palate .</li><li>➤ Palatine Bone: Posteriorly , the maxilla articulates with the horizontal plate of the palatine bone, helping to form the hard palate .</li><li>➤ Palatine Bone:</li><li>➤ Posteriorly</li><li>➤ horizontal plate</li><li>➤ hard palate</li><li>➤ Zygomatic Bone: Laterally , the maxilla articulates with the zygomatic bone , contributing to the prominence of the cheek and the lateral wall and floor of the orbit .</li><li>➤ Zygomatic Bone: Laterally , the maxilla articulates with the zygomatic bone , contributing to the prominence of the cheek and the lateral wall and floor of the orbit .</li><li>➤ Zygomatic Bone:</li><li>➤ Laterally</li><li>➤ zygomatic bone</li><li>➤ prominence</li><li>➤ cheek</li><li>➤ lateral wall</li><li>➤ floor</li><li>➤ orbit</li><li>➤ Vomer: The maxilla also articulates with the vomer bone along its posterior aspect , particularly at the nasal septum .</li><li>➤ Vomer: The maxilla also articulates with the vomer bone along its posterior aspect , particularly at the nasal septum .</li><li>➤ Vomer:</li><li>➤ posterior aspect</li><li>➤ nasal septum</li><li>➤ Nasal Bones: The maxilla articulates with the two nasal bones at the bridge of the nose , contributing to the upper part of the nasal septum and the lateral walls of the nasal cavity .</li><li>➤ Nasal Bones: The maxilla articulates with the two nasal bones at the bridge of the nose , contributing to the upper part of the nasal septum and the lateral walls of the nasal cavity .</li><li>➤ Nasal Bones:</li><li>➤ two nasal bones</li><li>➤ bridge</li><li>➤ nose</li><li>➤ upper part</li><li>➤ nasal septum</li><li>➤ lateral walls</li><li>➤ nasal cavity</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Extrinsic Membranes of Larynx are ALL except:", "options": [{"label": "A", "text": "Quadrate Membrane", "correct": true}, {"label": "B", "text": "Thyrohyoid Membrane", "correct": false}, {"label": "C", "text": "Hyoepiglottic Membrane", "correct": false}, {"label": "D", "text": "Cricotracheal Membrane", "correct": false}], "correct_answer": "A. Quadrate Membrane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture44.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture45.jpg"], "explanation": "<p><strong>Ans. A) Quadrate Membrane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: Thyrohyoid membrane pierced by superior laryngeal vessels and internal laryngeal nerve</li><li>• Option B:</li><li>• superior laryngeal vessels</li><li>• internal laryngeal nerve</li><li>• Option C: Hyoepiglottic ligament connects lower part of anterior surface of epiglottis to hyoid bone .</li><li>• Option C:</li><li>• lower part</li><li>• anterior surface</li><li>• epiglottis</li><li>• hyoid bone</li><li>• Option D: Cricotracheal membrane extends from the lower border of anterior arch to first tracheal ring .</li><li>• Option D:</li><li>• extends</li><li>• lower border</li><li>• anterior</li><li>• first tracheal ring</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The extrinsic membranes of the larynx are connective tissue structures that connect the larynx to adjacent parts of the throat and help to support and stabilize it. There are two main extrinsic membranes of the larynx :</li><li>➤ The extrinsic membranes of the larynx are connective tissue structures that connect the larynx to adjacent parts of the throat and help to support and stabilize it. There are two main extrinsic membranes of the larynx :</li><li>➤ extrinsic membranes</li><li>➤ larynx</li><li>➤ connective tissue structures</li><li>➤ connect</li><li>➤ larynx</li><li>➤ adjacent parts</li><li>➤ throat</li><li>➤ support</li><li>➤ stabilize</li><li>➤ two main</li><li>➤ extrinsic membranes</li><li>➤ larynx</li><li>➤ Thyrohyoid Membrane stretches between the hyoid bone and the thyroid cartilage . It is a broad , fibroelastic sheet that connects the upper border of the thyroid cartilage to the hyoid bone . The thyrohyoid membrane is important for suspending the larynx from the hyoid bone and for facilitating the movement and function of the larynx during speech and swallowing . The membrane has a central and lateral part , where the lateral part is thickened to form the thyrohyoid ligament . Cricotracheal Ligament (or Membrane) connects the lower border of the cricoid cartilage , which is the base of the larynx , to the first tracheal ring , effectively joining the larynx to the trachea . It provides continuity between the larynx above and the trachea below , ensuring a stable yet flexible airway that can accommodate movements such as swallowing , neck flexion , and extension .</li><li>➤ Thyrohyoid Membrane stretches between the hyoid bone and the thyroid cartilage . It is a broad , fibroelastic sheet that connects the upper border of the thyroid cartilage to the hyoid bone . The thyrohyoid membrane is important for suspending the larynx from the hyoid bone and for facilitating the movement and function of the larynx during speech and swallowing . The membrane has a central and lateral part , where the lateral part is thickened to form the thyrohyoid ligament .</li><li>➤ between</li><li>➤ hyoid bone</li><li>➤ thyroid cartilage</li><li>➤ broad</li><li>➤ fibroelastic sheet</li><li>➤ connects</li><li>➤ upper border</li><li>➤ thyroid cartilage</li><li>➤ hyoid bone</li><li>➤ suspending</li><li>➤ larynx</li><li>➤ hyoid bone</li><li>➤ facilitating</li><li>➤ movement</li><li>➤ function</li><li>➤ larynx</li><li>➤ speech</li><li>➤ swallowing</li><li>➤ central</li><li>➤ lateral part</li><li>➤ lateral part</li><li>➤ thickened</li><li>➤ thyrohyoid ligament</li><li>➤ Cricotracheal Ligament (or Membrane) connects the lower border of the cricoid cartilage , which is the base of the larynx , to the first tracheal ring , effectively joining the larynx to the trachea . It provides continuity between the larynx above and the trachea below , ensuring a stable yet flexible airway that can accommodate movements such as swallowing , neck flexion , and extension .</li><li>➤ lower border</li><li>➤ cricoid cartilage</li><li>➤ base</li><li>➤ larynx</li><li>➤ first tracheal ring</li><li>➤ effectively</li><li>➤ larynx</li><li>➤ trachea</li><li>➤ between</li><li>➤ larynx</li><li>➤ above</li><li>➤ trachea below</li><li>➤ stable</li><li>➤ flexible airway</li><li>➤ accommodate movements</li><li>➤ swallowing</li><li>➤ neck flexion</li><li>➤ extension</li><li>➤ The intrinsic membranes of the larynx , often referred to as intrinsic ligaments , are a series of connective tissue structures that connect the various cartilages of the larynx to each other. Unlike the extrinsic membranes that connect the larynx to other structures in the neck , the intrinsic membranes are entirely contained within the larynx and play a crucial role in its function , including voice production and the opening and closing of the glottis . The main intrinsic membranes and ligaments include:</li><li>➤ The intrinsic membranes of the larynx , often referred to as intrinsic ligaments , are a series of connective tissue structures that connect the various cartilages of the larynx to each other. Unlike the extrinsic membranes that connect the larynx to other structures in the neck , the intrinsic membranes are entirely contained within the larynx and play a crucial role in its function , including voice production and the opening and closing of the glottis . The main intrinsic membranes and ligaments include:</li><li>➤ intrinsic membranes</li><li>➤ larynx</li><li>➤ intrinsic ligaments</li><li>➤ series</li><li>➤ connective tissue</li><li>➤ connect</li><li>➤ cartilages</li><li>➤ larynx</li><li>➤ connect</li><li>➤ larynx</li><li>➤ neck</li><li>➤ intrinsic membranes</li><li>➤ within</li><li>➤ larynx</li><li>➤ crucial role</li><li>➤ function</li><li>➤ voice production</li><li>➤ opening</li><li>➤ closing</li><li>➤ glottis</li><li>➤ Conus Elasticus (Cricovocal Membrane) extends from the cricoid cartilage up to the vocal ligaments . It is comprised of two parts : The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages . The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages . Quadrangular Membranes are paired membranes that stretch between the epiglottis , the arytenoid cartilages , and the thyroid cartilage . The free lower edges of the quadrangular membranes form the vestibular ligaments (or false vocal cords ), which run parallel to the true vocal cords but are located just above them . Vocal Ligaments are not membranes per se but are often included in discussions of the intrinsic structures of the larynx due to their importance in voice production . The vocal ligaments are bands of elastic tissue that stretch from the thyroid cartilage in front to the arytenoid cartilage at the back . They are covered by a layer of mucous membrane and form the core of the true vocal cords (or vocal folds ).</li><li>➤ Conus Elasticus (Cricovocal Membrane) extends from the cricoid cartilage up to the vocal ligaments . It is comprised of two parts : The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages . The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages .</li><li>➤ cricoid cartilage</li><li>➤ vocal ligaments</li><li>➤ two parts</li><li>➤ The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages . The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages .</li><li>➤ The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages . The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages .</li><li>➤ The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages . The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages .</li><li>➤ The medial cricothyroid ligament , which is a thickened band in the midline , stretching between the cricoid and thyroid cartilages .</li><li>➤ medial cricothyroid ligament</li><li>➤ thickened band</li><li>➤ midline</li><li>➤ cricoid</li><li>➤ thyroid cartilages</li><li>➤ The lateral cricothyroid membranes , which extend from the cricoid cartilage to the vocal ligaments and arytenoid cartilages .</li><li>➤ lateral cricothyroid membranes</li><li>➤ extend</li><li>➤ cricoid cartilage</li><li>➤ vocal ligaments</li><li>➤ arytenoid cartilages</li><li>➤ Quadrangular Membranes are paired membranes that stretch between the epiglottis , the arytenoid cartilages , and the thyroid cartilage . The free lower edges of the quadrangular membranes form the vestibular ligaments (or false vocal cords ), which run parallel to the true vocal cords but are located just above them .</li><li>➤ paired</li><li>➤ stretch</li><li>➤ epiglottis</li><li>➤ arytenoid cartilages</li><li>➤ thyroid cartilage</li><li>➤ free lower edges</li><li>➤ quadrangular membranes</li><li>➤ vestibular ligaments</li><li>➤ false vocal cords</li><li>➤ parallel</li><li>➤ true vocal cords</li><li>➤ just above them</li><li>➤ Vocal Ligaments are not membranes per se but are often included in discussions of the intrinsic structures of the larynx due to their importance in voice production . The vocal ligaments are bands of elastic tissue that stretch from the thyroid cartilage in front to the arytenoid cartilage at the back . They are covered by a layer of mucous membrane and form the core of the true vocal cords (or vocal folds ).</li><li>➤ not membranes</li><li>➤ intrinsic structures</li><li>➤ larynx</li><li>➤ importance</li><li>➤ voice production</li><li>➤ vocal ligaments</li><li>➤ bands</li><li>➤ elastic tissue</li><li>➤ stretch</li><li>➤ thyroid cartilage</li><li>➤ front</li><li>➤ arytenoid cartilage</li><li>➤ back</li><li>➤ covered</li><li>➤ layer</li><li>➤ mucous membrane</li><li>➤ core</li><li>➤ true vocal cords</li><li>➤ vocal folds</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 236</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 236</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Blood Supply to Facial Nerve are all except:", "options": [{"label": "A", "text": "Ascending Pharyngeal Artery", "correct": false}, {"label": "B", "text": "Middle Meningeal Artery", "correct": false}, {"label": "C", "text": "Greater Palatine Artery", "correct": true}, {"label": "D", "text": "Stylomastoid Artery", "correct": false}], "correct_answer": "C. Greater Palatine Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture35.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture36.jpg"], "explanation": "<p><strong>Ans. C) Greater Palatine Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: True . The ascending pharyngeal artery, one of the branches of the external carotid artery , contributes to the blood supply of the facial nerve , particularly in its intracranial part . The ascending pharyngeal artery supplies the lower part of the nerve near its exit from the skull through the stylomastoid foramen , as well as the adjacent areas .</li><li>• Option A: True</li><li>• branches</li><li>• external carotid artery</li><li>• blood supply</li><li>• facial nerve</li><li>• intracranial part</li><li>• lower part</li><li>• nerve</li><li>• exit</li><li>• skull</li><li>• stylomastoid foramen</li><li>• adjacent areas</li><li>• Option B: True . The middle meningeal artery, another branch of the maxillary artery (which is itself a branch of the external carotid artery ), also contributes to the vascular supply of the facial nerve . Specifically, it supplies the facial nerve within the facial canal , particularly in the region of the geniculate ganglion .</li><li>• Option B: True</li><li>• branch</li><li>• maxillary artery</li><li>• branch</li><li>• external carotid artery</li><li>• vascular supply</li><li>• facial nerve</li><li>• supplies</li><li>• facial nerve</li><li>• facial canal</li><li>• region</li><li>• geniculate ganglion</li><li>• Option D: True . The stylomastoid artery, often a branch of the posterior auricular artery (which is a branch of the external carotid artery ), or directly from the external carotid artery itself, is a key supplier of blood to the facial nerve . It enters the facial canal through the stylomastoid foramen and supplies the facial nerve , particularly in the region where the nerve exits the skull .</li><li>• Option D: True</li><li>• branch</li><li>• posterior auricular artery</li><li>• branch</li><li>• external carotid artery</li><li>• external carotid artery</li><li>• supplier</li><li>• blood</li><li>• facial nerve</li><li>• enters</li><li>• facial canal</li><li>• stylomastoid foramen</li><li>• supplies</li><li>• facial nerve</li><li>• exits</li><li>• skull</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ False . The greater palatine artery , which arises from the maxillary artery , primarily supplies the hard palate and the nasal cavity but does not contribute to the blood supply of the facial nerve. This artery is more involved in the vascular supply to the oral and nasal mucosa and the periodontal ligament .</li><li>➤ False</li><li>➤ greater palatine artery</li><li>➤ arises</li><li>➤ maxillary artery</li><li>➤ hard palate</li><li>➤ nasal cavity</li><li>➤ vascular supply</li><li>➤ oral</li><li>➤ nasal mucosa</li><li>➤ periodontal ligament</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 321</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 321</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In Subclavian Artery block at Outer Border of First Rib all of the following Arteries help in maintaining Collateral Circulation except:", "options": [{"label": "A", "text": "Superior Thoracic", "correct": true}, {"label": "B", "text": "Subscapular", "correct": false}, {"label": "C", "text": "Thyrocervical Trunk", "correct": false}, {"label": "D", "text": "Suprascapular Artery", "correct": false}], "correct_answer": "A. Superior Thoracic", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture34.jpg"], "explanation": "<p><strong>Ans. A) Superior Thoracic</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The subscapular artery, one of the largest branches of the axillary artery , plays a significant role in collateral circulation . It can form anastomoses ( connections ) with branches of the thoracodorsal artery (itself a branch of the subscapular artery ) and the intercostal arteries , providing an alternative route for blood flow around a blockage in the subclavian artery .</li><li>• Option B:</li><li>• largest branches</li><li>• axillary artery</li><li>• significant role</li><li>• collateral circulation</li><li>• anastomoses</li><li>• connections</li><li>• branches</li><li>• thoracodorsal artery</li><li>• subscapular artery</li><li>• intercostal arteries</li><li>• alternative route</li><li>• blood flow</li><li>• blockage</li><li>• subclavian artery</li><li>• Option C: The thyrocervical trunk is a short , thick branch of the subclavian artery that gives rise to several arteries , including the suprascapular and the transverse cervical arteries . These arteries can form anastomoses with branches of the axillary artery , such as the circumflex scapular artery (a branch of the subscapular artery ), facilitating collateral circulation around a blockage in the subclavian artery .</li><li>• Option C:</li><li>• short</li><li>• thick branch</li><li>• subclavian artery</li><li>• arteries</li><li>• suprascapular</li><li>• transverse cervical arteries</li><li>• anastomoses</li><li>• branches</li><li>• axillary artery</li><li>• circumflex scapular artery</li><li>• subscapular artery</li><li>• blockage</li><li>• subclavian artery</li><li>• Option D: The suprascapular artery, which can arise from the thyrocervical trunk or directly from the third part of the subclavian artery , supplies the supraspinatus and infraspinatus muscles . It can also participate in collateral circulation by forming anastomoses with the circumflex scapular artery (a branch of the subscapular artery ), thus providing a bypass route for blood flow .</li><li>• Option D:</li><li>• arise</li><li>• thyrocervical trunk</li><li>• third part</li><li>• subclavian artery</li><li>• supplies</li><li>• supraspinatus</li><li>• infraspinatus muscles</li><li>• collateral circulation</li><li>• forming anastomoses</li><li>• circumflex scapular artery</li><li>• subscapular artery</li><li>• bypass</li><li>• route</li><li>• blood flow</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the event of a blockage at the outer border of the first rib in the subclavian artery , collateral circulation is crucial to maintain blood flow to the affected areas . Various arteries can contribute to this collateral circulation by providing alternative pathways for blood flow . The superior thoracic artery is a small branch of the axillary artery , which mainly supplies the upper and anterior parts of the chest wall . Given its size and the regions it supplies , it is less significant in compensating for a blockage in the subclavian artery at the outer border of the first rib . Therefore, it is less likely to contribute effectively to collateral circulation in this scenario, making it the correct answer as the artery that does not help in maintaining collateral circulation.</li><li>➤ In the event of a blockage at the outer border of the first rib in the subclavian artery , collateral circulation is crucial to maintain blood flow to the affected areas . Various arteries can contribute to this collateral circulation by providing alternative pathways for blood flow .</li><li>➤ blockage</li><li>➤ outer border</li><li>➤ first rib</li><li>➤ subclavian artery</li><li>➤ collateral circulation</li><li>➤ maintain blood flow</li><li>➤ affected areas</li><li>➤ collateral circulation</li><li>➤ alternative pathways</li><li>➤ blood flow</li><li>➤ The superior thoracic artery is a small branch of the axillary artery , which mainly supplies the upper and anterior parts of the chest wall . Given its size and the regions it supplies , it is less significant in compensating for a blockage in the subclavian artery at the outer border of the first rib . Therefore, it is less likely to contribute effectively to collateral circulation in this scenario, making it the correct answer as the artery that does not help in maintaining collateral circulation.</li><li>➤ small branch</li><li>➤ axillary artery</li><li>➤ supplies</li><li>➤ upper</li><li>➤ anterior parts</li><li>➤ chest wall</li><li>➤ size</li><li>➤ regions</li><li>➤ supplies</li><li>➤ less</li><li>➤ compensating</li><li>➤ blockage</li><li>➤ subclavian artery</li><li>➤ outer border</li><li>➤ first rib</li><li>➤ effectively</li><li>➤ collateral circulation</li><li>➤ correct answer</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 334</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 334</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man with a history of tobacco use presents to the clinic complaining of persistent sore throat, difficulty swallowing, and a notable pain in his left ear for the past two months. He denies any hearing loss but mentions the ear pain intensifies when he swallows. Physical examination reveals a unilateral mass at the base of his tongue. No abnormalities are noted in the external ear canal or tympanic membrane on otoscopic examination. Which of the following nerves is most likely responsible for the referred ear pain this patient is experiencing?", "options": [{"label": "A", "text": "Hypoglossal Nerve", "correct": false}, {"label": "B", "text": "Vagus Nerve", "correct": false}, {"label": "C", "text": "Glossopharyngeal Nerve", "correct": true}, {"label": "D", "text": "Lingual Nerve", "correct": false}], "correct_answer": "C. Glossopharyngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture33.jpg"], "explanation": "<p><strong>Ans. C) Glossopharyngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Hypoglossal Nerve (CN XII) is primarily a motor nerve responsible for controlling the movements of the tongue . It does not carry sensory or pain fibers, so it would not be involved in the referral of pain to the ear in carcinoma of the base of the tongue.</li><li>• Option A:</li><li>• motor nerve</li><li>• controlling</li><li>• movements</li><li>• tongue</li><li>• Option B: While the vagus nerve does have extensive sensory , motor , and autonomic functions , and does innervate parts of the ear , it is less directly involved in the sensation of pain referred from the base of the tongue to the ear in the context of carcinoma .</li><li>• Option B:</li><li>• extensive sensory</li><li>• motor</li><li>• autonomic functions</li><li>• innervate parts</li><li>• ear</li><li>• less directly involved</li><li>• sensation</li><li>• pain</li><li>• base</li><li>• tongue</li><li>• ear</li><li>• context</li><li>• carcinoma</li><li>• Option D: The lingual nerve, a branch of the mandibular division of the trigeminal nerve (CN V3 ), provides general somatic sensation to the anterior two-thirds of the tongue . It does not innervate the base of the tongue where the carcinoma is located, nor does it innervate the ear, so it would not be responsible for referring pain to the ear in this scenario.</li><li>• Option D:</li><li>• mandibular division</li><li>• trigeminal nerve</li><li>• V3</li><li>• general somatic sensation</li><li>• anterior two-thirds</li><li>• tongue</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ General sensation from posterior 1/3 tongue - IX nerve In cases of carcinoma at the base of the tongue , pain can be referred to the ear through the glossopharyngeal nerve ( CN IX ).</li><li>➤ General sensation from posterior 1/3 tongue - IX nerve</li><li>➤ General sensation</li><li>➤ posterior 1/3 tongue</li><li>➤ IX nerve</li><li>➤ In cases of carcinoma at the base of the tongue , pain can be referred to the ear through the glossopharyngeal nerve ( CN IX ).</li><li>➤ carcinoma</li><li>➤ base</li><li>➤ tongue</li><li>➤ pain</li><li>➤ ear</li><li>➤ glossopharyngeal nerve</li><li>➤ CN IX</li><li>➤ Glossopharyngeal Nerve (CN IX): This is the correct answer.</li><li>➤ Glossopharyngeal Nerve (CN IX): This is the correct answer.</li><li>➤ The glossopharyngeal nerve provides sensory innervation to the posterior one-third of the tongue , the oropharynx , and the tonsils . It also carries sensory fibers from the middle ear and the pharyngotympanic ( Eustachian ) tube . In cases of carcinoma at the base of the tongue , pain can be referred along the sensory pathways of the glossopharyngeal nerve to the ear , leading to otalgia ( ear pain ).</li><li>➤ The glossopharyngeal nerve provides sensory innervation to the posterior one-third of the tongue , the oropharynx , and the tonsils .</li><li>➤ sensory innervation</li><li>➤ posterior one-third</li><li>➤ tongue</li><li>➤ oropharynx</li><li>➤ tonsils</li><li>➤ It also carries sensory fibers from the middle ear and the pharyngotympanic ( Eustachian ) tube .</li><li>➤ carries sensory fibers</li><li>➤ middle ear</li><li>➤ pharyngotympanic</li><li>➤ Eustachian</li><li>➤ tube</li><li>➤ In cases of carcinoma at the base of the tongue , pain can be referred along the sensory pathways of the glossopharyngeal nerve to the ear , leading to otalgia ( ear pain ).</li><li>➤ base</li><li>➤ tongue</li><li>➤ pain</li><li>➤ along</li><li>➤ sensory pathways</li><li>➤ glossopharyngeal nerve</li><li>➤ ear</li><li>➤ otalgia</li><li>➤ ear pain</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 139</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 139</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Anterior Ethmoidal Nerve supplies ALL Except:", "options": [{"label": "A", "text": "Maxillary Sinus", "correct": true}, {"label": "B", "text": "Internal Nasal Cavity", "correct": false}, {"label": "C", "text": "Duramater of Anterior Cranial Fossa", "correct": false}, {"label": "D", "text": "Ethmoidal Cells", "correct": false}], "correct_answer": "A. Maxillary Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture32.jpg"], "explanation": "<p><strong>Ans. A) Maxillary Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The anterior ethmoidal nerve supplies the anterior part of the nasal septum and the lateral wall of the nasal cavity . It provides sensory innervation to these areas, contributing to the sensation of the internal nasal cavity .</li><li>• Option B:</li><li>• anterior part</li><li>• nasal septum</li><li>• lateral wall</li><li>• nasal cavity</li><li>• sensory innervation</li><li>• sensation</li><li>• internal nasal</li><li>• cavity</li><li>• Option C: The anterior ethmoidal nerve also gives off a meningeal branch that supplies the dura mater of the anterior cranial fossa. This is an example of the trigeminal nerve's extensive role in providing sensory innervation to the dura mater .</li><li>• Option C:</li><li>• meningeal branch</li><li>• supplies</li><li>• dura mater</li><li>• anterior cranial fossa.</li><li>• trigeminal nerve's</li><li>• sensory innervation</li><li>• dura mater</li><li>• Option D: The anterior ethmoidal nerve indeed supplies the anterior ethmoidal cells . These are air cells within the ethmoid bone that are part of the paranasal sinus system , and they receive sensory innervation from this nerve .</li><li>• Option D:</li><li>• anterior</li><li>• ethmoidal nerve</li><li>• anterior ethmoidal cells</li><li>• air cells</li><li>• ethmoid bone</li><li>• paranasal sinus system</li><li>• receive sensory</li><li>• nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anterior ethmoidal nerve, a branch of the nasociliary nerve (which is itself a branch of the ophthalmic division of the trigeminal nerve , CN V1 ), has several areas of innervation , but there are specific regions it does and does not supply. The anterior ethmoidal nerve does not supply the maxillary sinus. The maxillary sinus is primarily innervated by branches of the maxillary nerve (CN V2 ), specifically the superior alveolar nerves and the infraorbital nerve , which are all part of the second division of the trigeminal nerve .</li><li>➤ The anterior ethmoidal nerve, a branch of the nasociliary nerve (which is itself a branch of the ophthalmic division of the trigeminal nerve , CN V1 ), has several areas of innervation , but there are specific regions it does and does not supply.</li><li>➤ nasociliary nerve</li><li>➤ ophthalmic division</li><li>➤ trigeminal nerve</li><li>➤ V1</li><li>➤ innervation</li><li>➤ The anterior ethmoidal nerve does not supply the maxillary sinus. The maxillary sinus is primarily innervated by branches of the maxillary nerve (CN V2 ), specifically the superior alveolar nerves and the infraorbital nerve , which are all part of the second division of the trigeminal nerve .</li><li>➤ innervated</li><li>➤ branches</li><li>➤ maxillary nerve</li><li>➤ V2</li><li>➤ superior alveolar nerves</li><li>➤ infraorbital nerve</li><li>➤ second division</li><li>➤ trigeminal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 364</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Onodi and Haller Cells of Ethmoidal Labyrinth is seen in relation to following respectively:", "options": [{"label": "A", "text": "Optic Nerve and Floor of Orbit", "correct": true}, {"label": "B", "text": "Optic Nerve and Internal Carotid Artery", "correct": false}, {"label": "C", "text": "Optic Nerve and Nasolacrimal Duct", "correct": false}, {"label": "D", "text": "Orbital Floor and Nasolacrimal Duct", "correct": false}], "correct_answer": "A. Optic Nerve and Floor of Orbit", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture29.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture30.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture31.jpg"], "explanation": "<p><strong>Ans. A) Optic Nerve and Floor of Orbit</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: While Onodi cells are indeed related to the optic nerve due to their posterior and lateral extension towards the sphenoid sinus , they are not typically associated with the internal carotid artery. The internal carotid artery may be related to other sphenoid sinus structures but not specifically to Onodi cells.</li><li>• Option B:</li><li>• optic nerve</li><li>• posterior</li><li>• lateral extension</li><li>• sphenoid sinus</li><li>• Option C: Onodi cells are related to the optic nerve, but there is no direct association between Onodi cells and the nasolacrimal duct. The nasolacrimal duct primarily drains tears from the lacrimal sac into the nasal cavity and is located more anteriorly , not typically in close relation to the ethmoid air cells.</li><li>• Option C:</li><li>• nasolacrimal duct</li><li>• drains tears</li><li>• lacrimal sac</li><li>• nasal cavity</li><li>• anteriorly</li><li>• Option D: While Haller cells are associated with the floor of the orbit , they do not have a direct relationship with the nasolacrimal duct. Haller cells can impinge on the orbit's floor but are not specifically related to the nasolacrimal duct's anatomy or function.</li><li>• Option D:</li><li>• Haller cells</li><li>• floor</li><li>• orbit</li><li>• Haller cells</li><li>• orbit's floor</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Onodi cells , also known as sphenoethmoidal cells , are air cells that extend posteriorly and laterally to the sphenoid sinus and can be closely associated with the optic nerve .</li><li>➤ Onodi cells , also known as sphenoethmoidal cells , are air cells that extend posteriorly and laterally to the sphenoid sinus and can be closely associated with the optic nerve .</li><li>➤ Onodi cells</li><li>➤ sphenoethmoidal cells</li><li>➤ air cells</li><li>➤ extend posteriorly</li><li>➤ laterally</li><li>➤ sphenoid sinus</li><li>➤ optic nerve</li><li>➤ Due to their proximity , an infection or surgical intervention involving Onodi cells poses a risk to the optic nerve . Haller cells are ethmoidal air cells that extend into the floor of the orbit ( infraorbital ethmoid cells ), potentially affecting the maxillary sinus' drainage and the health of the orbital contents .</li><li>➤ Due to their proximity , an infection or surgical intervention involving Onodi cells poses a risk to the optic nerve .</li><li>➤ proximity</li><li>➤ infection</li><li>➤ surgical intervention</li><li>➤ Onodi cells</li><li>➤ risk</li><li>➤ optic nerve</li><li>➤ Haller cells are ethmoidal air cells that extend into the floor of the orbit ( infraorbital ethmoid cells ), potentially affecting the maxillary sinus' drainage and the health of the orbital contents .</li><li>➤ Haller cells</li><li>➤ ethmoidal air cells</li><li>➤ extend</li><li>➤ floor</li><li>➤ orbit</li><li>➤ infraorbital ethmoid cells</li><li>➤ affecting</li><li>➤ maxillary sinus' drainage</li><li>➤ health</li><li>➤ orbital contents</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 221</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 42-year-old woman presents to the neurology clinic with complaints of double vision and difficulty navigating stairs, particularly when looking down. She also reports discomfort when trying to read for prolonged periods. On examination, she demonstrates an inability to move her right eye downward and laterally. The rest of the neurological examination, including other cranial nerve functions, is normal. Based on the specific deficit in eye movement, which cranial nerve is most likely affected in this patient?", "options": [{"label": "A", "text": "III", "correct": false}, {"label": "B", "text": "IV", "correct": true}, {"label": "C", "text": "VI", "correct": false}, {"label": "D", "text": "V", "correct": false}], "correct_answer": "B. IV", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture28.jpg"], "explanation": "<p><strong>Ans. B) IV</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: III Nerve innervates levatorpalpebrae superioris , superior rectus , medial rectus , inferior rectus and inferior oblique .</li><li>• Option A:</li><li>• levatorpalpebrae superioris</li><li>• superior rectus</li><li>• medial rectus</li><li>• inferior rectus</li><li>• inferior oblique</li><li>• Option C: VI nerve innervates Lateral rectus muscle .</li><li>• Option C:</li><li>• Lateral rectus muscle</li><li>• Option D: Ophthalmic division of V nerve provides sensory innervation to eyeball .</li><li>• Option D:</li><li>• sensory innervation</li><li>• eyeball</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The trochlear nerve (CN IV) is the smallest and the only cranial nerve that exits dorsally from the brainstem . It innervates the superior oblique muscle of the eye , which is responsible for downward and outward movement ( depression and abduction ) of the eyeball . When the superior oblique muscle is paralyzed due to dysfunction of the trochlear nerve , the affected individual may experience difficulty with the following eye movements :</li><li>➤ The trochlear nerve (CN IV) is the smallest and the only cranial nerve that exits dorsally from the brainstem . It innervates the superior oblique muscle of the eye , which is responsible for downward and outward movement ( depression and abduction ) of the eyeball .</li><li>➤ trochlear nerve</li><li>➤ smallest</li><li>➤ only cranial nerve</li><li>➤ exits</li><li>➤ dorsally</li><li>➤ brainstem</li><li>➤ superior oblique muscle</li><li>➤ eye</li><li>➤ downward</li><li>➤ outward movement</li><li>➤ depression</li><li>➤ abduction</li><li>➤ eyeball</li><li>➤ When the superior oblique muscle is paralyzed due to dysfunction of the trochlear nerve , the affected individual may experience difficulty with the following eye movements :</li><li>➤ superior oblique muscle</li><li>➤ paralyzed</li><li>➤ dysfunction</li><li>➤ trochlear nerve</li><li>➤ affected</li><li>➤ experience difficulty</li><li>➤ following eye movements</li><li>➤ Depression (Looking Down): The superior oblique muscle primarily facilitates the downward movement of the eye, particularly when the eye is adducted (turned towards the nose ). Paralysis of this muscle impairs the ability to look downward , which is especially noticeable when the individual tries to look down , such as while reading or descending stairs . Abduction: While the primary function of the superior oblique is to depress the eye , it also contributes to abduction when the eye is in a partially adducted position . Therefore, paralysis can also affect the ability to look outward , but this is less pronounced compared to its effect on depression.</li><li>➤ Depression (Looking Down): The superior oblique muscle primarily facilitates the downward movement of the eye, particularly when the eye is adducted (turned towards the nose ). Paralysis of this muscle impairs the ability to look downward , which is especially noticeable when the individual tries to look down , such as while reading or descending stairs .</li><li>➤ Depression (Looking Down):</li><li>➤ downward movement</li><li>➤ adducted</li><li>➤ towards</li><li>➤ nose</li><li>➤ Paralysis</li><li>➤ impairs</li><li>➤ ability</li><li>➤ look downward</li><li>➤ look down</li><li>➤ while reading</li><li>➤ descending stairs</li><li>➤ Abduction: While the primary function of the superior oblique is to depress the eye , it also contributes to abduction when the eye is in a partially adducted position . Therefore, paralysis can also affect the ability to look outward , but this is less pronounced compared to its effect on depression.</li><li>➤ Abduction:</li><li>➤ superior oblique</li><li>➤ depress</li><li>➤ eye</li><li>➤ abduction</li><li>➤ partially adducted position</li><li>➤ paralysis</li><li>➤ affect</li><li>➤ ability</li><li>➤ look outward</li><li>➤ The typical clinical manifestation of trochlear nerve palsy includes vertical diplopia ( double vision ), where the patient sees two images that are vertically aligned , particularly when looking down or when tilting the head towards the shoulder opposite to the affected eye . This is because the unaffected eye moves down normally, but the eye with the paralyzed superior oblique muscle lags behind , leading to misalignment of the visual axes .</li><li>➤ trochlear nerve palsy</li><li>➤ vertical diplopia</li><li>➤ double vision</li><li>➤ two images</li><li>➤ vertically aligned</li><li>➤ looking down</li><li>➤ tilting</li><li>➤ head towards</li><li>➤ shoulder</li><li>➤ opposite</li><li>➤ affected eye</li><li>➤ unaffected eye</li><li>➤ down</li><li>➤ eye</li><li>➤ paralyzed superior</li><li>➤ oblique muscle</li><li>➤ behind</li><li>➤ misalignment</li><li>➤ visual axes</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 365</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 365</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Muscle of the Soft Palate that Dilates the Auditory Tube:", "options": [{"label": "A", "text": "Tensor Veli Palatini", "correct": true}, {"label": "B", "text": "Levatorveli Palatini", "correct": false}, {"label": "C", "text": "Palatopharyngeus", "correct": false}, {"label": "D", "text": "Musculus Uvulae", "correct": false}], "correct_answer": "A. Tensor Veli Palatini", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture20.jpg"], "explanation": "<p><strong>Ans. A) Tensor Veli Palatine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The Levator veli palatini muscle elevates the soft palate to close off the nasopharynx during swallowing and speech , preventing food from entering the nasal cavity . Although it plays a crucial role in the function of the soft palate , it does not directly dilate the auditory tube.</li><li>• Option B:</li><li>• elevates</li><li>• soft palate</li><li>• nasopharynx</li><li>• swallowing</li><li>• speech</li><li>• food</li><li>• entering</li><li>• nasal cavity</li><li>• function</li><li>• soft palate</li><li>• Option C: The palatopharyngeus muscle is involved in narrowing the pharyngeal cavity , lowering the soft palate , and helping in the elevation of the larynx and pharynx during swallowing . It does not have a direct role in the dilation of the auditory tube.</li><li>• Option C:</li><li>• narrowing</li><li>• pharyngeal cavity</li><li>• lowering</li><li>• soft palate</li><li>• elevation</li><li>• larynx</li><li>• pharynx</li><li>• swallowing</li><li>• Option D: The musculus uvulae is a small muscle that makes up the bulk of the uvula and helps in elevating the uvula . By shortening and elevating the uvula, it plays a role in the function of the soft palate but does not contribute to the dilation of the auditory tube.</li><li>• Option D:</li><li>• small muscle</li><li>• makes up</li><li>• bulk</li><li>• uvula</li><li>• elevating</li><li>• uvula</li><li>• shortening</li><li>• elevating</li><li>• function</li><li>• soft palate</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tensor Veli Palatini:</li><li>➤ The tensor veli palatini muscle originates from the sphenoid bone and the cartilaginous part of the auditory tube . It inserts into the palatine aponeurosis . The primary function of the tensor veli palatini is to tense the soft palate and open the auditory tube during swallowing and yawning . This action equalizes the pressure between the middle ear and the nasopharynx , which is crucial for proper hearing function . The muscle is innervated by a branch of the mandibular nerve ( CN V3 ), which is part of the trigeminal nerve .</li><li>➤ The tensor veli palatini muscle originates from the sphenoid bone and the cartilaginous part of the auditory tube .</li><li>➤ originates</li><li>➤ sphenoid bone</li><li>➤ cartilaginous part</li><li>➤ auditory</li><li>➤ tube</li><li>➤ It inserts into the palatine aponeurosis .</li><li>➤ palatine aponeurosis</li><li>➤ The primary function of the tensor veli palatini is to tense the soft palate and open the auditory tube during swallowing and yawning .</li><li>➤ tense</li><li>➤ soft palate</li><li>➤ open</li><li>➤ auditory tube</li><li>➤ swallowing</li><li>➤ yawning</li><li>➤ This action equalizes the pressure between the middle ear and the nasopharynx , which is crucial for proper hearing function .</li><li>➤ equalizes</li><li>➤ pressure</li><li>➤ middle ear</li><li>➤ nasopharynx</li><li>➤ proper hearing function</li><li>➤ The muscle is innervated by a branch of the mandibular nerve ( CN V3 ), which is part of the trigeminal nerve .</li><li>➤ branch</li><li>➤ mandibular nerve</li><li>➤ CN V3</li><li>➤ trigeminal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 133</li><li>➤ Ref</li><li>➤ : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 133</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 37-year-old woman presents to the clinic with numbness and tingling on the upper part of her right ear. She denies any trauma or injury to the ear but mentions recent episodes of severe headaches. On physical examination, the sensation is diminished on the anterior surface of the pinna and around the tragus. The rest of the cranial nerve examination is within normal limits. Given the distribution of her sensory loss, which of the following nerves is least likely to be involved in the innervation of the affected area?", "options": [{"label": "A", "text": "Auriculotemporal Nerve", "correct": false}, {"label": "B", "text": "Great Auricular Nerve", "correct": false}, {"label": "C", "text": "Lesser Occipital Nerve", "correct": false}, {"label": "D", "text": "Tympanic Branch of Glossopharyngeal Nerve", "correct": true}], "correct_answer": "D. Tympanic Branch of Glossopharyngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture18.jpg"], "explanation": "<p><strong>Ans. D) Tympanic Branch of Glossopharyngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The auriculotemporal nerve, a branch of the mandibular nerve ( V3 , which is the third branch of the trigeminal nerve ), does supply the pinna . It innervates the anterior and inferior portions of the external ear , as well as the external auditory meatus and the outer surface of the tympanic membrane .</li><li>• Option A:</li><li>• branch</li><li>• mandibular nerve</li><li>• V3</li><li>• third branch</li><li>• trigeminal nerve</li><li>• supply</li><li>• pinna</li><li>• innervates</li><li>• anterior</li><li>• inferior portions</li><li>• external ear</li><li>• external auditory</li><li>• meatus</li><li>• outer surface</li><li>• tympanic membrane</li><li>• Option B: The great auricular nerve, a branch of the cervical plexus (arising from C2 and C3 spinal nerves ), also supplies the pinna . It innervates the skin over the lower part of the pinna and the area behind the ear .</li><li>• Option B:</li><li>• cervical plexus</li><li>• C2</li><li>• C3 spinal nerves</li><li>• supplies</li><li>• pinna</li><li>• skin</li><li>• over</li><li>• lower part</li><li>• pinna</li><li>• area</li><li>• behind</li><li>• ear</li><li>• Option C: The lesser occipital nerve, another branch of the cervical plexus , innervates the skin of the neck and scalp posterior to the ear . While it is in close proximity to the pinna , its primary innervation is not the pinna itself but the area around it. However, there might be some overlapping sensory distribution.</li><li>• Option C:</li><li>• cervical plexus</li><li>• skin</li><li>• neck</li><li>• scalp posterior</li><li>• ear</li><li>• close proximity</li><li>• pinna</li><li>• overlapping sensory distribution.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nerves supplying pinna - Auriculotemporal nerve , Great auricular nerve , Lesser occipital nerve and Auricular branch of vagus . Tympanic branch of glossopharyngeal nerve forms tympanic plexus in middle ear cavity and doesn’t innervate pinna.</li><li>➤ Nerves supplying pinna - Auriculotemporal nerve , Great auricular nerve , Lesser occipital nerve and Auricular branch of vagus .</li><li>➤ Nerves supplying pinna - Auriculotemporal nerve , Great auricular nerve , Lesser occipital nerve and Auricular branch of vagus .</li><li>➤ Nerves supplying pinna</li><li>➤ Auriculotemporal nerve</li><li>➤ Great auricular</li><li>➤ nerve</li><li>➤ Lesser occipital nerve</li><li>➤ Auricular branch</li><li>➤ vagus</li><li>➤ Tympanic branch of glossopharyngeal nerve forms tympanic plexus in middle ear cavity and doesn’t innervate pinna.</li><li>➤ Tympanic branch of glossopharyngeal nerve forms tympanic plexus in middle ear cavity and doesn’t innervate pinna.</li><li>➤ Tympanic branch</li><li>➤ glossopharyngeal nerve</li><li>➤ tympanic plexus</li><li>➤ middle ear cavity</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 275</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 275</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the clinic with a Painful, Swollen Right Neck following a recent Upper Respiratory Tract Infection. He reports tenderness and warmth over the right side of his neck, which exacerbates when he turns his head to the left. On examination, there is noticeable swelling over the right sternocleidomastoid muscle, and palpation reveals tenderness along the length of the muscle. The patient has a restricted range of motion due to pain when attempting to rotate his head to the opposite side. Given the vascular supply to the sternocleidomastoid muscle, which of the following arteries is least likely to be involved in the blood supply to the affected area?", "options": [{"label": "A", "text": "Occipital Artery", "correct": false}, {"label": "B", "text": "Posterior Auricular Artery", "correct": true}, {"label": "C", "text": "Superior Thyroid Artery", "correct": false}, {"label": "D", "text": "Thyrocervical Trunk", "correct": false}], "correct_answer": "B. Posterior Auricular Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture16.jpg"], "explanation": "<p><strong>Ans. B) Posterior Auricular Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Sternomastoid branches from occipital artery supply the upper 1/3 of the muscle.</li><li>• Option A:</li><li>• Sternomastoid branches</li><li>• upper 1/3</li><li>• Option C: Sternomastoid branches from superior thyroid artery supply middle third of the muscle.</li><li>• Option C: Sternomastoid branches</li><li>• middle third</li><li>• Option D: Suprascapular artery from thyrocervical trunk supplies lower third of the muscle.</li><li>• Option D: Suprascapular artery</li><li>• lower third</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Occipital Artery: A branch of the external carotid artery, the occipital artery supplies the upper and posterior parts of the SCM. This artery typically runs up the back of the scalp but sends branches to the SCM as it ascends . Superior Thyroid Artery: Also, a branch of the external carotid artery , the superior thyroid artery primarily supplies the thyroid gland but sends branches to the adjacent neck muscles , including the SCM, particularly its superior part . Thyro-Cervical Trunk: The thyro-cervical trunk is a branch of the subclavian artery , and it gives rise to several branches, one of which is the inferior thyroid artery . The inferior thyroid artery often gives off ascending cervical branches that can supply the SCM . Suprascapular Artery: The suprascapular artery, another branch from the thyro-cervical trunk , can also supply parts of the SCM , especially its medial and inferior portions .</li><li>➤ Occipital Artery: A branch of the external carotid artery, the occipital artery supplies the upper and posterior parts of the SCM. This artery typically runs up the back of the scalp but sends branches to the SCM as it ascends .</li><li>➤ Occipital Artery:</li><li>➤ supplies</li><li>➤ upper</li><li>➤ posterior parts</li><li>➤ back</li><li>➤ scalp</li><li>➤ sends branches</li><li>➤ SCM</li><li>➤ ascends</li><li>➤ Superior Thyroid Artery: Also, a branch of the external carotid artery , the superior thyroid artery primarily supplies the thyroid gland but sends branches to the adjacent neck muscles , including the SCM, particularly its superior part .</li><li>➤ Superior Thyroid Artery:</li><li>➤ branch</li><li>➤ external carotid artery</li><li>➤ supplies</li><li>➤ branches</li><li>➤ adjacent neck</li><li>➤ muscles</li><li>➤ superior part</li><li>➤ Thyro-Cervical Trunk: The thyro-cervical trunk is a branch of the subclavian artery , and it gives rise to several branches, one of which is the inferior thyroid artery . The inferior thyroid artery often gives off ascending cervical branches that can supply the SCM .</li><li>➤ Thyro-Cervical Trunk:</li><li>➤ subclavian artery</li><li>➤ inferior thyroid artery</li><li>➤ inferior thyroid artery</li><li>➤ ascending cervical branches</li><li>➤ supply</li><li>➤ SCM</li><li>➤ Suprascapular Artery: The suprascapular artery, another branch from the thyro-cervical trunk , can also supply parts of the SCM , especially its medial and inferior portions .</li><li>➤ Suprascapular Artery:</li><li>➤ thyro-cervical trunk</li><li>➤ supply parts</li><li>➤ SCM</li><li>➤ medial</li><li>➤ inferior portions</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 185</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Nasolacrimal Duct opens into:", "options": [{"label": "A", "text": "Superior Meatus", "correct": false}, {"label": "B", "text": "Middle Meatus", "correct": false}, {"label": "C", "text": "Inferior Meatus", "correct": true}, {"label": "D", "text": "Sphenoethmoidal Recess", "correct": false}], "correct_answer": "C. Inferior Meatus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture11.jpg"], "explanation": "<p><strong>Ans. C) Inferior Meatus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A: Superior meatus receives the posterior ethmoidal sinus .</li><li>• Option A:</li><li>• posterior ethmoidal sinus</li><li>• Option B: Middle meatus receives- maxillary sinus , frontal sinus , anterior and middle ethmoidal sinus .</li><li>• Option B:</li><li>• maxillary sinus</li><li>• frontal sinus</li><li>• anterior</li><li>• middle ethmoidal sinus</li><li>• Option D: Sphenoidal sinus opens into sphenoethmoidal recess .</li><li>• Option D:</li><li>• sphenoethmoidal recess</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The nasolacrimal duct drains tears from the lacrimal sac into the nasal cavity . It opens into the inferior meatus of the nasal cavity , which is located beneath the inferior nasal concha (or turbinate ). This opening allows the tears that have been collected in the lacrimal sac to flow into the nasal cavity , where they can be reabsorbed or expelled .</li><li>➤ The nasolacrimal duct drains tears from the lacrimal sac into the nasal cavity .</li><li>➤ tears</li><li>➤ lacrimal sac</li><li>➤ nasal cavity</li><li>➤ It opens into the inferior meatus of the nasal cavity , which is located beneath the inferior nasal concha (or turbinate ).</li><li>➤ inferior meatus</li><li>➤ nasal cavity</li><li>➤ beneath</li><li>➤ inferior nasal concha</li><li>➤ turbinate</li><li>➤ This opening allows the tears that have been collected in the lacrimal sac to flow into the nasal cavity , where they can be reabsorbed or expelled .</li><li>➤ allows</li><li>➤ tears</li><li>➤ collected</li><li>➤ lacrimal sac</li><li>➤ flow</li><li>➤ nasal cavity</li><li>➤ reabsorbed</li><li>➤ expelled</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 218</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 218</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Apex of Thyroid Gland is Sandwiched between:", "options": [{"label": "A", "text": "Inferior Constrictor and Sternothyroid", "correct": true}, {"label": "B", "text": "Middle Constrictor and Sternohyoid", "correct": false}, {"label": "C", "text": "Inferior Constrictor and Sternohyoid", "correct": false}, {"label": "D", "text": "Middle Constrictor and Sternothyroid", "correct": false}], "correct_answer": "A. Inferior Constrictor and Sternothyroid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture10.jpg"], "explanation": "<p><strong>Ans. A) Inferior Constrictor and Sternothyroid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B: The middle constrictor muscle is a part of the pharyngeal constrictor muscles , but it does not form the boundary for the apex of the thyroid gland. The sternohyoid muscle , another infrahyoid muscle , also does not directly relate to the apex of the thyroid gland.</li><li>• Option B:</li><li>• middle constrictor muscle</li><li>• pharyngeal constrictor muscles</li><li>• sternohyoid muscle</li><li>• infrahyoid muscle</li><li>• Option C: While the inferior constrictor muscle is involved, the sternohyoid muscle is not the correct pairing for the apex of the thyroid gland. The sternohyoid lies more superficially compared to the sternothyroid and is not directly involved in sandwiching the thyroid glands apex.</li><li>• Option C:</li><li>• more superficially</li><li>• sternothyroid</li><li>• Option D: As mentioned, the middle constrictor muscle is not involved in the boundary of the thyroid glands’ apex. The sternothyroid muscle does play a role , but in conjunction with the inferior constrictor , not the middle constrictor.</li><li>• Option D:</li><li>• sternothyroid muscle</li><li>• play</li><li>• role</li><li>• conjunction</li><li>• inferior constrictor</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior Constrictor and Sternothyroid :</li><li>➤ Inferior Constrictor</li><li>➤ Sternothyroid</li><li>➤ The apex of the thyroid gland is indeed positioned between the inferior constrictor muscle and the sternothyroid muscle . The inferior constrictor is part of the pharyngeal constrictor muscles and is involved in swallowing , while the sternothyroid muscle is one of the infrahyoid muscles that play a role in the position of the larynx and thyroid cartilage .</li><li>➤ The apex of the thyroid gland is indeed positioned between the inferior constrictor muscle and the sternothyroid muscle .</li><li>➤ apex</li><li>➤ thyroid gland</li><li>➤ positioned</li><li>➤ inferior constrictor</li><li>➤ muscle</li><li>➤ sternothyroid muscle</li><li>➤ The inferior constrictor is part of the pharyngeal constrictor muscles and is involved in swallowing , while the sternothyroid muscle is one of the infrahyoid muscles that play a role in the position of the larynx and thyroid cartilage .</li><li>➤ inferior constrictor</li><li>➤ pharyngeal constrictor muscles</li><li>➤ swallowing</li><li>➤ sternothyroid muscle</li><li>➤ infrahyoid muscles</li><li>➤ position</li><li>➤ larynx</li><li>➤ thyroid cartilage</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 304</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Parasympathetic Ganglion that is functionally related to glossopharyngeal nerve:", "options": [{"label": "A", "text": "Ciliary Ganglion", "correct": false}, {"label": "B", "text": "Submandibular Ganglion", "correct": false}, {"label": "C", "text": "Pterygopalatine Ganglion", "correct": false}, {"label": "D", "text": "Otic Ganglion", "correct": true}], "correct_answer": "D. Otic Ganglion", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture9.jpg"], "explanation": "<p><strong>Ans. D) Otic Ganglion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Ciliary ganglion functionally related to Oculomotor nerve and topographically related to V1 .</li><li>• Option A:</li><li>• Oculomotor nerve</li><li>• topographically related</li><li>• V1</li><li>• Option B: Submandibular ganglion functionally related to VII nerve but topographically related to V2.</li><li>• Option B:</li><li>• VII nerve</li><li>• topographically</li><li>• V2.</li><li>• Option C: Pterygopalatine ganglion functionally related to VII nerve but topographically related to V3.</li><li>• Option C:</li><li>• VII nerve</li><li>• topographically</li><li>• V3.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The otic ganglion is indeed an interesting structure because of its unique topographical and functional relationships. It is a small , parasympathetic ganglion located just below the foramen ovale , in close proximity to the medial surface of the mandibular nerve (a branch of the trigeminal nerve , CN V3). This proximity leads to its topographical association with the mandibular nerve . Functionally, however, the otic ganglion is associated with the glossopharyngeal nerve (CN IX). The parasympathetic fibers that synapse in the otic ganglion originate from the inferior salivatory nucleus in the brainstem . These preganglionic parasympathetic fibers travel with the glossopharyngeal nerve and then branch off as the tympanic nerve , which enters the middle ear to form the tympanic plexus . From this plexus, the fibers continue as the lesser petrosal nerve , which exits the middle ear , and then these fibers enter the otic ganglion where they synapse . The postganglionic fibers from the otic ganglion then join the auriculotemporal nerve (a branch of the mandibular nerve , CN V3 ) to reach the parotid gland , where they stimulate the production of saliva . Despite its physical association with the mandibular nerve , the otic ganglion does not relay sensory or motor fibers from the trigeminal system. Its primary function is to mediate parasympathetic control of the parotid salivary gland , thus showing its functional relationship with the glossopharyngeal nerve ( CN IX ).</li><li>➤ The otic ganglion is indeed an interesting structure because of its unique topographical and functional relationships. It is a small , parasympathetic ganglion located just below the foramen ovale , in close proximity to the medial surface of the mandibular nerve (a branch of the trigeminal nerve , CN V3). This proximity leads to its topographical association with the mandibular nerve .</li><li>➤ small</li><li>➤ parasympathetic ganglion</li><li>➤ below</li><li>➤ foramen ovale</li><li>➤ medial surface</li><li>➤ mandibular nerve</li><li>➤ trigeminal nerve</li><li>➤ mandibular nerve</li><li>➤ Functionally, however, the otic ganglion is associated with the glossopharyngeal nerve (CN IX). The parasympathetic fibers that synapse in the otic ganglion originate from the inferior salivatory nucleus in the brainstem . These preganglionic parasympathetic fibers travel with the glossopharyngeal nerve and then branch off as the tympanic nerve , which enters the middle ear to form the tympanic plexus .</li><li>➤ otic ganglion</li><li>➤ glossopharyngeal nerve</li><li>➤ parasympathetic fibers</li><li>➤ synapse</li><li>➤ otic ganglion</li><li>➤ inferior salivatory nucleus</li><li>➤ brainstem</li><li>➤ preganglionic parasympathetic fibers</li><li>➤ glossopharyngeal nerve</li><li>➤ branch off</li><li>➤ tympanic nerve</li><li>➤ enters</li><li>➤ middle ear</li><li>➤ tympanic plexus</li><li>➤ From this plexus, the fibers continue as the lesser petrosal nerve , which exits the middle ear , and then these fibers enter the otic ganglion where they synapse .</li><li>➤ fibers</li><li>➤ lesser petrosal nerve</li><li>➤ exits</li><li>➤ middle ear</li><li>➤ enter</li><li>➤ otic ganglion</li><li>➤ synapse</li><li>➤ The postganglionic fibers from the otic ganglion then join the auriculotemporal nerve (a branch of the mandibular nerve , CN V3 ) to reach the parotid gland , where they stimulate the production of saliva .</li><li>➤ postganglionic fibers</li><li>➤ otic ganglion</li><li>➤ join</li><li>➤ auriculotemporal nerve</li><li>➤ mandibular nerve</li><li>➤ CN V3</li><li>➤ reach</li><li>➤ parotid gland</li><li>➤ stimulate</li><li>➤ production</li><li>➤ saliva</li><li>➤ Despite its physical association with the mandibular nerve , the otic ganglion does not relay sensory or motor fibers from the trigeminal system. Its primary function is to mediate parasympathetic control of the parotid salivary gland , thus showing its functional relationship with the glossopharyngeal nerve ( CN IX ).</li><li>➤ mandibular nerve</li><li>➤ mediate parasympathetic control</li><li>➤ parotid salivary gland</li><li>➤ showing</li><li>➤ glossopharyngeal nerve</li><li>➤ CN IX</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 367</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 367</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a boundary of Trautmann's Triangle:", "options": [{"label": "A", "text": "Superior Petrosal Sinus", "correct": false}, {"label": "B", "text": "Inferior Petrosal Sinus", "correct": true}, {"label": "C", "text": "Sigmoid Sinus", "correct": false}, {"label": "D", "text": "Semicircular Canals", "correct": false}], "correct_answer": "B. Inferior Petrosal Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture8.jpg"], "explanation": "<p><strong>Ans. B) Inferior Petrosal Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The superior petrosal sinus is indeed one of the boundaries of Trautmann's triangle . It runs along the petrous ridge of the temporal bone and forms the anterior boundary of the triangle .</li><li>• Option A:</li><li>• Trautmann's triangle</li><li>• petrous ridge</li><li>• temporal bone</li><li>• forms</li><li>• anterior boundary</li><li>• triangle</li><li>• Option C: The sigmoid sinus is a key boundary of Trautmann's triangle , forming the posterior boundary . It is a continuation of the transverse sinus , curving downward to become the internal jugular vein , and its relationship to the triangle is crucial for surgical approaches to the cerebellopontine angle .</li><li>• Option C:</li><li>• Trautmann's triangle</li><li>• forming</li><li>• posterior boundary</li><li>• continuation</li><li>• transverse sinus</li><li>• downward</li><li>• become</li><li>• internal jugular vein</li><li>• crucial</li><li>• surgical approaches</li><li>• cerebellopontine angle</li><li>• Option D: While the semicircular canals are located within the region of interest for surgeries involving Trautmann's triangle , they are not considered a boundary of the triangle itself. The semicircular canals are part of the inner ear and are important for balance and spatial orientation .</li><li>• Option D:</li><li>• region</li><li>• interest</li><li>• surgeries</li><li>• Trautmann's triangle</li><li>• semicircular canals</li><li>• inner ear and</li><li>• balance</li><li>• spatial orientation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trautmann's triangle , also known as the Cerebello Pontine Angle (CPA) cistern , is an anatomical region of significant clinical relevance , especially in neurosurgery and otolaryngology . It's important for accessing lesions in the cerebellopontine angle , such as vestibular schwannomas ( acoustic neuromas ) and meningiomas . The boundaries of Trautmann's triangle help in understanding the surgical approach to this area .</li><li>➤ Trautmann's triangle , also known as the Cerebello Pontine Angle (CPA) cistern , is an anatomical region of significant clinical relevance , especially in neurosurgery and otolaryngology .</li><li>➤ Trautmann's triangle</li><li>➤ Cerebello Pontine Angle (CPA) cistern</li><li>➤ anatomical region</li><li>➤ significant clinical relevance</li><li>➤ neurosurgery</li><li>➤ otolaryngology</li><li>➤ It's important for accessing lesions in the cerebellopontine angle , such as vestibular schwannomas ( acoustic neuromas ) and meningiomas . The boundaries of Trautmann's triangle help in understanding the surgical approach to this area .</li><li>➤ accessing lesions</li><li>➤ cerebellopontine angle</li><li>➤ vestibular schwannomas</li><li>➤ acoustic neuromas</li><li>➤ meningiomas</li><li>➤ Trautmann's triangle</li><li>➤ understanding</li><li>➤ surgical approach</li><li>➤ area</li><li>➤ The inferior petrosal sinus is not a boundary of Trautmann's triangle. It runs along the petroclival fissure , extending from the cavernous sinus to the jugular bulb , and is located more medially compared to the structures defining Trautmann's triangle .</li><li>➤ petroclival fissure</li><li>➤ cavernous sinus</li><li>➤ jugular bulb</li><li>➤ medially</li><li>➤ defining Trautmann's triangle</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 285</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 285</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman presents to the emergency department with a severe headache and blurred vision. She has a history of chronic ear infections and recently experienced a sudden onset of these symptoms. Imaging studies indicate increased intracranial pressure and thrombosis in one of the venous sinuses. Based on the anatomical drainage patterns, which of the following venous structures, if involved in the thrombosis, would likely be the first to contribute directly to the internal jugular vein and potentially relate to her symptoms?", "options": [{"label": "A", "text": "Sigmoid Sinus", "correct": false}, {"label": "B", "text": "Straight Sinus", "correct": false}, {"label": "C", "text": "Inferior Petrosal Sinus", "correct": true}, {"label": "D", "text": "Facial Vein", "correct": false}], "correct_answer": "C. Inferior Petrosal Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/20/picture7.jpg"], "explanation": "<p><strong>Ans. C) Inferior Petrosal Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Sigmoid sinus continues as internal jugular vein through posterior compartment of jugular foramen .</li><li>• Option A:</li><li>• internal jugular vein</li><li>• posterior compartment</li><li>• jugular foramen</li><li>• Option B: Inferior sagittal sinus unites with great cerebral vein of Galen to form straight sinus which becomes continuous with left transverse sinus .</li><li>• Option B:</li><li>• great cerebral vein</li><li>• Galen</li><li>• straight sinus</li><li>• continuous</li><li>• left transverse sinus</li><li>• Option D: Occipital veins , common facial vein , lingual vein , superior thyroid vein , middle thyroid vein and vein of Kocher are tributaries of IJV .</li><li>• Option D:</li><li>• Occipital veins</li><li>• common facial vein</li><li>• lingual vein</li><li>• superior thyroid vein</li><li>• middle thyroid vein</li><li>• vein of Kocher</li><li>• IJV</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The first tributary of the internal jugular vein is typically the inferior petrosal sinus . The inferior petrosal sinus drains blood from the cavernous sinus of the brain and empties into the internal jugular vein near its origin at the jugular foramen . This venous channel is significant for the drainage of venous blood from the cavernous sinus , bridging the intracranial and extracranial venous systems .</li><li>➤ The first tributary of the internal jugular vein is typically the inferior petrosal sinus .</li><li>➤ internal jugular</li><li>➤ vein</li><li>➤ inferior petrosal sinus</li><li>➤ The inferior petrosal sinus drains blood from the cavernous sinus of the brain and empties into the internal jugular vein near its origin at the jugular foramen .</li><li>➤ from</li><li>➤ cavernous sinus</li><li>➤ brain</li><li>➤ empties</li><li>➤ internal jugular vein</li><li>➤ origin</li><li>➤ jugular foramen</li><li>➤ This venous channel is significant for the drainage of venous blood from the cavernous sinus , bridging the intracranial and extracranial venous systems .</li><li>➤ drainage</li><li>➤ venous blood</li><li>➤ cavernous sinus</li><li>➤ intracranial</li><li>➤ extracranial venous systems</li><li>➤ Ref : IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg342</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy vol.3 Head and Neck, Neuroanatomy 7 th edition pg342</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Principal Artery of Palatine Tonsil?", "options": [{"label": "A", "text": "Superior Tonsillar Artery", "correct": false}, {"label": "B", "text": "Inferior Tonsillar Artery", "correct": true}, {"label": "C", "text": "Anterior Tonsillar Artery", "correct": false}, {"label": "D", "text": "Posterior Tonsillar Artery", "correct": false}], "correct_answer": "B. Inferior Tonsillar Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture31.jpg"], "explanation": "<p><strong>Ans. B) Inferior Tonsillar Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Superior tonsillar is branch from descending palatine artery ( maxillary artery )</li><li>• Option A:</li><li>• Superior tonsillar</li><li>• descending palatine artery</li><li>• maxillary artery</li><li>• Option C: Anterior tonsillar is branch from dorsal lingual artery ( lingual artery )</li><li>• Option C:</li><li>• Anterior tonsillar</li><li>• dorsal lingual artery</li><li>• lingual artery</li><li>• Option D: Posterior tonsillar branches arise from facial artery ascending palatine branch and ascending pharyngeal artery .</li><li>• Option D:</li><li>• Posterior tonsillar</li><li>• facial artery</li><li>• ascending palatine branch</li><li>• ascending pharyngeal artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The palatine tonsil , located in the oropharynx , receives its blood supply from several arteries , with the principal artery being the tonsillar branch of the facial artery . This branch is often referred to as the inferior tonsillar artery , although this specific naming can vary in different texts. The importance of the tonsillar branch arises from its direct contribution to the vascular supply of the tonsil . Here's a detailed explanation:</li><li>➤ The palatine tonsil , located in the oropharynx , receives its blood supply from several arteries , with the principal artery being the tonsillar branch of the facial artery .</li><li>➤ palatine tonsil</li><li>➤ oropharynx</li><li>➤ blood</li><li>➤ supply</li><li>➤ arteries</li><li>➤ principal artery</li><li>➤ tonsillar branch</li><li>➤ facial artery</li><li>➤ This branch is often referred to as the inferior tonsillar artery , although this specific naming can vary in different texts. The importance of the tonsillar branch arises from its direct contribution to the vascular supply of the tonsil . Here's a detailed explanation:</li><li>➤ inferior tonsillar artery</li><li>➤ tonsillar branch</li><li>➤ arises</li><li>➤ direct contribution</li><li>➤ vascular supply</li><li>➤ tonsil</li><li>➤ Facial Artery: The facial artery is a major branch of the external carotid artery . As it courses upwards along the side of the face , it gives off several branches that supply various structures, including the palatine tonsil . Tonsillar Branch: The tonsillar branch typically arises near the upper border of the tonsil . It enters the tonsillar fossa from below , often after giving off branches to the adjacent pharyngeal muscles and other nearby structures. Upon reaching the tonsil , the tonsillar branch penetrates the tonsillar capsule and provides the primary blood supply to the tonsil . Collateral Supply: Although the tonsillar branch of the facial artery is the principal artery , the tonsil also receives collateral blood supply from other arteries, including:</li><li>➤ Facial Artery: The facial artery is a major branch of the external carotid artery . As it courses upwards along the side of the face , it gives off several branches that supply various structures, including the palatine tonsil .</li><li>➤ Facial Artery:</li><li>➤ major branch</li><li>➤ external carotid artery</li><li>➤ side</li><li>➤ face</li><li>➤ supply</li><li>➤ palatine tonsil</li><li>➤ Tonsillar Branch: The tonsillar branch typically arises near the upper border of the tonsil . It enters the tonsillar fossa from below , often after giving off branches to the adjacent pharyngeal muscles and other nearby structures. Upon reaching the tonsil , the tonsillar branch penetrates the tonsillar capsule and provides the primary blood supply to the tonsil .</li><li>➤ Tonsillar Branch:</li><li>➤ arises</li><li>➤ upper border</li><li>➤ tonsil</li><li>➤ enters</li><li>➤ tonsillar fossa</li><li>➤ below</li><li>➤ giving off branches</li><li>➤ adjacent pharyngeal</li><li>➤ muscles</li><li>➤ reaching</li><li>➤ tonsil</li><li>➤ tonsillar branch</li><li>➤ tonsillar capsule</li><li>➤ primary blood supply</li><li>➤ tonsil</li><li>➤ Collateral Supply: Although the tonsillar branch of the facial artery is the principal artery , the tonsil also receives collateral blood supply from other arteries, including:</li><li>➤ Collateral Supply:</li><li>➤ tonsillar branch</li><li>➤ facial artery</li><li>➤ principal artery</li><li>➤ receives collateral blood supply</li><li>➤ Ascending Palatine Artery: A branch of the facial artery that ascends on the pharyngeal wall and supplies the tonsil from its posterior aspect . Dorsal Lingual Branches: From the lingual artery, supplying the base of the tongue and contributing to the tonsil's vascularization . Ascending Pharyngeal Artery: A branch of the external carotid artery , contributing to the vascular supply of the pharynx and tonsils . Lesser Palatine Arteries: Branches from the descending palatine artery (itself a branch of the maxillary artery ), supplying the soft palate and tonsils .</li><li>➤ Ascending Palatine Artery: A branch of the facial artery that ascends on the pharyngeal wall and supplies the tonsil from its posterior aspect .</li><li>➤ Ascending Palatine Artery:</li><li>➤ facial artery</li><li>➤ ascends</li><li>➤ pharyngeal wall</li><li>➤ supplies</li><li>➤ tonsil</li><li>➤ posterior aspect</li><li>➤ Dorsal Lingual Branches: From the lingual artery, supplying the base of the tongue and contributing to the tonsil's vascularization .</li><li>➤ Dorsal Lingual Branches:</li><li>➤ supplying</li><li>➤ base</li><li>➤ tongue</li><li>➤ tonsil's vascularization</li><li>➤ Ascending Pharyngeal Artery: A branch of the external carotid artery , contributing to the vascular supply of the pharynx and tonsils .</li><li>➤ Ascending Pharyngeal Artery:</li><li>➤ external carotid artery</li><li>➤ vascular supply</li><li>➤ pharynx</li><li>➤ tonsils</li><li>➤ Lesser Palatine Arteries: Branches from the descending palatine artery (itself a branch of the maxillary artery ), supplying the soft palate and tonsils .</li><li>➤ Lesser Palatine Arteries:</li><li>➤ descending palatine artery</li><li>➤ maxillary artery</li><li>➤ soft palate</li><li>➤ tonsils</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the clinic with a persistent, dull pain in his left ear and a recent onset of a metallic taste in his mouth. He has a history of chronic ear infections but denies any recent infections or trauma. Otoscopic examination reveals no acute inflammation or infection in the external auditory canal or tympanic membrane. Given the patient's symptoms and history, which anatomical structure in the middle ear, if affected, could explain his symptoms?", "options": [{"label": "A", "text": "Roof", "correct": false}, {"label": "B", "text": "Floor", "correct": true}, {"label": "C", "text": "Anterior Wall", "correct": false}, {"label": "D", "text": "Posterior Wall", "correct": false}], "correct_answer": "B. Floor", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture30.jpg"], "explanation": "<p><strong>Ans. B) Floor</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: Roof is formed by tegmen tympani and pierced by greater and lesser petrosal nerve .</li><li>• Option A:</li><li>• tegmen tympani</li><li>• pierced</li><li>• greater</li><li>• lesser petrosal nerve</li><li>• Option C: Anterior wall - lower part - carotid canal and pierced by superior and inferior caroticotympanic nerves .</li><li>• Option C:</li><li>• lower part</li><li>• carotid canal</li><li>• pierced</li><li>• superior</li><li>• inferior caroticotympanic nerves</li><li>• Option D: Posterior wall is related to the vertical course of facial nerve in its bony canal .</li><li>• Option D:</li><li>• vertical course</li><li>• facial nerve</li><li>• bony canal</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Jacobson's nerve , also known as the tympanic nerve , is a branch of the glossopharyngeal nerve (CN IX ). It carries parasympathetic fibers to the middle ear and is involved in the innervation of the mucosa of the middle ear , the mastoid air cells , and the Eustachian tube . Jacobson's nerve enters the middle ear by piercing the floor of the tympanic cavity . It does so through a small canal known as the tympanic canaliculus , which is located near the promontory of the medial wall of the middle ear . After entering the middle ear , the tympanic nerve contributes to the formation of the tympanic plexus on the surface of the promontory . This plexus is involved in providing sensory innervation to the mucous membrane of the tympanic cavity and mastoid air cells , as well as contributing parasympathetic fibers to the otic ganglion via the lesser petrosal nerve .</li><li>➤ Jacobson's nerve , also known as the tympanic nerve , is a branch of the glossopharyngeal nerve (CN IX ). It carries parasympathetic fibers to the middle ear and is involved in the innervation of the mucosa of the middle ear , the mastoid air cells , and the Eustachian tube .</li><li>➤ Jacobson's nerve</li><li>➤ tympanic nerve</li><li>➤ glossopharyngeal nerve</li><li>➤ IX</li><li>➤ parasympathetic fibers</li><li>➤ middle ear</li><li>➤ mucosa</li><li>➤ middle ear</li><li>➤ mastoid air cells</li><li>➤ Eustachian tube</li><li>➤ Jacobson's nerve enters the middle ear by piercing the floor of the tympanic cavity . It does so through a small canal known as the tympanic canaliculus , which is located near the promontory of the medial wall of the middle ear .</li><li>➤ Jacobson's nerve</li><li>➤ middle ear</li><li>➤ piercing</li><li>➤ floor</li><li>➤ tympanic cavity</li><li>➤ tympanic canaliculus</li><li>➤ promontory</li><li>➤ medial wall</li><li>➤ middle ear</li><li>➤ After entering the middle ear , the tympanic nerve contributes to the formation of the tympanic plexus on the surface of the promontory .</li><li>➤ After</li><li>➤ middle ear</li><li>➤ tympanic nerve</li><li>➤ formation</li><li>➤ tympanic plexus</li><li>➤ surface</li><li>➤ promontory</li><li>➤ This plexus is involved in providing sensory innervation to the mucous membrane of the tympanic cavity and mastoid air cells , as well as contributing parasympathetic fibers to the otic ganglion via the lesser petrosal nerve .</li><li>➤ sensory innervation</li><li>➤ mucous membrane</li><li>➤ tympanic cavity</li><li>➤ mastoid air cells</li><li>➤ parasympathetic fibers</li><li>➤ otic ganglion</li><li>➤ lesser petrosal nerve</li><li>➤ Ref : IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 278</li><li>➤ Ref :</li><li>➤ IB Singh Textbook of Anatomy Vol. 3 Head and Neck, Neuroanatomy 7 th Edition Pg 278</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male visited the ENT OPD with complaints of fever, headache, ear pain and reduced hearing in the right ear. The patient also complained of pain in the right ear while eating. On examination, there was a small swelling behind the ear and severe tenderness over and behind the right ear. There was also a purulent discharge from the right ear. CT scan showed fluid in mastoid air cells and other features diagnostic of Mastoiditis with chronic suppurative otitis media. The patient was posted for cortical mastoidectomy. Which of the following statements is not true pertaining to the above case?", "options": [{"label": "A", "text": "Mastoid Antrum posteriorly related to Sigmoid Sinus", "correct": false}, {"label": "B", "text": "Lateral Wall is the usual Surgical approach to the Antrum", "correct": false}, {"label": "C", "text": "Anteroinferior Boundary of MacEwens Triangle corresponds with the Horizontal Part of Facial Nerve Canal", "correct": true}, {"label": "D", "text": "Mastoid Antrum achieves Full Adult Size at Birth", "correct": false}], "correct_answer": "C. Anteroinferior Boundary of MacEwens Triangle corresponds with the Horizontal Part of Facial Nerve Canal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-19-191112.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture29.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/screenshot-2024-02-19-191525.jpg"], "explanation": "<p><strong>Ans. C) Anteroinferior Boundary of MacEwen’s Triangle corresponds with the Horizontal Part of Facial Nerve Canal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The mastoid antrum is indeed located posteriorly to the sigmoid sinus . The sigmoid sinus is a crucial landmark in mastoid surgery , and its relationship to the mastoid antrum is important to avoid injury during surgical procedures .</li><li>• Option A:</li><li>• posteriorly</li><li>• sigmoid sinus</li><li>• crucial landmark</li><li>• mastoid surgery</li><li>• mastoid antrum</li><li>• avoid injury</li><li>• surgical procedures</li><li>• Option B: The lateral wall ( cortical bone ) of the mastoid process is typically approached in mastoid surgery , such as in a cortical mastoidectomy . This approach allows access to the mastoid air cells and the mastoid antrum while minimizing the risk to vital structures .</li><li>• Option B:</li><li>• lateral wall</li><li>• cortical bone</li><li>• mastoid surgery</li><li>• cortical mastoidectomy</li><li>• access</li><li>• mastoid air</li><li>• cells</li><li>• mastoid antrum</li><li>• minimizing</li><li>• risk</li><li>• vital structures</li><li>• Option D: The mastoid antrum is one of the few parts of the mastoid process that is fully developed at birth . The rest of the mastoid air cells develop and pneumatize after birth , particularly in the first few years of life .</li><li>• Option D:</li><li>• mastoid process</li><li>• fully developed</li><li>• birth</li><li>• mastoid air cells</li><li>• develop</li><li>• pneumatize</li><li>• after</li><li>• birth</li><li>• first few years</li><li>• life</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ MacEwen's (or suprameatal ) triangle is an important surgical landmark in mastoid surgery . The anteroinferior boundary of this triangle corresponds to the spine of Henle , not the horizontal part of the facial nerve canal. The facial nerve canal runs a course that is more medial , and inferior compared to this triangle. Misidentifying this relationship can lead to the risk of damaging the facial nerve during surgery .</li><li>➤ MacEwen's (or suprameatal ) triangle is an important surgical landmark in mastoid surgery .</li><li>➤ MacEwen's</li><li>➤ suprameatal</li><li>➤ triangle</li><li>➤ surgical landmark</li><li>➤ mastoid surgery</li><li>➤ The anteroinferior boundary of this triangle corresponds to the spine of Henle , not the horizontal part of the facial nerve canal.</li><li>➤ anteroinferior boundary</li><li>➤ triangle</li><li>➤ spine of Henle</li><li>➤ The facial nerve canal runs a course that is more medial , and inferior compared to this triangle. Misidentifying this relationship can lead to the risk of damaging the facial nerve during surgery .</li><li>➤ more medial</li><li>➤ inferior</li><li>➤ risk</li><li>➤ damaging</li><li>➤ facial nerve</li><li>➤ surgery</li><li>➤ Mastoid Antrum Boundaries :</li><li>➤ Mastoid Antrum Boundaries</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 624</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg no. 624</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male who met with a road traffic accident after he was hit by a speeding truck. He was hit on his side and sustained a fall onto his chin. He was received in the ER. He had sustained multiple fractures in limbs and fracture of mandibular bone. He couldn’t open his mouth fully; his lower jaw teeth were not properly aligned and there was bleeding from gums. CT scan showed fracture of mandible and surgical reduction was planned. Which of the following statements is true pertaining to the above case?", "options": [{"label": "A", "text": "Mandible is the First Bone to start Ossification", "correct": false}, {"label": "B", "text": "In this patient, the Condylar Process will lie Higher than the Coronoid Process", "correct": true}, {"label": "C", "text": "Sphenomandibular Ligament attaches to the Angle of Mandible", "correct": false}, {"label": "D", "text": "Coronoid Process receives the Insertion of Masseter Muscle", "correct": false}], "correct_answer": "B. In this patient, the Condylar Process will lie Higher than the Coronoid Process", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture26_dOmaKn6.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/19/picture28_ceUNSyP.jpg"], "explanation": "<p><strong>Ans. B) In this patient, the Condylar Process will lie Higher than the Coronoid Process</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A: The clavicle is typically the first bone in the human body to begin ossification during embryonic development , not the mandible. The mandible begins ossification around the 6th week of embryonic development , but it is not the first.</li><li>• Option A:</li><li>• clavicle</li><li>• first bone</li><li>• begin ossification</li><li>• embryonic development</li><li>• mandible begins ossification</li><li>• 6th week</li><li>• embryonic development</li><li>• Option C: This statement is false . The sphenomandibular ligament, a thin band running from the spine of the sphenoid bone to the lingula of the mandible , does not attach to the angle of the mandible. Instead, it is considered a primary stabilizing ligament of the mandible but does not have an attachment at the angle.</li><li>• Option C:</li><li>• false</li><li>• thin band</li><li>• spine</li><li>• sphenoid bone</li><li>• lingula</li><li>• mandible</li><li>• primary stabilizing ligament</li><li>• mandible</li><li>• Option D: This statement is false . The masseter muscle , one of the muscles of mastication , inserts primarily on the lateral surface of the ramus of the mandible and the angle of the mandible , not the coronoid process. The coronoid process is the insertion point for the temporalis muscle , another muscle of mastication.</li><li>• Option D:</li><li>• false</li><li>• masseter muscle</li><li>• muscles</li><li>• mastication</li><li>• lateral surface</li><li>• ramus</li><li>• mandible</li><li>• angle</li><li>• mandible</li><li>• coronoid process</li><li>• insertion point</li><li>• temporalis muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In this patient, the condylar process will lie higher than the coronoid process :</li><li>➤ condylar process</li><li>➤ higher</li><li>➤ coronoid process</li><li>➤ This statement can be true in the context of a mandibular fracture , particularly if the patient has sustained a dislocation or fracture of the condylar process . In such cases, the muscular attachments (especially the lateral pterygoid muscle to the condylar process ) can pull the condylar fragment anteriorly and superiorly , positioning it higher than the coronoid process . This could also contribute to the difficulty in mouth opening ( trismus ) and malocclusion observed in the patient .</li><li>➤ This statement can be true in the context of a mandibular fracture , particularly if the patient has sustained a dislocation or fracture of the condylar process .</li><li>➤ context</li><li>➤ mandibular fracture</li><li>➤ dislocation</li><li>➤ fracture</li><li>➤ condylar process</li><li>➤ In such cases, the muscular attachments (especially the lateral pterygoid muscle to the condylar process ) can pull the condylar fragment anteriorly and superiorly , positioning it higher than the coronoid process .</li><li>➤ muscular attachments</li><li>➤ lateral pterygoid muscle</li><li>➤ condylar process</li><li>➤ condylar fragment</li><li>➤ anteriorly</li><li>➤ superiorly</li><li>➤ higher</li><li>➤ coronoid process</li><li>➤ This could also contribute to the difficulty in mouth opening ( trismus ) and malocclusion observed in the patient .</li><li>➤ difficulty</li><li>➤ mouth opening</li><li>➤ trismus</li><li>➤ malocclusion observed</li><li>➤ patient</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg. 537</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg. 537</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 75-year-old man celebrated his birthday with his family in a cruise. While he was eating his dinner he suddenly choked on a piece of mutton. He gasped that he had a bone stuck in his throat. Assuming that the bone was stuck in the piriform fossa, the following statements are correct except which?", "options": [{"label": "A", "text": "The Piriform Fossa is situated on the Lateral wall of Laryngopharynx", "correct": false}, {"label": "B", "text": "The Piriform Fossa is traversed by recurrent Laryngeal Nerve", "correct": true}, {"label": "C", "text": "Laryngopharynx is supported behind by the bodies of C4 to C6 Vertebra", "correct": false}, {"label": "D", "text": "Piriform Fossa is separated from the Epiglottic Vallecula by the lateral Glosso Epiglottic fold", "correct": false}], "correct_answer": "B. The Piriform Fossa is traversed by recurrent Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture23.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/picture24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/16/screenshot-2024-02-16-191649.jpg"], "explanation": "<p><strong>Ans. B) The piriform fossa is traversed by recurrent laryngeal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The piriform fossae are recesses located on either side of the laryngeal opening on the lateral walls of the laryngopharynx . They are common sites for foreign bodies to become lodged.</li><li>• Option A.</li><li>• located</li><li>• either side</li><li>• laryngeal opening</li><li>• lateral walls</li><li>• laryngopharynx</li><li>• foreign bodies</li><li>• Option C. The laryngopharynx, which includes the region of the piriform fossa , extends from the level of the hyoid bone (C3) to the esophagus at the level of C6 vertebra.</li><li>• Option C.</li><li>• region</li><li>• piriform fossa</li><li>• extends</li><li>• hyoid bone (C3)</li><li>• esophagus</li><li>• C6 vertebra.</li><li>• Option D. The piriform fossa is separated from the vallecula , which is a space at the base of the tongue between the folds of mucous membrane passing from the tongue to the epiglottis (glossoepiglottic fold).</li><li>• Option D.</li><li>• separated</li><li>• vallecula</li><li>• space at the base</li><li>• tongue</li><li>• folds of mucous membrane</li><li>• tongue</li><li>• epiglottis</li><li>• (glossoepiglottic fold).</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The recurrent laryngeal nerve does not traverse the piriform fossa. Instead, it runs in the tracheoesophageal groove and then ascends to the larynx behind the thyroid lobe , close to the laryngopharynx but not through the piriform fossa .</li><li>➤ The recurrent laryngeal nerve does not traverse the piriform fossa. Instead, it runs in the tracheoesophageal groove and then ascends to the larynx behind the thyroid lobe , close to the laryngopharynx but not through the piriform fossa .</li><li>➤ runs</li><li>➤ tracheoesophageal groove</li><li>➤ ascends</li><li>➤ larynx behind</li><li>➤ thyroid lobe</li><li>➤ laryngopharynx</li><li>➤ not through</li><li>➤ piriform fossa</li><li>➤ Boundaries</li><li>➤ Ref : Gray’s Anatomy 41 st Edition Pg No577</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition Pg No577</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 240 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 63-year-old woman with a history of cirrhosis is undergoing evaluation for potential complications. As part of her assessment, an ultrasound of the liver is performed, which shows altered blood flow patterns. Understanding the anatomy of the liver is crucial in interpreting these findings. Which of the following does not constitute a component of the portal triad, a key structure in liver anatomy?", "options": [{"label": "A", "text": "Hepatic Artery", "correct": false}, {"label": "B", "text": "Hepatic Vein", "correct": true}, {"label": "C", "text": "Bile Duct", "correct": false}, {"label": "D", "text": "Portal Vein", "correct": false}], "correct_answer": "B. Hepatic Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture36.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture37.jpg"], "explanation": "<p><strong>Ans. B) Hepatic Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The hepatic artery is one of the components of the portal triad. In the portal triad, branches of the hepatic artery provide essential oxygen to the liver tissue .</li><li>• Option A</li><li>• hepatic artery</li><li>• essential oxygen</li><li>• liver tissue</li><li>• Option C . The bile duct is another component of the portal triad. It carries bile produced by hepatocytes out of the liver to the gallbladder or directly to the duodenum . The bile duct in the portal triad is crucial for the excretion of bile and bilirubin .</li><li>• Option C</li><li>• bile</li><li>• hepatocytes out</li><li>• liver</li><li>• gallbladder</li><li>• directly</li><li>• duodenum</li><li>• excretion</li><li>• bile</li><li>• bilirubin</li><li>• Option D . The portal vein is the third component of the portal triad. It brings nutrient-rich , deoxygenated blood from the gastrointestinal tract and spleen to the liver . This blood is rich in substances absorbed from the intestines , which the liver processes .</li><li>• Option D</li><li>• nutrient-rich</li><li>• deoxygenated blood</li><li>• gastrointestinal tract</li><li>• spleen</li><li>• liver</li><li>• absorbed</li><li>• intestines</li><li>• liver processes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The hepatic vein is not part of the portal triad. Instead, hepatic veins are involved in draining deoxygenated blood from the liver and returning it to the systemic circulation , specifically to the inferior vena cava . The portal triad consists of the hepatic artery , portal vein , and bile duct .</li><li>➤ The hepatic vein is not part of the portal triad. Instead, hepatic veins are involved in draining deoxygenated blood from the liver and returning it to the systemic circulation , specifically to the inferior vena cava .</li><li>➤ hepatic veins</li><li>➤ draining deoxygenated blood</li><li>➤ liver</li><li>➤ returning</li><li>➤ systemic circulation</li><li>➤ inferior vena cava</li><li>➤ The portal triad consists of the hepatic artery , portal vein , and bile duct .</li><li>➤ portal triad</li><li>➤ hepatic artery</li><li>➤ portal vein</li><li>➤ bile duct</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 204</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 204</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old female with a history of hypertension and hyperlipidemia presents with palpitations and occasional dizziness. She denies any chest pain or shortness of breath. Her family history is significant for sudden cardiac death in her brother at the age of 50. On examination, her heart rate is irregular, and an ECG shows episodes of non-sustained ventricular tachycardia. An echocardiogram reveals mild right ventricular dilation with preserved ejection fraction. The patient's condition is related to abnormality of following cell junctions at marked area except.", "options": [{"label": "A", "text": "Gap Junctions", "correct": false}, {"label": "B", "text": "Zona Occludens", "correct": true}, {"label": "C", "text": "Fascia Adherens", "correct": false}, {"label": "D", "text": "Desmosomes", "correct": false}], "correct_answer": "B. Zona Occludens", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture5_J5R4E3L.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture4_1Vn2Zek.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture3_R2FWrAj.jpg"], "explanation": "<p><strong>Ans. B) Zona Occludens</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanations:</li><li>• Option A. Gap Junctions are a key component of intercalated discs . Gap junctions allow for direct cytoplasmic connections between adjacent cardiac muscle cells . It enables the rapid and coordinated spread of electrical impulses across the cardiac muscle . This synchronized contraction is essential for effective heart pumping .</li><li>• Option A.</li><li>• intercalated discs</li><li>• allow</li><li>• direct cytoplasmic</li><li>• between adjacent cardiac muscle cells</li><li>• enables</li><li>• rapid</li><li>• coordinated spread</li><li>• electrical impulses</li><li>• cardiac muscle</li><li>• synchronized contraction</li><li>• effective heart pumping</li><li>• Option C. Fascia Adherens are ribbon like protein structure that connect and bind cardiac muscle cells . They are broad intercellular junctions that anchor actin filaments . They are found at the peripheral region of cellular attachment where actin filaments of the I-band insert and terminate . They form large portion of intercalated disc , the structure at which myofibrils terminate in cardiomyocytes.</li><li>• Option C.</li><li>• ribbon like protein structure</li><li>• connect</li><li>• bind cardiac muscle cells</li><li>• broad intercellular junctions</li><li>• anchor actin filaments</li><li>• peripheral region</li><li>• cellular attachment</li><li>• actin filaments</li><li>• I-band insert</li><li>• terminate</li><li>• large portion</li><li>• intercalated disc</li><li>• myofibrils terminate</li><li>• cardiomyocytes.</li><li>• Option D. Desmosomes is also known as macula adherens . Desmosomes are a type of junction in the intercalated discs that provide strong adhesive connections between cardiac muscle cells . They are critical for maintaining the structural integrity of the heart during its relentless pumping action . They are composed of dense plaques of protein attached to the cell membrane, linked to intermediate filaments within the cell , providing strong mechanical attachment between cells .</li><li>• Option D.</li><li>• macula adherens</li><li>• junction</li><li>• intercalated discs</li><li>• strong adhesive</li><li>• cardiac muscle cells</li><li>• structural integrity</li><li>• heart</li><li>• relentless pumping action</li><li>• dense plaques</li><li>• protein</li><li>• intermediate filaments</li><li>• cell</li><li>• strong mechanical attachment</li><li>• cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Zona Occludens, a lso known as tight junctions , these are not a part of intercalated discs. Zona occludens are found in epithelial tissues and serve to prevent the passage of molecules and ions through the space between cells . They create a barrier and maintain cell polarity . The absence of tight junctions in intercalated discs allows for the free passage of ions and molecules necessary for cardiac muscle function .</li><li>➤ tight junctions</li><li>➤ epithelial tissues</li><li>➤ prevent</li><li>➤ passage</li><li>➤ molecules</li><li>➤ ions</li><li>➤ space</li><li>➤ cells</li><li>➤ barrier</li><li>➤ cell polarity</li><li>➤ absence</li><li>➤ tight junctions</li><li>➤ allows</li><li>➤ free passage</li><li>➤ ions</li><li>➤ molecules</li><li>➤ cardiac muscle function</li><li>➤ Ref : Histology, Text and Atlas, Brijesh kumar Page No. 119</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas, Brijesh kumar Page No. 119</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The Terminal Bronchiole is the Smallest Airway in the Respiratory Tract that conducts Air but does not engage in Gas Exchange. Clinically, it can be affected by conditions like Bronchiolitis, often leading to Airflow Obstruction. Treatment typically focuses on managing symptoms and, in severe cases, may require Bronchodilators to improve Airflow. Which of the following statement is true about Terminal Bronchiole?", "options": [{"label": "A", "text": "Composed of C Shaped Hyaline Cartilage Rings", "correct": false}, {"label": "B", "text": "Lined by Columnar Epithelium", "correct": true}, {"label": "C", "text": "Wall is composed of Smooth Muscle and Glands", "correct": false}, {"label": "D", "text": "Gaseous Exchange takes place here", "correct": false}], "correct_answer": "B. Lined by Columnar Epithelium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture6_pRIsclA.jpg"], "explanation": "<p><strong>Ans. B) Lined by Columnar Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is incorrect for terminal bronchioles . C-shaped hyaline cartilage rings are characteristic of the trachea and larger bronchi . As the bronchial tree branches into smaller bronchioles , these cartilage rings are no longer present. The terminal bronchioles, being smaller airways , lack these cartilage structures.</li><li>• Option A.</li><li>• incorrect</li><li>• terminal bronchioles</li><li>• trachea</li><li>• larger bronchi</li><li>• bronchial tree</li><li>• smaller bronchioles</li><li>• smaller airways</li><li>• Option C. The walls of terminal bronchioles do contain some of smooth muscle fibres , which allows for the regulation of airway resistance and airflow through the bronchioles . This muscle layer can contract or relax in response to various stimuli , affecting the size of the airway lumen . However, glands are not a prominent feature of terminal bronchioles. Glands are more commonly found in the larger bronchi .</li><li>• Option C.</li><li>• smooth muscle fibres</li><li>• allows</li><li>• regulation</li><li>• airway resistance</li><li>• airflow</li><li>• bronchioles</li><li>• muscle layer</li><li>• contract</li><li>• relax</li><li>• stimuli</li><li>• affecting</li><li>• size</li><li>• airway lumen</li><li>• larger bronchi</li><li>• Option D. This statement is not true for terminal bronchioles . Gaseous exchange , or the exchange of oxygen and carbon dioxide between the air in the lungs and the blood , occurs in the alveoli , not in the terminal bronchioles. Terminal bronchioles are part of the conducting zone of the respiratory system , which means their primary function is to conduct air to the regions where gas exchange occurs .</li><li>• Option D.</li><li>• not true</li><li>• terminal bronchioles</li><li>• Gaseous exchange</li><li>• exchange of oxygen</li><li>• carbon dioxide</li><li>• air</li><li>• lungs</li><li>• blood</li><li>• alveoli</li><li>• conducting zone</li><li>• respiratory system</li><li>• primary function</li><li>• conduct air</li><li>• regions</li><li>• gas exchange occurs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The terminal bronchioles are lined by a simple columnar epithelium . This epithelial lining is important for maintaining the airway's structure and function . The cells in this lining can include ciliated cells which help in moving mucus and trapped particles out of the airways .</li><li>➤ The terminal bronchioles are lined by a simple columnar epithelium . This epithelial lining is important for maintaining the airway's structure and function .</li><li>➤ lined</li><li>➤ simple columnar epithelium</li><li>➤ maintaining</li><li>➤ airway's structure</li><li>➤ function</li><li>➤ The cells in this lining can include ciliated cells which help in moving mucus and trapped particles out of the airways .</li><li>➤ include ciliated</li><li>➤ cells</li><li>➤ moving mucus</li><li>➤ trapped particles out</li><li>➤ airways</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 218</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 218</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old male presents with chronic lower back pain that worsens when standing or walking and slightly improves when sitting. Radiographic imaging shows degenerative changes in the lumbar spine. His medical history includes a long-standing issue with lumbar spinal stenosis. Which component of the Ligamentum Flavum, known to be involved in the pathophysiology of lumbar spinal stenosis, is likely to be altered in this patient?", "options": [{"label": "A", "text": "Type II Collagen", "correct": false}, {"label": "B", "text": "Type I Collagen", "correct": false}, {"label": "C", "text": "Reticulin", "correct": false}, {"label": "D", "text": "Elastin", "correct": true}], "correct_answer": "D. Elastin", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture7_yWO4lpZ.jpg"], "explanation": "<p><strong>Ans. D) Elastin</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Type II collagen is primarily found in cartilaginous tissues , such as the hyaline cartilage that makes up articular surfaces in joints and the intervertebral discs . The ligamentum flavum, however, does not predominantly consist of type II collagen.</li><li>• Option A</li><li>• cartilaginous tissues</li><li>• hyaline cartilage</li><li>• articular surfaces</li><li>• joints</li><li>• intervertebral discs</li><li>• Option B . Type I collagen is the most abundant collagen type in the human body and is found in structures that require high tensile strength , such as tendons , skin , and the fibrous portions of the organ capsules . While there might be some presence of type I collagen in the ligamentum flavum , it is not the main component.</li><li>• Option B</li><li>• most abundant collagen type</li><li>• human body</li><li>• high tensile strength</li><li>• tendons</li><li>• skin</li><li>• fibrous portions</li><li>• organ capsules</li><li>• type I collagen</li><li>• ligamentum flavum</li><li>• Option C . Reticulin is a type of fiber found in connective tissue , and it's actually composed of very fine , type III collagen fibers . It is not the main component of the ligamentum flavum. Reticulin fibers are typically found in areas like the liver , lymph nodes , and bone marrow , where they form a supporting framework for cells.</li><li>• Option C</li><li>• type</li><li>• fiber</li><li>• connective tissue</li><li>• very fine</li><li>• type III collagen fibers</li><li>• liver</li><li>• lymph nodes</li><li>• bone marrow</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ligamentum flavum, which is a ligament that connects the vertebrae of the spine , is known for its high content of elastin . Elastin is a highly elastic protein in connective tissue and allows many tissues in the body to resume their shape after stretching or contracting . The high elastin content in the ligamentum flavum allows it to stretch and recoil , providing flexibility and support to the spinal column .</li><li>➤ The ligamentum flavum, which is a ligament that connects the vertebrae of the spine , is known for its high content of elastin .</li><li>➤ connects</li><li>➤ vertebrae</li><li>➤ spine</li><li>➤ high content</li><li>➤ elastin</li><li>➤ Elastin is a highly elastic protein in connective tissue and allows many tissues in the body to resume their shape after stretching or contracting .</li><li>➤ Elastin</li><li>➤ highly elastic protein</li><li>➤ connective tissue</li><li>➤ allows</li><li>➤ body</li><li>➤ resume</li><li>➤ shape</li><li>➤ stretching</li><li>➤ contracting</li><li>➤ The high elastin content in the ligamentum flavum allows it to stretch and recoil , providing flexibility and support to the spinal column .</li><li>➤ high elastin content</li><li>➤ ligamentum flavum</li><li>➤ stretch</li><li>➤ recoil</li><li>➤ flexibility</li><li>➤ spinal column</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 57</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Collagen, a key structural protein in the human body, is essential for maintaining the integrity of various tissues, including skin, bones, and tendons. Clinically, collagen disorders, such as osteogenesis imperfecta or Ehlers-Danlos syndrome, can lead to symptoms like joint hypermobility, skin elasticity, and fragile bones. Treatment is often supportive, focusing on managing symptoms and preventing complications. Which of the following does not contain Type I collagen?\"", "options": [{"label": "A", "text": "Bone", "correct": false}, {"label": "B", "text": "Ligament", "correct": false}, {"label": "C", "text": "Basement Membrane", "correct": true}, {"label": "D", "text": "Aponeurosis", "correct": false}], "correct_answer": "C. Basement Membrane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture8_Yn4BlpY.jpg"], "explanation": "<p><strong>Ans. C) Basement Membrane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Type I collagen is indeed present in bone . It is the most abundant collagen in the human body and a major component of the organic part of bone . Type I collagen fibers provide bone with tensile strength , allowing it to withstand stretching forces . These fibers are embedded in a mineral matrix , which gives bone its hardness and ability to withstand compressive forces .</li><li>• Option A</li><li>• Type I collagen</li><li>• bone</li><li>• most abundant collagen</li><li>• human body</li><li>• organic part</li><li>• bone</li><li>• Type I collagen fibers</li><li>• bone</li><li>• tensile strength</li><li>• stretching forces</li><li>• mineral matrix</li><li>• hardness</li><li>• ability</li><li>• withstand compressive forces</li><li>• Option B . Ligaments also contain Type I collagen . Ligaments are fibrous connective tissues that connect bones to other bones. The high content of Type I collagen in ligaments provides them with great tensile strength , necessary for their role in stabilizing joints and supporting the normal alignment and movement of bones .</li><li>• Option B</li><li>• Type I collagen</li><li>• fibrous connective tissues</li><li>• connect bones</li><li>• high content</li><li>• Type I collagen</li><li>• ligaments</li><li>• great tensile strength</li><li>• role</li><li>• stabilizing joints</li><li>• supporting</li><li>• normal alignment</li><li>• movement</li><li>• bones</li><li>• Option D . Type I collagen is present in aponeuroses . An aponeurosis is a flat , broad tendon -like structure that attaches muscles to the bones they move or to other muscles. It is made of dense fibrous connective tissue containing high amounts of Type I collagen , providing strength and support for muscular force transmission .</li><li>• Option D</li><li>• aponeuroses</li><li>• flat</li><li>• broad tendon</li><li>• attaches muscles</li><li>• bones</li><li>• move</li><li>• dense fibrous connective tissue</li><li>• high amounts</li><li>• Type I collagen</li><li>• strength</li><li>• support</li><li>• muscular force transmission</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The basement membrane, which underlies epithelial tissues , does not contain Type I collagen. Instead, it is primarily composed of Type IV collagen , along with other components like laminins , nidogens , and heparan sulfate proteoglycans . The basement membrane provides structural support to the overlying epithelial cells and acts as a selective barrier between tissues . Type I collagen is a major component of bone , ligaments , and aponeuroses , providing these tissues with strength and flexibility .</li><li>➤ The basement membrane, which underlies epithelial tissues , does not contain Type I collagen.</li><li>➤ The basement membrane, which underlies epithelial tissues , does not contain Type I collagen.</li><li>➤ epithelial tissues</li><li>➤ Instead, it is primarily composed of Type IV collagen , along with other components like laminins , nidogens , and heparan sulfate proteoglycans .</li><li>➤ Instead, it is primarily composed of Type IV collagen , along with other components like laminins , nidogens , and heparan sulfate proteoglycans .</li><li>➤ Type IV collagen</li><li>➤ laminins</li><li>➤ nidogens</li><li>➤ heparan sulfate proteoglycans</li><li>➤ The basement membrane provides structural support to the overlying epithelial cells and acts as a selective barrier between tissues .</li><li>➤ The basement membrane provides structural support to the overlying epithelial cells and acts as a selective barrier between tissues .</li><li>➤ overlying epithelial cells</li><li>➤ acts</li><li>➤ selective barrier</li><li>➤ tissues</li><li>➤ Type I collagen is a major component of bone , ligaments , and aponeuroses , providing these tissues with strength and flexibility .</li><li>➤ Type I collagen is a major component of bone , ligaments , and aponeuroses , providing these tissues with strength and flexibility .</li><li>➤ Type I collagen</li><li>➤ bone</li><li>➤ ligaments</li><li>➤ aponeuroses</li><li>➤ strength</li><li>➤ flexibility</li><li>➤ Clinical:</li><li>➤ Clinical:</li><li>➤ Goodpasture syndrome is an autoimmune disorder characterized by the presence of antibodies attacking type IV collagen in basement membranes of the kidneys and lungs . This leads to glomerulonephritis and pulmonary hemorrhage . Treatment typically involves immunosuppressive therapy and plasmapheresis to reduce antibody levels , with a focus on preserving renal function and managing pulmonary symptoms . Regular monitoring is essential for early detection of renal and pulmonary complications .</li><li>➤ Goodpasture syndrome is an autoimmune disorder characterized by the presence of antibodies attacking type IV collagen in basement membranes of the kidneys and lungs . This leads to glomerulonephritis and pulmonary hemorrhage . Treatment typically involves immunosuppressive therapy and plasmapheresis to reduce antibody levels , with a focus on preserving renal function and managing pulmonary symptoms . Regular monitoring is essential for early detection of renal and pulmonary complications .</li><li>➤ Goodpasture syndrome is an autoimmune disorder characterized by the presence of antibodies attacking type IV collagen in basement membranes of the kidneys and lungs . This leads to glomerulonephritis and pulmonary hemorrhage . Treatment typically involves immunosuppressive therapy and plasmapheresis to reduce antibody levels , with a focus on preserving renal function and managing pulmonary symptoms . Regular monitoring is essential for early detection of renal and pulmonary complications .</li><li>➤ Goodpasture syndrome</li><li>➤ autoimmune disorder</li><li>➤ presence</li><li>➤ antibodies</li><li>➤ type IV collagen</li><li>➤ basement membranes</li><li>➤ kidneys</li><li>➤ lungs</li><li>➤ glomerulonephritis</li><li>➤ pulmonary hemorrhage</li><li>➤ immunosuppressive therapy</li><li>➤ plasmapheresis</li><li>➤ reduce antibody levels</li><li>➤ renal function</li><li>➤ pulmonary symptoms</li><li>➤ Regular monitoring</li><li>➤ early detection</li><li>➤ renal</li><li>➤ pulmonary complications</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 53</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 53</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the Respiratory Tract, up to what point does the Hyaline Cartilage extend?", "options": [{"label": "A", "text": "Bronchus", "correct": true}, {"label": "B", "text": "Terminal Bronchiole", "correct": false}, {"label": "C", "text": "Respiratory Bronchiole", "correct": false}, {"label": "D", "text": "Alveolar Duct", "correct": false}], "correct_answer": "A. Bronchus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture9_V7Q2AhQ.jpg"], "explanation": "<p><strong>Ans. A) Bronchus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Terminal Bronchiole : Hyaline cartilage does not extend to the terminal bronchioles. These small airways lack cartilage and are instead surrounded by smooth muscle . This allows the diameter of the terminal bronchioles to be adjusted through muscle contraction and relaxation , aiding in the control of airflow and resistance in the respiratory tract . Bronchioles are lined by simple columnar epithelium and Bronchi lined by pseudostratified ciliated columnar epithelium .</li><li>• Option B</li><li>• Terminal Bronchiole</li><li>• small airways lack cartilage</li><li>• smooth muscle</li><li>• allows</li><li>• diameter</li><li>• terminal bronchioles</li><li>• muscle contraction</li><li>• relaxation</li><li>• control</li><li>• airflow</li><li>• resistance</li><li>• respiratory tract</li><li>• simple columnar epithelium</li><li>• Bronchi</li><li>• pseudostratified ciliated columnar epithelium</li><li>• Option C . Like terminal bronchioles, respiratory bronchioles also do not contain hyaline cartilage. These structures mark the beginning of the respiratory zone of the lungs , where gas exchange begins to occur. They are composed of a thin layer of smooth muscle and connective tissue , but the absence of cartilage allows for more flexibility and the ability to adjust airflow more precisely . Respiratory bronchiole lined by simple cuboidal epithelium .</li><li>• Option C</li><li>• beginning</li><li>• respiratory zone</li><li>• lungs</li><li>• gas exchange</li><li>• composed</li><li>• thin layer</li><li>• smooth muscle</li><li>• connective tissue</li><li>• absence</li><li>• cartilage</li><li>• allows</li><li>• more flexibility</li><li>• ability</li><li>• adjust airflow</li><li>• precisely</li><li>• simple cuboidal epithelium</li><li>• Option D . Alveolar ducts are even further along in the respiratory tract than respiratory bronchioles and are part of the gas exchange system of the lungs . They too lack hyaline cartilage . The alveolar ducts lead to the alveolar sacs and alveoli , which are the primary sites of gas exchange . The structure of the alveolar ducts is designed to maximize surface area for gas exchange and does not require the rigidity that hyaline cartilage provides.</li><li>• Option D</li><li>• respiratory tract</li><li>• respiratory bronchioles</li><li>• gas exchange system</li><li>• lungs</li><li>• too lack hyaline cartilage</li><li>• alveolar sacs</li><li>• alveoli</li><li>• primary sites</li><li>• gas exchange</li><li>• maximize surface area</li><li>• gas exchange</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the respiratory tract , hyaline cartilage extends up to the bronchi . Hyaline cartilage provides structure and keeps the airways open , preventing them from collapsing . In the trachea and larger bronchi , this cartilage is present in the form of C-shaped rings or irregular plates , providing rigidity and structural integrity to these airways .</li><li>➤ respiratory tract</li><li>➤ hyaline cartilage</li><li>➤ bronchi</li><li>➤ Hyaline cartilage</li><li>➤ structure</li><li>➤ keeps</li><li>➤ open</li><li>➤ collapsing</li><li>➤ trachea</li><li>➤ larger bronchi</li><li>➤ present</li><li>➤ form</li><li>➤ C-shaped rings</li><li>➤ irregular plates</li><li>➤ rigidity</li><li>➤ structural integrity</li><li>➤ airways</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 218</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 218</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Skin Histology reveals a complex structure comprising the Epidermis, Dermis, and Subcutaneous Tissue, each with distinct roles in Protection, Sensation, and Thermoregulation. Disorders affecting Skin Histology, such as Psoriasis or Dermatitis, can disrupt these functions, leading to symptoms like Inflammation, Itching, and Altered Skin Appearance. Clinical Management typically involves Topical Treatments, Systemic Medications, and Regular Skin Assessments to monitor Disease Progression and treatment response. Which type of Connective Tissue is present in the marked area?", "options": [{"label": "A", "text": "Loose and Irregular", "correct": false}, {"label": "B", "text": "Specialized", "correct": false}, {"label": "C", "text": "Dense Irregular", "correct": true}, {"label": "D", "text": "Dense Regular", "correct": false}], "correct_answer": "C. Dense Irregular", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture15_VmqfYTj.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dense Irregular</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Loose and Irregular Connective Tissue , also known as areolar tissue , is characterized by a loose arrangement of fibers, cells , and matrix . Loose areolar tissue is present in hypodermis , lamina propria and submucosa . This tissue contains collagen , elastic , and reticular fibers , and it fills the spaces between organs and connects the skin to underlying tissues .</li><li>• Option A.</li><li>• areolar tissue</li><li>• loose arrangement</li><li>• fibers,</li><li>• cells</li><li>• matrix</li><li>• hypodermis</li><li>• lamina propria</li><li>• submucosa</li><li>• collagen</li><li>• elastic</li><li>• reticular fibers</li><li>• spaces</li><li>• organs</li><li>• connects</li><li>• skin</li><li>• underlying tissues</li><li>• Option B . Specialized Connective Tissue includes connective tissues that have specialized functions, such as adipose tissue ( fat ), cartilage , bone , and blood . Each of these tissues has unique components and properties tailored to their specific roles in the body . They differ from general connective tissues in their composition and structure .</li><li>• Option B</li><li>• adipose tissue</li><li>• fat</li><li>• cartilage</li><li>• bone</li><li>• blood</li><li>• specific roles</li><li>• body</li><li>• general connective tissues</li><li>• composition</li><li>• structure</li><li>• Option D. Dense Regular Connective Tissue is also rich in collagen fibers , but unlike dense irregular connective tissue , the fibers in dense regular connective tissue are parallel to each other . This arrangement provides great tensile strength in one direction . It's typically found in tendon and ligaments .</li><li>• Option D.</li><li>• rich</li><li>• collagen fibers</li><li>• dense irregular connective tissue</li><li>• dense regular connective tissue</li><li>• parallel</li><li>• each other</li><li>• great tensile strength</li><li>• one direction</li><li>• tendon</li><li>• ligaments</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Dense Irregular Connective Tissue is characterized by a densely packed and randomly organized array of collagen fibers . This tissue provides strength and support to areas subjected to stresses from multiple directions , such as the dermis of the skin , submucosa of the gastrointestinal tract , and fibrous capsules of organs and joints .</li><li>➤ Dense Irregular Connective Tissue is characterized by a densely packed and randomly organized array of collagen fibers .</li><li>➤ densely packed</li><li>➤ collagen fibers</li><li>➤ This tissue provides strength and support to areas subjected to stresses from multiple directions , such as the dermis of the skin , submucosa of the gastrointestinal tract , and fibrous capsules of organs and joints .</li><li>➤ strength</li><li>➤ support</li><li>➤ stresses</li><li>➤ multiple directions</li><li>➤ dermis</li><li>➤ skin</li><li>➤ submucosa</li><li>➤ gastrointestinal tract</li><li>➤ fibrous capsules</li><li>➤ organs</li><li>➤ joints</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 57</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Meissner's Corpuscles are specialized nerve endings in the skin responsible for detecting Light Touch and Texture. Damage or Loss of these corpuscles lead to Sensory Deficits, particularly in fine tactile discrimination, impacting daily activities and quality of life. Where is it present?", "options": [{"label": "A", "text": "Lucidum", "correct": false}, {"label": "B", "text": "Basal", "correct": false}, {"label": "C", "text": "Reticular Dermis", "correct": false}, {"label": "D", "text": "Papillary Dermis", "correct": true}], "correct_answer": "D. Papillary Dermis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture16_J7QW6lD.jpg"], "explanation": "<p><strong>Ans. D) Papillary Dermis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The stratum lucidum is a thin , clear layer of dead skin cells in the epidermis . It's found only in certain areas of the body like the palms of the hands and the soles of the feet . Meissner’s corpuscles are not located in the stratum lucidum. They are found deeper in the skin layers .</li><li>• Option A</li><li>• thin</li><li>• clear layer</li><li>• dead skin cells</li><li>• epidermis</li><li>• palms</li><li>• hands</li><li>• soles</li><li>• feet</li><li>• deeper</li><li>• skin layers</li><li>• Option B. The stratum basal, or basal layer , is the deepest layer of the five layers of the epidermis . This layer contains basal cells that divide to form the keratinocytes of the epidermis . Cells of stratum basal divide and replenish the cells in more superficial layers . Meissner’s corpuscles are not found in this layer, as they are specialized structures involved in tactile sensation and are located deeper in the dermis.</li><li>• Option B.</li><li>• basal layer</li><li>• deepest layer</li><li>• five layers</li><li>• epidermis</li><li>• basal cells</li><li>• keratinocytes</li><li>• epidermis</li><li>• Cells</li><li>• stratum basal divide</li><li>• replenish</li><li>• superficial layers</li><li>• tactile sensation</li><li>• located deeper</li><li>• Option C. The reticular dermis is the lower layer of the dermis , located underneath the papillary dermis . It contains dense irregular connective tissue , blood vessels , sweat and sebaceous glands , and hair follicles . While this layer plays an important role in the skin's structure and elasticity , Meissner’s corpuscles are not typically found here.</li><li>• Option C.</li><li>• lower layer</li><li>• dermis</li><li>• papillary</li><li>• dermis</li><li>• dense irregular connective tissue</li><li>• blood vessels</li><li>• sweat</li><li>• sebaceous glands</li><li>• hair follicles</li><li>• skin's structure</li><li>• elasticity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meissner’s corpuscles are located in the papillary dermis , which is the uppermost layer of the dermis . The papillary dermis lies just beneath the epidermal junction and is composed of loose connective tissue . Meissner’s corpuscles are sensitive to light touch and are most abundant in areas of the skin that are highly sensitive to touch , like the fingertips , palms , lips , and face .</li><li>➤ Meissner’s corpuscles are located in the papillary dermis , which is the uppermost layer of the dermis .</li><li>➤ papillary dermis</li><li>➤ uppermost layer</li><li>➤ dermis</li><li>➤ The papillary dermis lies just beneath the epidermal junction and is composed of loose connective tissue .</li><li>➤ epidermal junction</li><li>➤ loose connective tissue</li><li>➤ Meissner’s corpuscles are sensitive to light touch and are most abundant in areas of the skin that are highly sensitive to touch , like the fingertips , palms , lips , and face .</li><li>➤ sensitive</li><li>➤ light touch</li><li>➤ abundant</li><li>➤ highly sensitive</li><li>➤ touch</li><li>➤ fingertips</li><li>➤ palms</li><li>➤ lips</li><li>➤ face</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 362</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 362</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the Golgi Apparatus in Serous Acinar Cells located?", "options": [{"label": "A", "text": "Supranuclear", "correct": true}, {"label": "B", "text": "Apical", "correct": false}, {"label": "C", "text": "Adjacent to Nucleus", "correct": false}, {"label": "D", "text": "Basal", "correct": false}], "correct_answer": "A. Supranuclear", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture17_PsqeQZS.jpg"], "explanation": "<p><strong>Ans. A) Supranuclear</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The apical region of a cell is the part that is furthest from the basal surface , usually facing the lumen or external environment . In serous acinar cells , the apical region is primarily involved in the release of secretory products . While secretory granules are found in the apical region, the Golgi apparatus itself is not typically located here.</li><li>• Option B.</li><li>• basal surface</li><li>• facing</li><li>• lumen</li><li>• external environment</li><li>• serous acinar cells</li><li>• release</li><li>• secretory products</li><li>• Option C. While the Golgi apparatus is indeed close to the nucleus, describing its location as simply \" adjacent to the nucleus \" is not specific enough. In serous acinar cells, the Golgi apparatus is more precisely located above the nucleus ( supranuclear ), which reflects its role in processing secretory products that are then directed towards the apical side of the cell .</li><li>• Option C.</li><li>• adjacent to the nucleus</li><li>• above</li><li>• nucleus</li><li>• supranuclear</li><li>• reflects</li><li>• secretory products</li><li>• towards</li><li>• apical side</li><li>• cell</li><li>• Option D. The basal region of a cell refers to the part of the cell that is closest to the base or underlying tissue . In glandular cells, the basal region often contains structures involved in synthesizing proteins (like rough endoplasmic reticulum ) and absorbing materials from the blood supply .</li><li>• Option D.</li><li>• part</li><li>• cell</li><li>• closest</li><li>• base</li><li>• underlying tissue</li><li>• synthesizing proteins</li><li>• rough endoplasmic reticulum</li><li>• absorbing materials</li><li>• blood supply</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In serous acinar cells , the Golgi apparatus is typically located in the supranuclear region , meaning it is situated above the nucleus . This positioning is strategic for the cell's function . The Golgi apparatus is involved in modifying , sorting , and packaging proteins for secretion . In serous acinar cells , which are involved in secreting enzymes and other proteins , the Golgi apparatus processes these secretory proteins before they are transported to their destination .</li><li>➤ In serous acinar cells , the Golgi apparatus is typically located in the supranuclear region , meaning it is situated above the nucleus .</li><li>➤ serous acinar cells</li><li>➤ Golgi apparatus</li><li>➤ supranuclear region</li><li>➤ above</li><li>➤ nucleus</li><li>➤ This positioning is strategic for the cell's function . The Golgi apparatus is involved in modifying , sorting , and packaging proteins for secretion .</li><li>➤ strategic</li><li>➤ cell's function</li><li>➤ modifying</li><li>➤ sorting</li><li>➤ packaging proteins</li><li>➤ secretion</li><li>➤ In serous acinar cells , which are involved in secreting enzymes and other proteins , the Golgi apparatus processes these secretory proteins before they are transported to their destination .</li><li>➤ serous acinar cells</li><li>➤ secreting enzymes</li><li>➤ proteins</li><li>➤ secretory proteins</li><li>➤ before</li><li>➤ transported</li><li>➤ destination</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 196</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 196</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the clinic with a history of recurrent epigastric pain, especially after meals. He reports significant weight loss and has been experiencing occasional vomiting. Endoscopy reveals hypertrophied gastric folds. Biopsy shows increased number of oxyntic cells. Which part of the stomach is predominantly affected in this patient?", "options": [{"label": "A", "text": "Pylorus", "correct": false}, {"label": "B", "text": "Cardiac Notch", "correct": false}, {"label": "C", "text": "Body", "correct": true}, {"label": "D", "text": "Fundus", "correct": false}], "correct_answer": "C. Body", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture18_ObRGslZ.jpg"], "explanation": "<p><strong>Ans. C) Body</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The pylorus is the part of the stomach that connects to the duodenum (the first part of the small intestine). It primarily contains mucus-secreting cells and G cells (which secrete gastrin), but not a significant number of oxyntic cells. Oxyntic cells are mainly responsible for secreting Hydro-Chloric Acid (HCl) and intrinsic factor , and their presence is more prominent in other parts of the stomach.</li><li>• Option A.</li><li>• connects</li><li>• duodenum</li><li>• mucus-secreting cells</li><li>• G cells</li><li>• Oxyntic cells</li><li>• Hydro-Chloric Acid (HCl)</li><li>• intrinsic factor</li><li>• Option B. The cardiac notch is an area near the esophageal opening into the stomach . This region mainly contains mucus-secreting cells that protect the esophagus from the acidic environment of the stomach . Oxyntic cells are not a major feature of this region.</li><li>• Option B.</li><li>• area</li><li>• esophageal</li><li>• stomach</li><li>• mucus-secreting cells</li><li>• protect</li><li>• esophagus</li><li>• acidic environment</li><li>• stomach</li><li>• Option D . The fundus is the upper part of the stomach , which is above the level of the cardiac opening . While the fundus does contain oxyntic cells , they are more densely populated and functionally significant in the body of the stomach . The fundus primarily acts as a storage area for undigested food and gases released during the process of chemical digestion .</li><li>• Option D</li><li>• upper part</li><li>• stomach</li><li>• above</li><li>• level</li><li>• cardiac opening</li><li>• oxyntic cells</li><li>• densely populated</li><li>• significant</li><li>• body</li><li>• stomach</li><li>• storage area</li><li>• undigested food</li><li>• gases</li><li>• process</li><li>• chemical digestion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The body of the stomach is the main central region and is the primary location of oxyntic cells . These cells are essential for the stomach's function , as they secrete hydrochloric acid , which helps in digestion , and intrinsic factor , which is crucial for the absorption of vitamin B12 .</li><li>➤ The body of the stomach is the main central region and is the primary location of oxyntic cells .</li><li>➤ main central region</li><li>➤ primary</li><li>➤ oxyntic cells</li><li>➤ These cells are essential for the stomach's function , as they secrete hydrochloric acid , which helps in digestion , and intrinsic factor , which is crucial for the absorption of vitamin B12 .</li><li>➤ essential</li><li>➤ stomach's function</li><li>➤ secrete hydrochloric acid</li><li>➤ digestion</li><li>➤ intrinsic factor</li><li>➤ crucial</li><li>➤ absorption</li><li>➤ vitamin B12</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 172</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 172</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female presents with widespread, itchy, red plaques covered with silvery scales, predominantly on her elbows and knees. She mentions that the lesions often get worse during winter. A skin biopsy reveals thickening and increased cell turnover in certain layers of the epidermis. Which layers of the skin, constituting the Malpighian layer, are primarily involved in this patient's condition?", "options": [{"label": "A", "text": "Stratum Lucidum", "correct": false}, {"label": "B", "text": "Stratum Spinosum", "correct": false}, {"label": "C", "text": "Stratum Granulosum", "correct": false}, {"label": "D", "text": "Stratum Spinosum and Basal", "correct": true}], "correct_answer": "D. Stratum Spinosum and Basal", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture19_4euXA2S.jpg"], "explanation": "<p><strong>Ans. D) Stratum Spinosum and Basal</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The stratum lucidum is a thin , clear layer of dead skin cells found in the epidermis . It's typically present only in certain areas of the body, like the palms of the hands and the soles of the feet . However, the stratum lucidum is not part of the Malpighian layer. It lies above the Malpighian layer in the thick skin.</li><li>• Option A.</li><li>• thin</li><li>• clear layer</li><li>• dead skin</li><li>• cells</li><li>• epidermis</li><li>• palms</li><li>• hands</li><li>• soles</li><li>• feet</li><li>• Option B . The stratum spinosum, also known as the \" prickle cell layer \" of the epidermis , is one of the layers constituting the Malpighian layer . It lies above the stratum basal and is characterized by its spiny appearance due to the desmosomal connections between cells . This layer provides strength and flexibility to the skin .</li><li>• Option B</li><li>• prickle cell layer</li><li>• epidermis</li><li>• Malpighian layer</li><li>• above</li><li>• stratum basal</li><li>• spiny appearance</li><li>• desmosomal connections</li><li>• cells</li><li>• strength</li><li>• flexibility</li><li>• skin</li><li>• Option C . The stratum granulosum, or granular layer , is located above the stratum spinosum . It's characterized by keratinocytes that contain granules contributing to water proofing the skin . However, it is not typically considered part of the Malpighian layer. The stratum granulosum marks the transition between the deeper , metabolically active layers and the more superficial , dead layers of the epidermis .</li><li>• Option C</li><li>• granular layer</li><li>• stratum spinosum</li><li>• keratinocytes</li><li>• granules</li><li>• water proofing</li><li>• skin</li><li>• deeper</li><li>• metabolically active layers</li><li>• more superficial</li><li>• dead layers</li><li>• epidermis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Malpighian layer is constituted by the stratum basal and the stratum spinosum . The stratum basal is the deepest layer of the epidermis , containing basal keratinocytes which continually divide to form new cells . These cells move up into the stratum spinosum , where they continue to mature . Together, these two layers are responsible for the regeneration and strength of the epidermis .</li><li>➤ The Malpighian layer is constituted by the stratum basal and the stratum spinosum .</li><li>➤ Malpighian layer</li><li>➤ stratum basal</li><li>➤ stratum spinosum</li><li>➤ The stratum basal is the deepest layer of the epidermis , containing basal keratinocytes which continually divide to form new cells .</li><li>➤ stratum basal</li><li>➤ deepest layer</li><li>➤ epidermis</li><li>➤ basal keratinocytes</li><li>➤ divide</li><li>➤ new cells</li><li>➤ These cells move up into the stratum spinosum , where they continue to mature . Together, these two layers are responsible for the regeneration and strength of the epidermis .</li><li>➤ stratum spinosum</li><li>➤ continue</li><li>➤ mature</li><li>➤ two layers</li><li>➤ regeneration</li><li>➤ strength</li><li>➤ epidermis</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 328</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 328</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following speech disorder is caused by the injury of the structure shown in the given slide", "options": [{"label": "A", "text": "Apraxia", "correct": false}, {"label": "B", "text": "Sensory Aphasia", "correct": false}, {"label": "C", "text": "Dysarthria", "correct": true}, {"label": "D", "text": "Motor Aphasia", "correct": false}], "correct_answer": "C. Dysarthria", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture27_1hNepAI.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Dysarthria</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Apraxia is a motor disorder caused by damage to the cerebral cortex in which a person has difficulty with the motor planning to perform tasks or movements when asked, provided that the request or command is understood and the individual is willing to perform the task . Apraxia is usually not associated with cerebellar lesions; it's more related to lesions in the parietal lobes of the cerebral cortex .</li><li>• Option A.</li><li>• motor disorder</li><li>• damage</li><li>• cerebral cortex</li><li>• motor planning</li><li>• tasks</li><li>• movements</li><li>• request</li><li>• command</li><li>• understood</li><li>• task</li><li>• parietal lobes</li><li>• cerebral cortex</li><li>• Option B. Sensory Aphasia , also known as Wernicke's aphasia , this is a type of aphasia characterized by impaired comprehension of speech and writing , with preserved fluency . It's typically associated with damage to the Wernicke's area in the temporal lobe of the cerebral cortex , not the cerebellum.</li><li>• Option B.</li><li>• ,</li><li>• Wernicke's aphasia</li><li>• impaired comprehension</li><li>• speech</li><li>• writing</li><li>• fluency</li><li>• damage</li><li>• Wernicke's area</li><li>• temporal lobe</li><li>• cerebral cortex</li><li>• Option D. Motor Aphasia, also known as Broca's aphasia , this is characterized by impaired speech production but preserved comprehension . It is typically due to damage in the Broca's area of the frontal lobe of the cerebral cortex , not the cerebellum.</li><li>• Option D.</li><li>• Broca's aphasia</li><li>• impaired speech production</li><li>• comprehension</li><li>• damage</li><li>• Broca's area</li><li>• frontal lobe</li><li>• cerebral cortex</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system . It is characterized by poor articulation of phonemes . In the case of cerebellar lesions , dysarthria is quite common . The cerebellum plays a significant role in coordinating motor functions , including speech , so damage here can lead to difficulties in articulating words clearly. Lesions in the cerebellum are more likely to cause issues related to these functions, such as dysarthria , ataxia (lack of voluntary coordination of muscle movements ), and nystagmus (rapid involuntary movements of the eyes ), rather than apraxia or aphasia , which are typically associated with cerebral cortex damage .</li><li>• Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system .</li><li>• Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system .</li><li>• motor speech disorder</li><li>• neurological injury</li><li>• motor component</li><li>• motor-speech system</li><li>• It is characterized by poor articulation of phonemes . In the case of cerebellar lesions , dysarthria is quite common .</li><li>• It is characterized by poor articulation of phonemes . In the case of cerebellar lesions , dysarthria is quite common .</li><li>• poor articulation</li><li>• phonemes</li><li>• cerebellar lesions</li><li>• quite common</li><li>• The cerebellum plays a significant role in coordinating motor functions , including speech , so damage here can lead to difficulties in articulating words clearly.</li><li>• The cerebellum plays a significant role in coordinating motor functions , including speech , so damage here can lead to difficulties in articulating words clearly.</li><li>• coordinating motor functions</li><li>• speech</li><li>• Lesions in the cerebellum are more likely to cause issues related to these functions, such as dysarthria , ataxia (lack of voluntary coordination of muscle movements ), and nystagmus (rapid involuntary movements of the eyes ), rather than apraxia or aphasia , which are typically associated with cerebral cortex damage .</li><li>• Lesions in the cerebellum are more likely to cause issues related to these functions, such as dysarthria , ataxia (lack of voluntary coordination of muscle movements ), and nystagmus (rapid involuntary movements of the eyes ), rather than apraxia or aphasia , which are typically associated with cerebral cortex damage .</li><li>• Lesions</li><li>• cerebellum</li><li>• dysarthria</li><li>• ataxia</li><li>• voluntary coordination</li><li>• muscle movements</li><li>• nystagmus</li><li>• eyes</li><li>• apraxia</li><li>• aphasia</li><li>• cerebral cortex damage</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 319</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 319</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old man presents to the clinic with a complaint of rectal discomfort and occasional bleeding during bowel movements. He denies any significant medical history except for hemorrhoids a few years ago. On physical examination, there is no visible external pathology, but a digital rectal exam reveals a slight roughness in the anal canal. A biopsy is performed for further evaluation. Which type of epithelium is most likely to be found lining the area of the anal canal where the biopsy was taken?", "options": [{"label": "A", "text": "Stratified Columnar Epithelium", "correct": false}, {"label": "B", "text": "Keratinized Stratified Squamous Epithelium", "correct": false}, {"label": "C", "text": "Simple Columnar Epithelium", "correct": false}, {"label": "D", "text": "Non Keratinized Stratified Squamous Epithelium", "correct": true}], "correct_answer": "D. Non Keratinized Stratified Squamous Epithelium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture1_f8UQz05.jpg"], "explanation": "<p><strong>Ans. D) Non-Keratinized Stratified Squamous Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Stratified Columnar Epithelium is relatively rare and is typically found in areas like the conjunctiva of the eye , parts of the pharynx , urethra , and in some glandular ducts. It is not the type of epithelium that lines the pectin of the anal canal.</li><li>• Option A.</li><li>• rare</li><li>• conjunctiva</li><li>• eye</li><li>• parts</li><li>• pharynx</li><li>• urethra</li><li>• Option B. Keratinized Stratified Squamous Epithelium has multiple layers of cells , with the outermost layers being flat and keratinized (filled with the protein keratin ). This type of epithelium is typical of the skin's surface , providing a waterproof and protective barrier .</li><li>• Option B.</li><li>• multiple layers</li><li>• cells</li><li>• outermost layers</li><li>• flat</li><li>• keratinized</li><li>• protein keratin</li><li>• epithelium</li><li>• typical</li><li>• skin's surface</li><li>• waterproof</li><li>• protective barrier</li><li>• Option C. Simple Columnar Epithelium consists of a single layer of tall , column-like cells . It is commonly found in areas that require absorption and secretion , such as the lining of the stomach , intestine , and some parts of the respiratory tract . While simple columnar epithelium lines the upper part of the anal canal (derived from the endoderm ), it does not line the pectin.</li><li>• Option C.</li><li>• single layer</li><li>• tall</li><li>• column-like cells</li><li>• require absorption</li><li>• secretion</li><li>• lining</li><li>• stomach</li><li>• intestine</li><li>• respiratory tract</li><li>• upper part</li><li>• anal canal</li><li>• endoderm</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The pectin of the anal canal is lined by non-keratinized stratified squamous epithelium . Unlike keratinized epithelium, non-keratinized epithelium does not have a layer of dead cells filled with keratin on the surface. This allows for a moist and flexible lining , which is essential for the function of the anal canal .</li><li>• The pectin of the anal canal is lined by non-keratinized stratified squamous epithelium .</li><li>• pectin</li><li>• anal canal</li><li>• non-keratinized stratified squamous epithelium</li><li>• Unlike keratinized epithelium, non-keratinized epithelium does not have a layer of dead cells filled with keratin on the surface. This allows for a moist and flexible lining , which is essential for the function of the anal canal .</li><li>• moist</li><li>• flexible lining</li><li>• function</li><li>• anal canal</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 188</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 188</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old woman presents to the emergency department with severe right upper quadrant abdominal pain that started 6 hours ago. The pain is constant, sharp, and worsens with deep breathing. She also reports experiencing nausea and a mild fever. Her medical history is significant for obesity and high cholesterol. On examination, you note a positive Murphy's sign. An ultrasound of the abdomen is ordered, which shows gallstones and a thickened gallbladder wall. Given these findings, which type of epithelium is most likely to be found lining the mucosa of this patient's gallbladder?", "options": [{"label": "A", "text": "Stratified Columnar Epithelium", "correct": false}, {"label": "B", "text": "Pseudostratified Columnar Epithelium", "correct": false}, {"label": "C", "text": "Simple Columnar Epithelium", "correct": true}, {"label": "D", "text": "Columnar Epithelium with Brush Borders", "correct": false}], "correct_answer": "C. Simple Columnar Epithelium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture2_R8LMi78.jpg"], "explanation": "<p><strong>Ans. C) Simple Columnar Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A</li><li>• several layers</li><li>• column-shaped cells</li><li>• parts</li><li>• male urethra</li><li>• large ducts</li><li>• glands</li><li>• Option B. Pseudostratified Columnar Epithelium appears to have multiple layers due to the varying heights of its cells, but in reality, each cell touches the basement membrane . It's commonly found in the respiratory tract .</li><li>• Option B.</li><li>• multiple layers</li><li>• varying heights</li><li>• each cell touches</li><li>• basement membrane</li><li>• respiratory tract</li><li>• Option D . Columnar Epithelium with Brush Borders is characterized by columnar cells with microvilli on their apical surface , giving a brush border appearance. It is typically found in the small intestine , where it increases surface area for absorption . While this structure is suitable for absorptive functions, it is not what lines the gallbladder.</li><li>• Option D</li><li>• microvilli</li><li>• apical surface</li><li>• small intestine</li><li>• increases surface area</li><li>• absorption</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The gallbladder is lined with simple columnar epithelium . This type of single-layered , column-shaped epithelial lining is efficient for absorption and secretion , which are key functions in the gallbladder as it concentrates bile by absorbing water and ions .</li><li>• The gallbladder is lined with simple columnar epithelium .</li><li>• The gallbladder is lined with simple columnar epithelium .</li><li>• gallbladder</li><li>• simple columnar epithelium</li><li>• This type of single-layered , column-shaped epithelial lining is efficient for absorption and secretion , which are key functions in the gallbladder as it concentrates bile by absorbing water and ions .</li><li>• This type of single-layered , column-shaped epithelial lining is efficient for absorption and secretion , which are key functions in the gallbladder as it concentrates bile by absorbing water and ions .</li><li>• single-layered</li><li>• column-shaped epithelial lining</li><li>• efficient</li><li>• absorption</li><li>• secretion</li><li>• gallbladder</li><li>• concentrates bile</li><li>• absorbing water</li><li>• ions</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 213</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 213</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 58-year-old man presents to the clinic with a six-month history of progressive difficulty swallowing, both solids and liquids. He describes a sensation of food 'sticking' in his chest after swallowing. He has lost 10 pounds over the last two months and occasionally experiences mild chest pain. An Esophago-Gastro-Duodenoscopy (EGD) is performed, which reveals a narrowed segment in the lower esophagus with no signs of ulceration or bleeding. Biopsy results are pending. Given these findings, which of the following layers is absent in the esophagus, likely contributing to the patient's symptoms?", "options": [{"label": "A", "text": "Muscularis Externa", "correct": false}, {"label": "B", "text": "Muscularis Interna", "correct": false}, {"label": "C", "text": "Serosa", "correct": true}, {"label": "D", "text": "Submucosa", "correct": false}], "correct_answer": "C. Serosa", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture2_ZikH4dq.jpg"], "explanation": "<p><strong>Ans. C) Serosa</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• present</li><li>• esophagus</li><li>• muscle fibers</li><li>• peristaltic movements</li><li>• propel</li><li>• food down</li><li>• esophagus</li><li>• upper part</li><li>• esophagus</li><li>• striated muscle</li><li>• lower part</li><li>• smooth muscle</li><li>• Option B.</li><li>• both</li><li>• inner circular</li><li>• outer longitudinal layer</li><li>• muscle fibers</li><li>• muscularis externa</li><li>• Option D</li><li>• esophagus</li><li>• dense</li><li>• irregular connective tissue</li><li>• supports</li><li>• mucosa</li><li>• muscularis externa</li><li>• blood vessels</li><li>• nerves</li><li>• glands</li><li>• secrete mucus</li><li>• lubricate</li><li>• esophagus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ The esophagus does not have a serosa layer . Instead, it is covered by adventitia . Adventitia is a connective tissue layer that binds the esophagus to surrounding structures in the mediastinum . In contrast, a serosa is a smooth , slippery membrane that covers organs that lie within a body cavity .</li><li>➤ The esophagus does not have a serosa layer . Instead, it is covered by adventitia .</li><li>➤ The esophagus does not have a serosa layer . Instead, it is covered by adventitia .</li><li>➤ does not</li><li>➤ serosa layer</li><li>➤ adventitia</li><li>➤ Adventitia is a connective tissue layer that binds the esophagus to surrounding structures in the mediastinum . In contrast, a serosa is a smooth , slippery membrane that covers organs that lie within a body cavity .</li><li>➤ Adventitia is a connective tissue layer that binds the esophagus to surrounding structures in the mediastinum . In contrast, a serosa is a smooth , slippery membrane that covers organs that lie within a body cavity .</li><li>➤ Adventitia</li><li>➤ connective tissue</li><li>➤ layer</li><li>➤ binds</li><li>➤ esophagus</li><li>➤ mediastinum</li><li>➤ serosa</li><li>➤ smooth</li><li>➤ slippery membrane</li><li>➤ organs</li><li>➤ within</li><li>➤ body cavity</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page no. 170</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page no. 170</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Auerbach Plexus lies in which of the following Layer’s of Oesophagus?", "options": [{"label": "A", "text": "Mucosa", "correct": false}, {"label": "B", "text": "Submucosa", "correct": false}, {"label": "C", "text": "Muscular", "correct": true}, {"label": "D", "text": "Serosa", "correct": false}], "correct_answer": "C. Muscular", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Muscular</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The mucosa is the innermost layer of the esophagus , consisting of the epithelial lining , lamina propria , and muscularis mucosae . It is involved in secretion and absorption . The Auerbach's plexus is not located in the mucosa; instead, it is found in a different layer responsible for muscular coordination .</li><li>• Option A</li><li>• innermost layer</li><li>• esophagus</li><li>• epithelial lining</li><li>• lamina propria</li><li>• muscularis mucosae</li><li>• secretion</li><li>• absorption</li><li>• different layer</li><li>• muscular coordination</li><li>• Option B . The submucosa is a layer of connective tissue that supports the mucosa . It contains blood vessels , nerves , and glands . The submucosal plexus ( Meissner's plexus ), which is involved in regulating secretions and blood flow , is found here. However, Auerbach's plexus is located in a different layer , associated with muscle control .</li><li>• Option B</li><li>• connective tissue</li><li>• supports</li><li>• mucosa</li><li>• blood vessels</li><li>• nerves</li><li>• glands</li><li>• submucosal plexus</li><li>• Meissner's plexus</li><li>• regulating secretions</li><li>• blood flow</li><li>• different layer</li><li>• muscle control</li><li>• Option D . The serosa is a membrane that covers some parts of the gastrointestinal tract , providing a smooth , lubricated surface . However, as previously mentioned, the esophagus does not have a serosa layer; it is covered by adventitia . Additionally, Auerbach's plexus is not located in the serosa but in the muscular layer.</li><li>• Option D</li><li>• covers</li><li>• gastrointestinal tract</li><li>• smooth</li><li>• lubricated surface</li><li>• adventitia</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Auerbach's (myenteric) plexus is located in the muscular layer of the esophagus , specifically between the inner circular and outer longitudinal muscle layers of the muscularis externa . This plexus plays a crucial role in regulating the peristaltic movement of the esophagus , coordinating the contraction and relaxation of these muscle layers for effective propulsion of food .</li><li>• Auerbach's (myenteric) plexus is located in the muscular layer of the esophagus , specifically between the inner circular and outer longitudinal muscle layers of the muscularis externa .</li><li>• muscular layer</li><li>• esophagus</li><li>• inner circular</li><li>• outer longitudinal muscle layers</li><li>• muscularis externa</li><li>• This plexus plays a crucial role in regulating the peristaltic movement of the esophagus , coordinating the contraction and relaxation of these muscle layers for effective propulsion of food .</li><li>• crucial role</li><li>• regulating</li><li>• peristaltic movement</li><li>• esophagus</li><li>• contraction</li><li>• relaxation</li><li>• muscle layers</li><li>• effective propulsion</li><li>• food</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 170</li><li>• Ref</li><li>• : Histology, Text and Atlas Brijesh Kumar Page No. 170</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents to the ophthalmology clinic with a complaint of persistent tearing and a sensation of irritation in his left eye for several weeks. He also reports occasional mild pain around the inner corner of the eye, especially when pressing on the area. Examination reveals slight swelling near the nasolacrimal area without any erythema or discharge. Considering these symptoms, which type of epithelium is most likely to be found lining the inner lining of this patient's lacrimal sac?", "options": [{"label": "A", "text": "Stratified Columnar Epithelium", "correct": true}, {"label": "B", "text": "Stratified Cuboidal Epithelium", "correct": false}, {"label": "C", "text": "Stratified Squamous Epithelium", "correct": false}, {"label": "D", "text": "Simple Columnar Epithelium", "correct": false}], "correct_answer": "A. Stratified Columnar Epithelium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture5_gON91Is.jpg"], "explanation": "<p><strong>Ans. A) Stratified Columnar Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Stratified cuboidal epithelium is typically found in the ducts of some glands, such as sweat glands . It consists of two or more layers of cube-shaped cells . However, this is not the type of epithelium that lines the lacrimal sac.</li><li>• Option B.</li><li>• ducts</li><li>• sweat glands</li><li>• two</li><li>• more layers</li><li>• cube-shaped cells</li><li>• Option C. Stratified squamous epithelium is designed to protect against abrasion and is found in areas such as the skin , mouth , and esophagus . While it provides a strong barrier , it is not specialized for secretion and absorption, which are functions necessary for the lacrimal sac's epithelium .</li><li>• Option C.</li><li>• protect against abrasion</li><li>• skin</li><li>• mouth</li><li>• esophagus</li><li>• strong barrier</li><li>• lacrimal sac's epithelium</li><li>• Option D. Simple columnar epithelium is a single layer of column-shaped cells and is found in areas where absorption and secretion are important , such as the stomach and intestines .</li><li>• Option D.</li><li>• single layer</li><li>• column-shaped cells</li><li>• absorption</li><li>• secretion</li><li>• important</li><li>• stomach</li><li>• intestines</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The lacrimal sac , which is part of the tear drainage system , is lined with stratified columnar epithelium . This type of epithelial tissue consists of several layers of column-shaped cells . The stratified nature of the epithelium provides durability , while the columnar shape of the cells allows for some degree of secretion and absorption , which are important for maintaining the tear film and proper functioning of the lacrimal apparatus .</li><li>➤ The lacrimal sac , which is part of the tear drainage system , is lined with stratified columnar epithelium .</li><li>➤ lacrimal sac</li><li>➤ tear drainage system</li><li>➤ stratified columnar epithelium</li><li>➤ This type of epithelial tissue consists of several layers of column-shaped cells . The stratified nature of the epithelium provides durability , while the columnar shape of the cells allows for some degree of secretion and absorption , which are important for maintaining the tear film and proper functioning of the lacrimal apparatus .</li><li>➤ several layers</li><li>➤ column-shaped cells</li><li>➤ stratified nature</li><li>➤ epithelium</li><li>➤ durability</li><li>➤ columnar shape</li><li>➤ cells</li><li>➤ degree</li><li>➤ secretion</li><li>➤ absorption</li><li>➤ tear film</li><li>➤ proper functioning</li><li>➤ lacrimal apparatus</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 29</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 29</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cells are present in Cerebrum?", "options": [{"label": "A", "text": "Betz Cells", "correct": true}, {"label": "B", "text": "Purkinje Cell", "correct": false}, {"label": "C", "text": "Golgi Cells", "correct": false}, {"label": "D", "text": "Granule Cells", "correct": false}], "correct_answer": "A. Betz Cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture6_kLvBNNk.jpg"], "explanation": "<p><strong>Ans. A) Betz Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Purkinje cells are found in the cerebellum , not the cerebrum. They are large neurons with an extensively branched dendritic tree . These cells play a crucial role in the cerebellar function , particularly in motor coordination and balance . They are one of the most distinctive neurons in the nervous system due to their unique shape .</li><li>• Option B.</li><li>• cerebellum</li><li>• large neurons</li><li>• extensively branched dendritic tree</li><li>• crucial role</li><li>• cerebellar function</li><li>• motor coordination</li><li>• balance</li><li>• most distinctive neurons</li><li>• unique shape</li><li>• Option C. Golgi cells are interneurons found in the cerebellum , specifically in the granular layer . They are not typically found in the cerebrum. These cells play a role in modulating the input to the cerebellum , influencing the function of granule cells and the processing of motor and sensory information .</li><li>• Option C.</li><li>• interneurons</li><li>• cerebellum</li><li>• granular layer</li><li>• modulating</li><li>• input</li><li>• cerebellum</li><li>• influencing</li><li>• granule cells</li><li>• processing</li><li>• motor</li><li>• sensory information</li><li>• Option D . Granule cells are found in various parts of the brain , including the cerebrum , particularly in the hippocampus and the olfactory bulb . In the cerebellum, they form a specific layer known as the granular layer . These cells are small and densely packed and play various roles depending on their location , including processing information related to memory , learning , and sensory perception .</li><li>• Option D</li><li>• brain</li><li>• cerebrum</li><li>• hippocampus</li><li>• olfactory bulb</li><li>• granular layer</li><li>• small</li><li>• densely packed</li><li>• location</li><li>• memory</li><li>• learning</li><li>• sensory perception</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Betz cells are a type of large pyramidal neuron found in the primary motor cortex , which is part of the cerebrum . These cells are particularly significant due to their size and their role in motor function . They are involved in the voluntary control of muscles , sending signals from the motor cortex to the spinal cord .</li><li>➤ Betz cells are a type of large pyramidal neuron found in the primary motor cortex , which is part of the cerebrum .</li><li>➤ large pyramidal neuron</li><li>➤ primary motor cortex</li><li>➤ cerebrum</li><li>➤ These cells are particularly significant due to their size and their role in motor function . They are involved in the voluntary control of muscles , sending signals from the motor cortex to the spinal cord .</li><li>➤ size</li><li>➤ role</li><li>➤ motor function</li><li>➤ voluntary control</li><li>➤ muscles</li><li>➤ sending signals</li><li>➤ motor cortex</li><li>➤ spinal cord</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 322</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 322</li><li>➤ </li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old female presents to your clinic with a three-month history of recurrent abdominal pain, diarrhea, and occasional bloody stools. She reports that the pain is often localized to the lower right side of her abdomen. She also notes a recent unexplained weight loss and fatigue. A physical examination reveals mild tenderness in the right lower quadrant of the abdomen. Laboratory tests show elevated inflammatory markers. A colonoscopy is planned to further investigate her symptoms. Based on the patient's presentation, in which part of the gastrointestinal tract are Peyer's patches, potentially involved in her condition, most commonly located?", "options": [{"label": "A", "text": "Duodenum", "correct": false}, {"label": "B", "text": "Jejunum", "correct": false}, {"label": "C", "text": "Ileum", "correct": true}, {"label": "D", "text": "All", "correct": false}], "correct_answer": "C. Ileum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture9.jpg"], "explanation": "<p><strong>Ans. C) Ileum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Peyer's patches are not typically found in the duodenum. The primary immune structures in the duodenum are isolated lymphoid follicles rather than the aggregated lymphoid tissue seen in Peyer's patches.</li><li>• Option A</li><li>• not</li><li>• found</li><li>• isolated lymphoid follicles</li><li>• Option B . While lymphoid tissue is present throughout the small intestine , including the jejunum , Peyer's patches are most numerous and prominent in another part of the small intestine .</li><li>• Option B</li><li>• throughout</li><li>• small intestine</li><li>• jejunum</li><li>• most numerous</li><li>• prominent</li><li>• another part</li><li>• small intestine</li><li>• Option D . While it is true that lymphoid tissue can be found throughout the small intestine , Peyer's patches as distinct and aggregated lymphoid structures are predominantly located in the ileum . They are not uniformly distributed across all sections of the small intestine.</li><li>• Option D</li><li>• lymphoid tissue</li><li>• throughout</li><li>• small intestine</li><li>• distinct</li><li>• aggregated lymphoid structures</li><li>• ileum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Peyer's patches are most commonly found in the ileum , which is the last part of the small intestine . These are aggregated lymphoid follicles that are important components of the Gut-Associated Lymphoid Tissue (GALT) . Peyer's patches play a significant role in the immune surveillance of the intestinal lumen and in the generation of immune responses to gut pathogens .</li><li>➤ Peyer's patches are most commonly found in the ileum , which is the last part of the small intestine .</li><li>➤ Peyer's patches</li><li>➤ ileum</li><li>➤ last part</li><li>➤ small intestine</li><li>➤ These are aggregated lymphoid follicles that are important components of the Gut-Associated Lymphoid Tissue (GALT) .</li><li>➤ aggregated lymphoid follicles</li><li>➤ Gut-Associated Lymphoid Tissue (GALT)</li><li>➤ Peyer's patches play a significant role in the immune surveillance of the intestinal lumen and in the generation of immune responses to gut pathogens .</li><li>➤ immune surveillance</li><li>➤ intestinal lumen</li><li>➤ generation</li><li>➤ immune responses</li><li>➤ gut pathogens</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 187</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 187</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following type of cells are not found in stomach?", "options": [{"label": "A", "text": "Chief cells", "correct": false}, {"label": "B", "text": "Parietal cells", "correct": false}, {"label": "C", "text": "Argentaffin cells", "correct": false}, {"label": "D", "text": "Goblet cells", "correct": true}], "correct_answer": "D. Goblet cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture10.jpg"], "explanation": "<p><strong>Ans. D) Goblet cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Chief cells are indeed found in the stomach , specifically in the base of gastric glands of the stomach's fundus and body . These cells are responsible for secreting pepsinogen , an inactive enzyme that is converted into pepsin in the presence of stomach acid .</li><li>• Option A</li><li>• stomach</li><li>• base</li><li>• gastric glands</li><li>• stomach's fundus</li><li>• body</li><li>• secreting pepsinogen</li><li>• inactive enzyme</li><li>• converted</li><li>• pepsin</li><li>• presence</li><li>• stomach acid</li><li>• Option B . Parietal cells are also located in the gastric glands of the stomach . Parietal cells / oxyntic cells present in all regions of gastric glands except few at base and secrete gastric acid . They have a very important role in secreting hydrochloric acid (HCl) and intrinsic factor .</li><li>• Option B</li><li>• gastric glands</li><li>• stomach</li><li>• Parietal cells</li><li>• oxyntic cells</li><li>• base</li><li>• secrete gastric</li><li>• acid</li><li>• secreting hydrochloric acid (HCl)</li><li>• intrinsic factor</li><li>• Option C. Argentaffin Cells, or Enterochromaffin Cells , are found in the stomach as well. These cells are part of the endocrine system of the gastrointestinal tract and are known for producing serotonin . Serotonin released in the gut can regulate intestinal movements and contribute to the regulation of gastric acid secretion .</li><li>• Option C.</li><li>• Enterochromaffin Cells</li><li>• stomach</li><li>• endocrine system</li><li>• gastrointestinal tract</li><li>• producing serotonin</li><li>• released</li><li>• gut</li><li>• regulate intestinal movements</li><li>• regulation</li><li>• gastric acid secretion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Goblet cells are not typically found in the stomach lining. These cells are characterized by their production and secretion of mucus . While the stomach does have mucus-secreting cells , these are not the typical goblet cells found in other parts of the gastrointestinal tract, such as the intestines , where goblet cells play a crucial role in lubricating and protecting the intestinal lining .</li><li>➤ Goblet cells are not typically found in the stomach lining. These cells are characterized by their production and secretion of mucus .</li><li>➤ production</li><li>➤ secretion</li><li>➤ mucus</li><li>➤ While the stomach does have mucus-secreting cells , these are not the typical goblet cells found in other parts of the gastrointestinal tract, such as the intestines , where goblet cells play a crucial role in lubricating and protecting the intestinal lining .</li><li>➤ mucus-secreting cells</li><li>➤ intestines</li><li>➤ goblet cells</li><li>➤ lubricating</li><li>➤ protecting</li><li>➤ intestinal lining</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 176</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 176</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old woman presents to the clinic with upper abdominal pain that radiates to her back, nausea, and vomiting. She has a history of chronic alcohol use and has experienced similar, but milder, episodes in the past. On examination, her abdomen is tender in the epigastric region. Blood tests reveal elevated serum amylase and lipase levels. An abdominal ultrasound is suggestive of inflammation in the pancreas. Given these findings, in which anatomical structure are Centroacinar cells, potentially involved in this patient's condition, most commonly located?", "options": [{"label": "A", "text": "Pancreas", "correct": true}, {"label": "B", "text": "Parotid Gland", "correct": false}, {"label": "C", "text": "Prostate", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "A. Pancreas", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture11.jpg"], "explanation": "<p><strong>Ans. A) Pancreas</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . The parotid gland is a major salivary gland , but it does not contain centroacinar cells. The parotid gland primarily consists of serous acini that produce a watery , enzyme-rich saliva . The structure of the parotid gland is different from that of the pancreas, and centroacinar cells are specific to the pancreatic acini .</li><li>• Option B</li><li>• major salivary gland</li><li>• serous acini</li><li>• watery</li><li>• enzyme-rich saliva</li><li>• centroacinar cells</li><li>• pancreatic acini</li><li>• Option C . The prostate is an exocrine gland of the male reproductive system that produces components of semen . The glandular structure of the prostate is quite different from that of the pancreas , and it does not contain centroacinar cells. The prostate consists of glandular tissue that is divided into several zones and secretes prostate fluid .</li><li>• Option C</li><li>• exocrine gland</li><li>• male reproductive system</li><li>• semen</li><li>• glandular structure</li><li>• prostate</li><li>• quite different</li><li>• pancreas</li><li>• glandular tissue</li><li>• several zones</li><li>• secretes prostate fluid</li><li>• Option D . None : This option is incorrect as centroacinar cells are indeed present in a specific organ, which is the pancreas.</li><li>• Option D</li><li>• None</li><li>• incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Centroacinar cells are a unique feature of the pancreas . They are located in the acini , which are the clusters of exocrine cells in the pancreas that secrete digestive enzymes . Centroacinar cells are situated at the center of these acinar clusters and extend into the small , intercalated ducts . They are part of the duct system and are important for the transport of the pancreatic enzymes into the larger ducts and eventually into the duodenum . In summary, centroacinar cells are distinctive cells found in the pancreas . These cells are not found in the parotid gland, prostate, or any other organ.</li><li>➤ Centroacinar cells are a unique feature of the pancreas . They are located in the acini , which are the clusters of exocrine cells in the pancreas that secrete digestive enzymes .</li><li>➤ Centroacinar cells</li><li>➤ pancreas</li><li>➤ acini</li><li>➤ clusters</li><li>➤ exocrine cells</li><li>➤ pancreas</li><li>➤ secrete digestive enzymes</li><li>➤ Centroacinar cells are situated at the center of these acinar clusters and extend into the small , intercalated ducts .</li><li>➤ center</li><li>➤ acinar clusters</li><li>➤ extend</li><li>➤ small</li><li>➤ intercalated ducts</li><li>➤ They are part of the duct system and are important for the transport of the pancreatic enzymes into the larger ducts and eventually into the duodenum .</li><li>➤ duct system</li><li>➤ transport</li><li>➤ pancreatic enzymes</li><li>➤ larger ducts</li><li>➤ eventually</li><li>➤ duodenum</li><li>➤ In summary, centroacinar cells are distinctive cells found in the pancreas . These cells are not found in the parotid gland, prostate, or any other organ.</li><li>➤ centroacinar cells</li><li>➤ pancreas</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 197</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 197</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 63-year-old man with a history of chronic Gastro-Esophageal Reflux Disease (GERD) presents to the clinic with worsening dysphagia, especially for solid foods. He also reports occasional chest pain and a recent unintentional weight loss. An upper gastrointestinal endoscopy reveals esophageal narrowing with irregular mucosal lining. A biopsy is taken for further evaluation. Given these findings, which of the following layers of the esophagus is considered the toughest and may be involved in this patient's esophageal pathology?", "options": [{"label": "A", "text": "Mucosa", "correct": false}, {"label": "B", "text": "Submucosa", "correct": true}, {"label": "C", "text": "Muscularis", "correct": false}, {"label": "D", "text": "Adventitia", "correct": false}], "correct_answer": "B. Submucosa", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Submucosa</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The mucosa is the innermost layer of the esophagus , consisting of the epithelial lining , lamina propria , and a thin layer of muscle called the muscularis mucosae . Its primary function is to provide a barrier and facilitate the passage of food . The mucosa is not particularly tough; it is designed more for flexibility and secretion .</li><li>• Option A.</li><li>• innermost layer</li><li>• esophagus</li><li>• epithelial lining</li><li>• lamina</li><li>• propria</li><li>• thin layer</li><li>• muscle</li><li>• muscularis mucosae</li><li>• barrier</li><li>• facilitate</li><li>• passage</li><li>• food</li><li>• flexibility</li><li>• secretion</li><li>• Option C . The muscularis ( muscularis externa ) is the layer that consists of muscle fibers , typically an inner circular layer and an outer longitudinal layer . These muscles are responsible for the peristaltic movements that propel food down the esophagus . While this layer provides the force needed for peristalsis , it is not the toughest layer in terms of structural integrity.</li><li>• Option C</li><li>• muscularis externa</li><li>• muscle fibers</li><li>• inner circular layer</li><li>• outer longitudinal layer</li><li>• peristaltic movements</li><li>• propel</li><li>• food down</li><li>• esophagus</li><li>• force</li><li>• peristalsis</li><li>• Option D . The adventitia is the outermost layer of the esophagus , consisting of loose connective tissue that attaches the esophagus to surrounding structures. In the thoracic portion of the esophagus , the adventitia acts as a connective tissue layer rather than a serosa. Adventitia provides support and anchors the esophagus , but it is not considered the toughest layer.</li><li>• Option D</li><li>• outermost layer</li><li>• esophagus</li><li>• loose connective tissue</li><li>• attaches</li><li>• esophagus</li><li>• thoracic portion</li><li>• esophagus</li><li>• adventitia</li><li>• connective tissue layer</li><li>• support</li><li>• anchors</li><li>• esophagus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Submucosa lies just beneath the mucosa and is composed of dense, irregular connective tissue . The submucosa gives the esophagus its strength and flexibility . It contains blood vessels , nerves , and glands that secrete mucus to lubricate the esophagus . The connective tissue in the submucosa is what provides the esophagus with much of its structural integrity , making it the toughest layer .</li><li>➤ Submucosa lies just beneath the mucosa and is composed of dense, irregular connective tissue .</li><li>➤ mucosa</li><li>➤ dense, irregular connective tissue</li><li>➤ The submucosa gives the esophagus its strength and flexibility . It contains blood vessels , nerves , and glands that secrete mucus to lubricate the esophagus .</li><li>➤ esophagus</li><li>➤ strength</li><li>➤ flexibility</li><li>➤ blood vessels</li><li>➤ nerves</li><li>➤ glands</li><li>➤ secrete mucus</li><li>➤ lubricate</li><li>➤ esophagus</li><li>➤ The connective tissue in the submucosa is what provides the esophagus with much of its structural integrity , making it the toughest layer .</li><li>➤ connective tissue</li><li>➤ submucosa</li><li>➤ esophagus</li><li>➤ structural integrity</li><li>➤ toughest layer</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 171</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 171</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following group has similar kind of epithelium?", "options": [{"label": "A", "text": "Alveoli-Olfactory Epithelium", "correct": false}, {"label": "B", "text": "Olfactory Epithelium-Skin", "correct": false}, {"label": "C", "text": "Esophagus-Urinary Bladder", "correct": false}, {"label": "D", "text": "Lung Alveoli-Bowman's Capsule", "correct": true}], "correct_answer": "D. Lung Alveoli-Bowman's Capsule", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Lung Alveoli-Bowman's Capsule</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The alveoli of the lungs are lined with simple squamous epithelium , which is thin and allows for efficient gas exchange . In contrast, the olfactory epithelium , found in the nasal cavity , is a type of pseudostratified columnar epithelium containing specialized sensory cells for smell .</li><li>• Option A.</li><li>• alveoli</li><li>• simple squamous epithelium</li><li>• thin</li><li>• allows</li><li>• efficient gas exchange</li><li>• olfactory epithelium</li><li>• nasal cavity</li><li>• pseudostratified columnar epithelium</li><li>• specialized sensory cells</li><li>• smell</li><li>• Option B. As mentioned, the olfactory epithelium is a type of pseudostratified columnar epithelium specialized for detecting odors . The skin , on the other hand, is primarily covered by stratified squamous epithelium , which is thick and protective .</li><li>• Option B.</li><li>• olfactory epithelium</li><li>• pseudostratified columnar epithelium</li><li>• odors</li><li>• skin</li><li>• stratified squamous epithelium</li><li>• thick</li><li>• protective</li><li>• Option C. The esophagus is lined with non-keratinized stratified squamous epithelium , which protects against abrasion from food particles . The urinary bladder is lined with transitional epithelium , also known as urothelium , which is unique to the urinary tract and can stretch and change shape .</li><li>• Option C.</li><li>• esophagus</li><li>• non-keratinized stratified squamous epithelium</li><li>• against abrasion</li><li>• food particles</li><li>• urinary bladder</li><li>• transitional epithelium</li><li>• urothelium</li><li>• urinary tract</li><li>• stretch</li><li>• change shape</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Both the lung alveoli and Bowman's capsule are lined with simple squamous epithelium . In the alveoli, this thin epithelium facilitates gas exchange between the air and blood . In Bowman's capsule, it allows for the filtration of blood to form urine . The similarity lies in their thin , simple squamous structure , which is essential for efficient diffusion and filtration .</li><li>➤ Both the lung alveoli and Bowman's capsule are lined with simple squamous epithelium .</li><li>➤ Both the lung alveoli and Bowman's capsule are lined with simple squamous epithelium .</li><li>➤ Both</li><li>➤ simple squamous epithelium</li><li>➤ In the alveoli, this thin epithelium facilitates gas exchange between the air and blood .</li><li>➤ In the alveoli, this thin epithelium facilitates gas exchange between the air and blood .</li><li>➤ thin epithelium</li><li>➤ gas exchange</li><li>➤ air</li><li>➤ blood</li><li>➤ In Bowman's capsule, it allows for the filtration of blood to form urine . The similarity lies in their thin , simple squamous structure , which is essential for efficient diffusion and filtration .</li><li>➤ In Bowman's capsule, it allows for the filtration of blood to form urine . The similarity lies in their thin , simple squamous structure , which is essential for efficient diffusion and filtration .</li><li>➤ allows</li><li>➤ filtration</li><li>➤ blood</li><li>➤ form urine</li><li>➤ thin</li><li>➤ simple squamous structure</li><li>➤ efficient diffusion</li><li>➤ filtration</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 333</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 333</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old male patient presents with lower urinary tract symptoms, including frequent urination, difficulty initiating urination, and a weak urinary stream. Digital rectal examination reveals a firm and enlarged prostate gland. A biopsy of the prostate is performed, and histological examination reveals the presence of Corpora amylacea. What is the most likely location where Corpora amylacea is seen in this patient?", "options": [{"label": "A", "text": "Pineal Gland", "correct": false}, {"label": "B", "text": "Prostate", "correct": true}, {"label": "C", "text": "Penis", "correct": false}, {"label": "D", "text": "Bladder", "correct": false}], "correct_answer": "B. Prostate", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture14.jpg"], "explanation": "<p><strong>Ans. B) Prostate</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The pineal gland can accumulate calcium deposits known as brain sand or corpora arenacea , but these are not the same as corpora amylacea. Corpora amylacea are polyglucosan bodies and are not a characteristic feature of the pineal gland.</li><li>• Option A</li><li>• accumulate calcium deposits</li><li>• brain</li><li>• sand</li><li>• corpora arenacea</li><li>• polyglucosan bodies</li><li>• Option C . The penis does not typically exhibit corpora amylacea. This structure is not a feature of the penile tissue.</li><li>• Option C</li><li>• Option D . While the urinary bladder can show some forms of calcification or other deposits, especially in the context of chronic inflammation or infection , corpora amylacea are not a typical finding in the bladder.</li><li>• Option D</li><li>• urinary bladder</li><li>• calcification</li><li>• context</li><li>• chronic inflammation</li><li>• infection</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Corpora amylacea are commonly found in the prostate , especially with advancing age . In the prostate gland, these are small , round , hyaline bodies that increase in number and size as men age . They are believed to be the result of a degenerative process and are often seen in Benign Prostatic Hyperplasia (BPH) and, occasionally, in prostatic cancer .</li><li>➤ Corpora amylacea are commonly found in the prostate , especially with advancing age .</li><li>➤ Corpora amylacea are commonly found in the prostate , especially with advancing age .</li><li>➤ Corpora amylacea</li><li>➤ prostate</li><li>➤ advancing age</li><li>➤ In the prostate gland, these are small , round , hyaline bodies that increase in number and size as men age .</li><li>➤ In the prostate gland, these are small , round , hyaline bodies that increase in number and size as men age .</li><li>➤ small</li><li>➤ round</li><li>➤ hyaline bodies</li><li>➤ increase</li><li>➤ number</li><li>➤ size</li><li>➤ men age</li><li>➤ They are believed to be the result of a degenerative process and are often seen in Benign Prostatic Hyperplasia (BPH) and, occasionally, in prostatic cancer .</li><li>➤ They are believed to be the result of a degenerative process and are often seen in Benign Prostatic Hyperplasia (BPH) and, occasionally, in prostatic cancer .</li><li>➤ degenerative process</li><li>➤ Benign Prostatic Hyperplasia (BPH)</li><li>➤ prostatic cancer</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 234</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 234</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient complains of Blurry Vision, Redness, and Tearing in their Right Eye. On examination, you observe a Clear, Dome-Shaped Structure at the Front of the Eye, and further evaluation reveals that this structure is Irregular and Thickened. The patient's Left Eye appears Normal. Which part of the eye is affected in this patient?", "options": [{"label": "A", "text": "Retina", "correct": false}, {"label": "B", "text": "Cornea", "correct": true}, {"label": "C", "text": "Conjunctiva", "correct": false}, {"label": "D", "text": "Iris", "correct": false}], "correct_answer": "B. Cornea", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture15.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture16.jpg"], "explanation": "<p><strong>Ans. B) Cornea</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The retina is the light-sensitive layer at the back of the eye . It contains photoreceptor cells that convert light into neural signals for vision . The retina does not contain Descemet's membrane.</li><li>• Option A</li><li>• light-sensitive layer</li><li>• back</li><li>• eye</li><li>• photoreceptor cells</li><li>• convert light</li><li>• neural signals</li><li>• vision</li><li>• Option C . The conjunctiva is a thin , transparent tissue that covers the white part of the eye and lines the inside of the eyelids . It does not contain Descemet's membrane. The conjunctiva's primary functions are to lubricate the eye by producing mucus and tears and to help prevent the entry of microbes into the eye .</li><li>• Option C</li><li>• thin</li><li>• transparent tissue</li><li>• covers</li><li>• white part</li><li>• eye</li><li>• lines</li><li>• inside</li><li>• eyelids</li><li>• lubricate</li><li>• eye</li><li>• producing mucus</li><li>• tears</li><li>• prevent</li><li>• entry</li><li>• microbes</li><li>• eye</li><li>• Option D. The iris is the colored part of the eye , responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina .</li><li>• Option D.</li><li>• colored part</li><li>• eye</li><li>• controlling</li><li>• diameter</li><li>• size</li><li>• pupil</li><li>• amount</li><li>• light</li><li>• reaching</li><li>• retina</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Descemet's membrane is located in the cornea, which is the clear , dome-shaped surface covering the front of the eye . Descemet's membrane is a thin but strong layer of tissue that serves as the basement membrane of the corneal endothelium . It plays a crucial role in maintaining corneal transparency and hydration .</li><li>• Descemet's membrane is located in the cornea, which is the clear , dome-shaped surface covering the front of the eye .</li><li>• clear</li><li>• dome-shaped surface</li><li>• front</li><li>• eye</li><li>• Descemet's membrane is a thin but strong layer of tissue that serves as the basement membrane of the corneal endothelium .</li><li>• thin</li><li>• strong layer</li><li>• tissue</li><li>• serves</li><li>• basement membrane</li><li>• corneal endothelium</li><li>• It plays a crucial role in maintaining corneal transparency and hydration .</li><li>• crucial role</li><li>• maintaining corneal transparency</li><li>• hydration</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 346</li><li>• Ref</li><li>• : Histology, Text and Atlas Brijesh Kumar Page No. 346</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following is microvilli not present?", "options": [{"label": "A", "text": "Gallbladder", "correct": false}, {"label": "B", "text": "Small Intestine", "correct": false}, {"label": "C", "text": "Proximal Convoluted Tubule", "correct": false}, {"label": "D", "text": "Distal Convoluted Tubule", "correct": true}], "correct_answer": "D. Distal Convoluted Tubule", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Distal Convoluted Tubule</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The gallbladder is lined with simple columnar epithelium , but it does not typically have microvilli. The primary function of the gallbladder is to store and concentrate bile , not absorption, which is the main function associated with microvilli .</li><li>• Option A</li><li>• simple columnar epithelium</li><li>• store</li><li>• concentrate bile</li><li>• main function</li><li>• microvilli</li><li>• Option B . The small intestine is lined with simple columnar epithelium that has prominent microvilli , forming the brush border . These microvilli significantly increase the surface area for absorption , which is a key function of the small intestine in nutrient absorption and digestion.</li><li>• Option B</li><li>• simple columnar epithelium</li><li>• prominent microvilli</li><li>• brush</li><li>• border</li><li>• increase</li><li>• surface area</li><li>• absorption</li><li>• small intestine</li><li>• nutrient absorption</li><li>• digestion.</li><li>• Option C . The Proximal Convoluted Tubule (PCT) in the kidney is lined with simple cuboidal epithelium with a brush border of microvilli . These microvilli increase the surface area for reabsorption of water, ions , and organic nutrients from the filtrate back into the bloodstream .</li><li>• Option C</li><li>• simple cuboidal epithelium</li><li>• microvilli</li><li>• increase</li><li>• surface area</li><li>• reabsorption</li><li>• water,</li><li>• ions</li><li>• organic nutrients</li><li>• filtrate back</li><li>• bloodstream</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Distal Convoluted Tubule (DCT) , also part of the nephron in the kidney , is involved in selective reabsorption and secretion , primarily of ions . It is lined with simple cuboidal epithelium but does not have the brush border of microvilli like the proximal convoluted tubule. The absence of microvilli in the DCT relates to its different function compared to the PCT .</li><li>➤ The Distal Convoluted Tubule (DCT) , also part of the nephron in the kidney , is involved in selective reabsorption and secretion , primarily of ions .</li><li>➤ Distal Convoluted Tubule (DCT)</li><li>➤ nephron</li><li>➤ kidney</li><li>➤ selective reabsorption</li><li>➤ secretion</li><li>➤ ions</li><li>➤ It is lined with simple cuboidal epithelium but does not have the brush border of microvilli like the proximal convoluted tubule.</li><li>➤ simple cuboidal epithelium</li><li>➤ The absence of microvilli in the DCT relates to its different function compared to the PCT .</li><li>➤ absence</li><li>➤ microvilli</li><li>➤ DCT</li><li>➤ different function</li><li>➤ PCT</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 34</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 34</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What occupies Howship's Lacunae?", "options": [{"label": "A", "text": "Osteoprogenitor Cell", "correct": false}, {"label": "B", "text": "Osteoclast", "correct": true}, {"label": "C", "text": "Osteoblasts", "correct": false}, {"label": "D", "text": "Osteocytes", "correct": false}], "correct_answer": "B. Osteoclast", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture17.jpg"], "explanation": "<p><strong>Ans. B) Osteoclast</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Osteoprogenitor cells are stem cells found in bone that have the potential to differentiate into osteoblasts. They are important for bone growth and repair .</li><li>• Option A.</li><li>• stem cells</li><li>• bone</li><li>• potential</li><li>• differentiate</li><li>• osteoblasts.</li><li>• bone growth</li><li>• repair</li><li>• Option C . Osteoblasts are cells responsible for bone formation . They secrete bone matrix and are involved in the mineralization process . While osteoblasts are essential for building bone , they do not occupy Howship's lacunae.</li><li>• Option C</li><li>• bone formation</li><li>• secrete bone matrix</li><li>• mineralization process</li><li>• osteoblasts</li><li>• building bone</li><li>• Option D . Osteocytes are mature bone cells derived from osteoblasts . They reside in lacunae within the bone matrix , but these are not Howship's lacunae.</li><li>• Option D</li><li>• mature bone cells</li><li>• osteoblasts</li><li>• reside</li><li>• lacunae</li><li>• bone matrix</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Howship's lacunae are small pits or cavities found on the surface of bones . They are formed by the bone resorption activity of osteoclasts . Osteoclasts are large , multinucleated cells that break down bone tissue during bone remodeling . When osteoclasts resorb bone , they create these characteristic lacunae .</li><li>➤ Howship's lacunae are small pits or cavities found on the surface of bones .</li><li>➤ Howship's lacunae</li><li>➤ small pits</li><li>➤ cavities</li><li>➤ surface</li><li>➤ bones</li><li>➤ They are formed by the bone resorption activity of osteoclasts . Osteoclasts are large , multinucleated cells that break down bone tissue during bone remodeling .</li><li>➤ formed</li><li>➤ bone resorption activity</li><li>➤ osteoclasts</li><li>➤ large</li><li>➤ multinucleated cells</li><li>➤ break down bone tissue</li><li>➤ bone remodeling</li><li>➤ When osteoclasts resorb bone , they create these characteristic lacunae .</li><li>➤ osteoclasts resorb bone</li><li>➤ characteristic lacunae</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 71</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 71</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cell lines the ventricles of brain?", "options": [{"label": "A", "text": "Astrocytes", "correct": false}, {"label": "B", "text": "Oligodendrocytes", "correct": false}, {"label": "C", "text": "Ependymal Cells", "correct": true}, {"label": "D", "text": "Microglia", "correct": false}], "correct_answer": "C. Ependymal Cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Ependymal Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Astrocytes are a type of glial cell in the central nervous system . They perform several functions, including supporting neurons , maintaining the blood-brain barrier , and regulating neurotransmitter levels . However, they do not line the ventricles of the brain.</li><li>• Option A</li><li>• glial cell</li><li>• central nervous system</li><li>• supporting neurons</li><li>• maintaining</li><li>• blood-brain barrier</li><li>• regulating neurotransmitter levels</li><li>• Option B . Oligodendrocytes are another type of glial cell , and their main function is to provide support and insulation to axons in the central nervous system by forming myelin sheaths .</li><li>• Option B</li><li>• another type</li><li>• glial cell</li><li>• main</li><li>• function</li><li>• support</li><li>• insulation</li><li>• axons</li><li>• central nervous system</li><li>• forming myelin sheaths</li><li>• Option D. Microglia are the resident immune cells of the central nervous system . They act as macrophages , clearing away dead cells and debris , and are involved in immune defense within the brain and spinal cord .</li><li>• Option D.</li><li>• resident immune cells</li><li>• central nervous system</li><li>• macrophages</li><li>• clearing away dead</li><li>• cells</li><li>• debris</li><li>• immune defense</li><li>• brain</li><li>• spinal cord</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ependymal cells are the cells that line the ventricles of the brain and the central canal of the spinal cord . They form a simple epithelium known as ependyma . These cells are involved in the production and circulation of Cerebro Spinal Fluid (CSF) , which fills the ventricles and surrounds the brain and spinal cord .</li><li>➤ Ependymal cells are the cells that line the ventricles of the brain and the central canal of the spinal cord .</li><li>➤ ventricles</li><li>➤ brain</li><li>➤ central canal</li><li>➤ spinal cord</li><li>➤ They form a simple epithelium known as ependyma . These cells are involved in the production and circulation of Cerebro Spinal Fluid (CSF) , which fills the ventricles and surrounds the brain and spinal cord .</li><li>➤ simple epithelium</li><li>➤ ependyma</li><li>➤ production</li><li>➤ circulation</li><li>➤ Cerebro Spinal Fluid (CSF)</li><li>➤ ventricles</li><li>➤ surrounds</li><li>➤ brain</li><li>➤ spinal cord</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 95</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 95</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which type of neurons are the cell bodies large with a large, eccentrically positioned nucleus?", "options": [{"label": "A", "text": "Ganglia in Mesenteric Plexus", "correct": false}, {"label": "B", "text": "Cervical Ganglia", "correct": false}, {"label": "C", "text": "Coeliac Ganglia", "correct": false}, {"label": "D", "text": "Spinal Ganglia", "correct": true}], "correct_answer": "D. Spinal Ganglia", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Spinal Ganglia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The mesenteric plexus primarily contains neurons involved in the control of gastrointestinal functions . While these neurons are important for gut motility , secretion , and blood flow , they typically do not have large cell bodies with large, eccentric nuclei characteristic of spinal ganglia neurons.</li><li>• Option A.</li><li>• neurons</li><li>• control</li><li>• gastrointestinal functions</li><li>• gut motility</li><li>• secretion</li><li>• blood flow</li><li>• Option B. The cervical ganglia are part of the sympathetic nervous system and contain neurons that influence various functions, such as heart rate and blood vessel constriction . Neurons in the cervical ganglia are important for autonomic control , but their morphology is not specifically characterized by large cell bodies with large, eccentric nuclei, as seen in spinal ganglia.</li><li>• Option B.</li><li>• sympathetic nervous system</li><li>• neurons</li><li>• influence</li><li>• heart rate</li><li>• blood vessel constriction</li><li>• Neurons</li><li>• cervical ganglia</li><li>• autonomic control</li><li>• Option C. The coeliac ganglia are also part of the sympathetic nervous system and are involved in innervating abdominal organs . The neurons in the coeliac ganglia play a role in autonomic functions , but their structure is not typically described as having large cell bodies with large, eccentric nuclei.</li><li>• Option C.</li><li>• sympathetic nervous system</li><li>• innervating abdominal organs</li><li>• neurons</li><li>• coeliac ganglia</li><li>• autonomic functions</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Neurons in the Spinal Ganglia (Dorsal Root Ganglia) , also known as dorsal root ganglia , are sensory neurons that convey information from sensory receptors to the central nervous system . These neurons are characterized by large cell bodies with a large , eccentrically positioned nucleus . The unique morphology of these sensory neurons is associated with their role in transmitting sensory information , including pain , temperature , touch , and proprioception .</li><li>• Neurons in the Spinal Ganglia (Dorsal Root Ganglia) , also known as dorsal root ganglia , are sensory neurons that convey information from sensory receptors to the central nervous system .</li><li>• Spinal Ganglia (Dorsal Root Ganglia)</li><li>• dorsal root ganglia</li><li>• sensory neurons</li><li>• sensory receptors</li><li>• central nervous system</li><li>• These neurons are characterized by large cell bodies with a large , eccentrically positioned nucleus . The unique morphology of these sensory neurons is associated with their role in transmitting sensory information , including pain , temperature , touch , and proprioception .</li><li>• characterized</li><li>• large cell</li><li>• bodies</li><li>• large</li><li>• eccentrically positioned</li><li>• nucleus</li><li>• role</li><li>• transmitting sensory information</li><li>• pain</li><li>• temperature</li><li>• touch</li><li>• proprioception</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 108</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 108</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male patient presents with lower limb swelling, pain, and discomfort. Duplex ultrasonography reveals the presence of a thrombus (blood clot) within a large venous structure in the abdomen. The patient is at risk for pulmonary embolism. Which of the following venous structures, often associated with smooth muscle fibers in its tunica adventitia, is most likely affected in this patient?", "options": [{"label": "A", "text": "Aorta", "correct": false}, {"label": "B", "text": "IVC", "correct": true}, {"label": "C", "text": "Pterygoid Venous Plexus", "correct": false}, {"label": "D", "text": "Femoral Artery", "correct": false}], "correct_answer": "B. IVC", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) IVC</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The aorta has a well-developed tunica media composed primarily of elastic fibers to accommodate the high pressure from the heart and maintain blood flow . While the tunica adventitia of the aorta contains connective tissue that supports the vessel , it is not characterized by the presence of smooth muscle fibers.</li><li>• Option A</li><li>• well-developed tunica media</li><li>• elastic fibers</li><li>• high pressure</li><li>• heart</li><li>• maintain blood flow</li><li>• tunica adventitia</li><li>• aorta</li><li>• connective tissue</li><li>• supports</li><li>• vessel</li><li>• Option C . The pterygoid venous plexus is a network of veins in the region of the pterygoid muscles , which is part of the venous drainage of the deep face . Like most veins, its tunica adventitia does not typically contain smooth muscle fibers.</li><li>• Option C</li><li>• network</li><li>• veins</li><li>• region</li><li>• pterygoid muscles</li><li>• venous drainage</li><li>• deep face</li><li>• Option D . The femoral artery, has a well-developed tunica media containing smooth muscle and elastic fibers , which is typical for arteries . The tunica adventitia of the femoral artery primarily consists of connective tissue and does not have smooth muscle fibers as a characteristic component.</li><li>• Option D</li><li>• well-developed tunica media</li><li>• smooth muscle</li><li>• elastic fibers</li><li>• arteries</li><li>• femoral artery</li><li>• connective tissue</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Inferior Vena Cava (IVC), which is a large vein carrying deoxygenated blood from the lower body to the heart , has a unique feature in its tunica adventitia . It contains longitudinally arranged smooth muscle fibers in the tunica adventitia , which is unusual for veins . These muscle fibers are thought to help in the regulation of venous return to the heart .</li><li>➤ The Inferior Vena Cava (IVC), which is a large vein carrying deoxygenated blood from the lower body to the heart , has a unique feature in its tunica adventitia .</li><li>➤ large vein</li><li>➤ deoxygenated blood</li><li>➤ lower</li><li>➤ heart</li><li>➤ tunica adventitia</li><li>➤ It contains longitudinally arranged smooth muscle fibers in the tunica adventitia , which is unusual for veins . These muscle fibers are thought to help in the regulation of venous return to the heart .</li><li>➤ longitudinally</li><li>➤ smooth muscle fibers</li><li>➤ tunica adventitia</li><li>➤ unusual</li><li>➤ veins</li><li>➤ help</li><li>➤ regulation</li><li>➤ venous return</li><li>➤ heart</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 116</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 116</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following structure portal triad is seen in the centre?", "options": [{"label": "A", "text": "Hepatic Acinus", "correct": false}, {"label": "B", "text": "Portal Lobule", "correct": true}, {"label": "C", "text": "Classical Lobule", "correct": false}, {"label": "D", "text": "All the above", "correct": false}], "correct_answer": "B. Portal Lobule", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture23.jpg"], "explanation": "<p><strong>Ans. B) Portal Lobule</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The hepatic acinus, proposed by Rappaport , is a concept of liver architecture based on blood supply . It is a small functional unit of the liver , shaped like a diamond or an oval , with the portal triad branches located at the periphery , not the center. The central vein is located at the center of each acinus .</li><li>• Option A</li><li>• Rappaport</li><li>• concept</li><li>• liver architecture</li><li>• blood supply</li><li>• small functional unit</li><li>• liver</li><li>• diamond</li><li>• oval</li><li>• portal triad branches</li><li>• periphery</li><li>• located</li><li>• center</li><li>• each acinus</li><li>• Option C . The classical lobule is the traditional concept of the liver's functional unit , centered around the central vein . The portal triad is located at the corners of the hexagonal lobule in this model. In the classical lobule, the emphasis is on the hepatic venous drainage rather than the biliary or arterial supply.</li><li>• Option C</li><li>• traditional concept</li><li>• liver's functional unit</li><li>• centered</li><li>• central vein</li><li>• corners</li><li>• hexagonal lobule</li><li>• hepatic venous drainage</li><li>• Option D . This option is incorrect because the portal triad is centrally located only in the portal lobule concept . In the hepatic acinus and classical lobule , the portal triad is not centrally located.</li><li>• Option D</li><li>• incorrect</li><li>• portal triad</li><li>• centrally</li><li>• only</li><li>• portal lobule concept</li><li>• hepatic acinus</li><li>• classical lobule</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The portal lobule is a concept in liver histology where the portal triad is considered the center of the lobule . This triangular model emphasizes the biliary drainage area of the liver . Each portal lobule is centered around a portal triad, which contains a branch of the hepatic artery , a branch of the portal vein , and a bile duct .</li><li>➤ The portal lobule is a concept in liver histology where the portal triad is considered the center of the lobule .</li><li>➤ liver histology</li><li>➤ portal triad</li><li>➤ center</li><li>➤ lobule</li><li>➤ This triangular model emphasizes the biliary drainage area of the liver . Each portal lobule is centered around a portal triad, which contains a branch of the hepatic artery , a branch of the portal vein , and a bile duct .</li><li>➤ biliary drainage</li><li>➤ area</li><li>➤ liver</li><li>➤ centered</li><li>➤ branch</li><li>➤ hepatic artery</li><li>➤ portal vein</li><li>➤ bile duct</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 204</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 204</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male patient presents with infertility and a history of exposure to potential testicular toxins in his workplace. Upon further investigation, it is discovered that the patient has impaired spermatogenesis. Which of the following statements regarding Sertoli cells, which play a crucial role in the testicular microenvironment, is true and relevant to this patient's condition?", "options": [{"label": "A", "text": "They are Oval in Shape", "correct": false}, {"label": "B", "text": "Basal Aspect of adjacent Sertoli Cells connected via Gap Junctions", "correct": false}, {"label": "C", "text": "Contribute to Blood Testis Barrier", "correct": true}, {"label": "D", "text": "Secrete Testosterone", "correct": false}], "correct_answer": "C. Contribute to Blood Testis Barrier", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Contribute to Blood Testis Barrier</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While the specific shape of Sertoli cells can vary, they are generally described as tall , columnar cells rather than simply oval . They extend from the basal to the luminal compartment of the seminiferous tubules . Their complex shape allows them to interact with and support developing sperm cells at various stages of spermatogenesis.</li><li>• Option A.</li><li>• tall</li><li>• columnar cells</li><li>• simply oval</li><li>• extend</li><li>• basal</li><li>• luminal compartment</li><li>• seminiferous tubules</li><li>• complex shape</li><li>• interact with</li><li>• sperm cells</li><li>• Option B . Sertoli cells are connected to each other at their basal aspects by tight junctions , not gap junctions. These tight junctions are crucial in forming the blood-testis barrier , which separates the germ cells in the adluminal compartment from blood-borne substances in the basal compartment .</li><li>• Option B</li><li>• Sertoli cells</li><li>• connected</li><li>• basal aspects</li><li>• tight junctions</li><li>• blood-testis barrier</li><li>• separates</li><li>• germ cells</li><li>• adluminal compartment</li><li>• blood-borne substances</li><li>• basal compartment</li><li>• Option D . Sertoli cells do not secrete testosterone. Testosterone is primarily produced by the Leydig cells , which are located in the interstitial space of the testes . Sertoli cells, however, do respond to testosterone and are involved in the nourishment and development of sperm cells .</li><li>• Option D</li><li>• Testosterone</li><li>• Leydig cells</li><li>• interstitial space</li><li>• testes</li><li>• respond</li><li>• testosterone</li><li>• nourishment</li><li>• development</li><li>• sperm cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sertoli cells play a key role in forming the blood-testis barrier through their tight junctions . This barrier is essential for creating a specialized environment necessary for spermatogenesis . It protects developing germ cells from harmful substances in the blood and immune responses against the genetically distinct sperm cells .</li><li>➤ Sertoli cells play a key role in forming the blood-testis barrier through their tight junctions .</li><li>➤ Sertoli cells</li><li>➤ forming</li><li>➤ blood-testis barrier</li><li>➤ tight junctions</li><li>➤ This barrier is essential for creating a specialized environment necessary for spermatogenesis .</li><li>➤ barrier</li><li>➤ creating</li><li>➤ specialized environment</li><li>➤ spermatogenesis</li><li>➤ It protects developing germ cells from harmful substances in the blood and immune responses against the genetically distinct sperm cells .</li><li>➤ developing germ cells</li><li>➤ harmful</li><li>➤ substances</li><li>➤ blood</li><li>➤ immune</li><li>➤ against</li><li>➤ genetically distinct sperm cells</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 252</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 252</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is present in the surface epithelium of ovary?", "options": [{"label": "A", "text": "Simple Squamous Epithelium", "correct": false}, {"label": "B", "text": "Simple Cuboidal Epithelium", "correct": true}, {"label": "C", "text": "Simple Columnar Epithelium", "correct": false}, {"label": "D", "text": "Stratified Columnar Epithelium", "correct": false}], "correct_answer": "B. Simple Cuboidal Epithelium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture25.jpg"], "explanation": "<p><strong>Ans. B) Simple Cuboidal Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While simple squamous epithelium is found in many parts of the body , particularly where there is passive movement of liquids and gases, it is not the primary epithelial type covering the ovary.</li><li>• Option A.</li><li>• many parts</li><li>• body</li><li>• passive movement</li><li>• Option C . Simple Columnar Epithelium is commonly found in areas that require absorption and secretion , such as the lining of the stomach and intestines . However, this is not the type of epithelium that covers the surface of the ovary.</li><li>• Option C</li><li>• areas</li><li>• require absorption</li><li>• secretion</li><li>• lining</li><li>• stomach</li><li>• intestines</li><li>• Option D . Stratified Columnar Epithelium is relatively rare and found in specific areas such as parts of the male urethra and some glandular ducts, but it is not the epithelial type found on the surface of the ovary.</li><li>• Option D</li><li>• rare</li><li>• parts</li><li>• male urethra</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The surface of the ovary is covered by a layer of simple cuboidal epithelium , often referred to as the germinal epithelium . This epithelium is important for its protective role and is involved in the formation of the ovarian follicles .</li><li>➤ The surface of the ovary is covered by a layer of simple cuboidal epithelium , often referred to as the germinal epithelium .</li><li>➤ The surface of the ovary is covered by a layer of simple cuboidal epithelium , often referred to as the germinal epithelium .</li><li>➤ layer</li><li>➤ simple cuboidal epithelium</li><li>➤ germinal epithelium</li><li>➤ This epithelium is important for its protective role and is involved in the formation of the ovarian follicles .</li><li>➤ This epithelium is important for its protective role and is involved in the formation of the ovarian follicles .</li><li>➤ protective role</li><li>➤ formation</li><li>➤ ovarian follicles</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 267</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 267</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the Glassy Membrane is seen?", "options": [{"label": "A", "text": "Corpus Luteum", "correct": false}, {"label": "B", "text": "Atretic Follicles", "correct": true}, {"label": "C", "text": "Graafian Follicle", "correct": false}, {"label": "D", "text": "Antral Follicle", "correct": false}], "correct_answer": "B. Atretic Follicles", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture26.jpg"], "explanation": "<p><strong>Ans. B) Atretic Follicles</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Corpus Luteum is formed from the remnants of a follicle that has released an egg during ovulation . The corpus luteum does not have a structure known as the glassy membrane.</li><li>• Option A</li><li>• remnants</li><li>• follicle</li><li>• egg</li><li>• during ovulation</li><li>• Option C. While the Graafian follicle has several important layers and structures (like the cumulus oophorus and the antrum ), it does not have a glassy membrane in the sense described for atretic follicles.</li><li>• Option C.</li><li>• important layers</li><li>• structures</li><li>• cumulus oophorus</li><li>• antrum</li><li>• Option D. Antral Follicle are in the process of maturing but have not yet reached the stage of the Graafian follicle. The antral follicle does not typically have a glassy membrane; this feature is more characteristic of the degenerating atretic follicles .</li><li>• Option D.</li><li>• maturing</li><li>• characteristic</li><li>• degenerating atretic follicles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Atretic follicles are ovarian follicles that have ceased developing and undergone degeneration . During the process of atresia , the granulosa cells and theca cells of the follicle are replaced by a dense , eosinophilic ( pink-staining ) material known as the glassy membrane . This membrane becomes more pronounced and visible as the follicle undergoes atresia .</li><li>➤ Atretic follicles are ovarian follicles that have ceased developing and undergone degeneration .</li><li>➤ ovarian follicles</li><li>➤ ceased developing</li><li>➤ undergone degeneration</li><li>➤ During the process of atresia , the granulosa cells and theca cells of the follicle are replaced by a dense , eosinophilic ( pink-staining ) material known as the glassy membrane .</li><li>➤ atresia</li><li>➤ granulosa cells</li><li>➤ theca cells</li><li>➤ follicle</li><li>➤ replaced</li><li>➤ dense</li><li>➤ eosinophilic</li><li>➤ pink-staining</li><li>➤ material</li><li>➤ glassy membrane</li><li>➤ This membrane becomes more pronounced and visible as the follicle undergoes atresia .</li><li>➤ pronounced</li><li>➤ visible</li><li>➤ follicle</li><li>➤ atresia</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 270</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 270</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the Hassal’s corpuscle is present??", "options": [{"label": "A", "text": "Thymus", "correct": true}, {"label": "B", "text": "Spleen", "correct": false}, {"label": "C", "text": "Lymph node", "correct": false}, {"label": "D", "text": "Appendix", "correct": false}], "correct_answer": "A. Thymus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture31.jpg"], "explanation": "<p><strong>Ans. A) Thymus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Spleen contains white pulp and red pulp , but it does not contain Hassall's corpuscles. Spleen has white pulp which consists of lymphoid follicles with eccentrically placed arteriole . Hassall's corpuscles are specific to the thymus gland .</li><li>• Option B.</li><li>• white pulp</li><li>• red pulp</li><li>• white pulp</li><li>• lymphoid follicles</li><li>• eccentrically placed arteriole</li><li>• thymus gland</li><li>• Option C. Lymph nodes are small , bean-shaped structures that are part of the lymphatic system . It has cortex with lymphoid follicles , paracortex with T lymphocytes , medulla . While lymph nodes contain follicles and germinal centers important for immune function , they do not have Hassall's corpuscles, which are unique to the thymus .</li><li>• Option C.</li><li>• small</li><li>• bean-shaped structures</li><li>• lymphatic system</li><li>• cortex</li><li>• lymphoid follicles</li><li>• paracortex</li><li>• T lymphocytes</li><li>• medulla</li><li>• follicles</li><li>• germinal centers</li><li>• immune function</li><li>• unique</li><li>• thymus</li><li>• Option D. Appendix has lymphoid follicles in lamina propria and submucous . However, it does not contain Hassall's corpuscles. These structures are specifically associated with the thymus gland .</li><li>• Option D.</li><li>• lymphoid follicles</li><li>• lamina propria</li><li>• submucous</li><li>• thymus gland</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Hassall's corpuscles are distinctive structures found in the thymus gland . They are composed of concentrically arranged epithelial cells and are characteristic of the medulla of the thymus . Hassall's corpuscles are thought to play a role in the maturation of T cells and in the induction of tolerance in the immune system .</li><li>➤ Hassall's corpuscles are distinctive structures found in the thymus gland .</li><li>➤ Hassall's corpuscles are distinctive structures found in the thymus gland .</li><li>➤ Hassall's corpuscles</li><li>➤ thymus gland</li><li>➤ They are composed of concentrically arranged epithelial cells and are characteristic of the medulla of the thymus .</li><li>➤ They are composed of concentrically arranged epithelial cells and are characteristic of the medulla of the thymus .</li><li>➤ concentrically</li><li>➤ epithelial cells</li><li>➤ medulla</li><li>➤ thymus</li><li>➤ Hassall's corpuscles are thought to play a role in the maturation of T cells and in the induction of tolerance in the immune system .</li><li>➤ Hassall's corpuscles are thought to play a role in the maturation of T cells and in the induction of tolerance in the immune system .</li><li>➤ maturation</li><li>➤ T cells</li><li>➤ tolerance</li><li>➤ immune system</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 142</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 142</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following structure, sinusoids not typically seen?", "options": [{"label": "A", "text": "Liver", "correct": false}, {"label": "B", "text": "Kidney", "correct": true}, {"label": "C", "text": "Lymph nodes", "correct": false}, {"label": "D", "text": "Spleen", "correct": false}], "correct_answer": "B. Kidney", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture32.jpg"], "explanation": "<p><strong>Ans. B) Kidney</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Sinusoids are a key feature of the liver. Liver sinusoids are unique blood vessels that differ from capillaries due to their larger size , irregular shape , and fenestrated endothelium . These sinusoids facilitate the exchange of materials between the blood and liver cells .</li><li>• Option A. Sinusoids</li><li>• unique blood vessels</li><li>• capillaries</li><li>• larger size</li><li>• irregular shape</li><li>• fenestrated endothelium</li><li>• facilitate</li><li>• exchange</li><li>• materials</li><li>• blood</li><li>• liver cells</li><li>• Option C. Lymph nodes contain sinusoids , known as lymphatic sinusoids or lymph sinuses . These are channels within the lymph node that allow lymph to flow through the node , where it is filtered . Lymph sinuses are lined by endothelial cells and are crucial for the immune function of lymph nodes .</li><li>• Option C.</li><li>• sinusoids</li><li>• lymphatic sinusoids</li><li>• lymph sinuses</li><li>• lymph node</li><li>• allow lymph</li><li>• flow</li><li>• node</li><li>• filtered</li><li>• endothelial cells</li><li>• crucial</li><li>• immune function</li><li>• lymph nodes</li><li>• Option D. The spleen also contains sinusoids , known as splenic sinusoids or sinusoidal capillaries . These are part of the red pulp of the spleen and are involved in filtering blood , removing old or damaged red blood cells , and recycling iron . The unique structure of splenic sinusoids facilitates the spleen's role in blood filtration .</li><li>• Option D.</li><li>• sinusoids</li><li>• splenic sinusoids</li><li>• sinusoidal capillaries</li><li>• red pulp</li><li>• spleen</li><li>• filtering blood</li><li>• removing old</li><li>• damaged red blood cells</li><li>• recycling iron</li><li>• spleen's role</li><li>• blood filtration</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The kidney does not contain sinusoids . Instead, it has a specialized structure of blood vessels , including glomeruli and a series of arterioles and capillaries , which are essential for the kidney's function in filtering blood and forming urine . Renal circulation is specialized for the process of ultrafiltration and does not involve sinusoids.</li><li>• The kidney does not contain sinusoids . Instead, it has a specialized structure of blood vessels , including glomeruli and a series of arterioles and capillaries , which are essential for the kidney's function in filtering blood and forming urine .</li><li>• The kidney does not contain sinusoids . Instead, it has a specialized structure of blood vessels , including glomeruli and a series of arterioles and capillaries , which are essential for the kidney's function in filtering blood and forming urine .</li><li>• does not</li><li>• sinusoids</li><li>• specialized structure</li><li>• blood vessels</li><li>• glomeruli</li><li>• arterioles</li><li>• capillaries</li><li>• kidney's function</li><li>• filtering blood</li><li>• forming urine</li><li>• Renal circulation is specialized for the process of ultrafiltration and does not involve sinusoids.</li><li>• Renal circulation is specialized for the process of ultrafiltration and does not involve sinusoids.</li><li>• Renal circulation</li><li>• process</li><li>• ultrafiltration</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 234</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 234</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following structures Sub-Capsular Sinuses are seen?", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Thymus", "correct": false}, {"label": "C", "text": "Thyroid", "correct": false}, {"label": "D", "text": "Lymph Nodes", "correct": true}], "correct_answer": "D. Lymph Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture33.jpg"], "explanation": "<p><strong>Ans. D) Lymph nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Spleen contains structures called sinusoids in the red pulp , it does not have subcapsular sinuses. The spleen's architecture is different from that of lymph nodes , which do have subcapsular sinuses .</li><li>• Option A</li><li>• Spleen</li><li>• sinusoids</li><li>• red pulp</li><li>• lymph nodes</li><li>• subcapsular sinuses</li><li>• Option B . The thymus is a primary lymphoid organ where T cells mature . It is divided into a cortex and medulla and does not contain subcapsular sinuses. It has hassall's corpuscle in medulla .</li><li>• Option B</li><li>• primary lymphoid</li><li>• organ</li><li>• T cells mature</li><li>• cortex</li><li>• medulla</li><li>• hassall's corpuscle</li><li>• medulla</li><li>• Option C . Thyroid is composed of follicles filled with colloid , surrounded by follicular cells and lined by simple cuboidal epithelium . The thyroid does not have subcapsular sinuses, as its structure and function are related to hormone production rather than lymph filtration.</li><li>• Option C</li><li>• follicles</li><li>• filled</li><li>• colloid</li><li>• follicular cells</li><li>• lined</li><li>• simple cuboidal epithelium</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Lymph nodes are small , bean-shaped structures that are part of the lymphatic system . They contain subcapsular sinuses , which are spaces just beneath the capsule of the lymph node . These sinuses act as channels for lymph to flow into the lymph node , where it is filtered . Subcapsular sinuses are an essential part of the lymph node's structure for filtering and trapping antigens and other particles present in the lymph .</li><li>➤ Lymph nodes are small , bean-shaped structures that are part of the lymphatic system .</li><li>➤ small</li><li>➤ bean-shaped structures</li><li>➤ part</li><li>➤ lymphatic system</li><li>➤ They contain subcapsular sinuses , which are spaces just beneath the capsule of the lymph node .</li><li>➤ subcapsular sinuses</li><li>➤ spaces</li><li>➤ beneath</li><li>➤ capsule</li><li>➤ lymph node</li><li>➤ These sinuses act as channels for lymph to flow into the lymph node , where it is filtered . Subcapsular sinuses are an essential part of the lymph node's structure for filtering and trapping antigens and other particles present in the lymph .</li><li>➤ channels</li><li>➤ lymph</li><li>➤ flow</li><li>➤ lymph node</li><li>➤ filtered</li><li>➤ essential part</li><li>➤ lymph node's structure</li><li>➤ filtering</li><li>➤ trapping antigens</li><li>➤ present</li><li>➤ lymph</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 144</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 144</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents to the clinic with a two-week history of swollen glands in her neck. She reports a recent episode of sore throat and fever, which resolved a few days ago. On examination, you palpate several small, mobile, non-tender lymph nodes in her cervical region. These lymph nodes are most likely responding to a recent infection. In a biopsy of one of these lymph nodes, which part would predominantly contain follicles, structures associated with the adaptive immune response?", "options": [{"label": "A", "text": "Red pulp", "correct": false}, {"label": "B", "text": "White pulp", "correct": false}, {"label": "C", "text": "Cortex", "correct": true}, {"label": "D", "text": "Medulla", "correct": false}], "correct_answer": "C. Cortex", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture34.jpg"], "explanation": "<p><strong>Ans. C) Cortex</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Red pulp is a term associated with the spleen , not lymph nodes. In the spleen, red pulp is involved in filtering blood and removing old or damaged red blood cells . Red pulp of spleen has lymphocytes arranged in the form of splenic cords of Billroth and splenic sinusoids .</li><li>• Option A</li><li>• spleen</li><li>• filtering blood</li><li>• removing old</li><li>• damaged red blood cells</li><li>• Red pulp</li><li>• spleen</li><li>• lymphocytes</li><li>• form</li><li>• splenic cords</li><li>• Billroth</li><li>• splenic sinusoids</li><li>• Option B. Like red pulp, white pulp is a term related to the spleen . It consists of lymphatic tissue surrounding the splenic arteries and is involved in the immune response . White pulp of spleen has lymphoid follicles with eccentrically placed central arteriole .</li><li>• Option B.</li><li>• spleen</li><li>• lymphatic tissue</li><li>• splenic arteries</li><li>• involved</li><li>• immune response</li><li>• lymphoid follicles</li><li>• eccentrically</li><li>• central arteriole</li><li>• Option D. The medulla is the innermost part of the lymph node and contains medullary cords . These cords are composed of lymphatic tissue and include lymphocytes , plasma cells , and macrophages . While the medulla is important for the function of the lymph node, it is not the primary location of the lymphoid follicle .</li><li>• Option D.</li><li>• innermost part</li><li>• lymph node</li><li>• medullary cords</li><li>• lymphatic tissue</li><li>• lymphocytes</li><li>• plasma cells</li><li>• macrophages</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In lymph nodes, follicles are primarily located in the cortex . The cortical region contains lymphoid follicles , which are sites of B cell localization and proliferation . These follicles are often active or germinal centers where B cells proliferate , differentiate , and mutate their antibody genes during an immune response .</li><li>• In lymph nodes, follicles are primarily located in the cortex .</li><li>• follicles</li><li>• cortex</li><li>• The cortical region contains lymphoid follicles , which are sites of B cell localization and proliferation . These follicles are often active or germinal centers where B cells proliferate , differentiate , and mutate their antibody genes during an immune response .</li><li>• lymphoid follicles</li><li>• sites</li><li>• B cell localization</li><li>• proliferation</li><li>• active</li><li>• germinal centers</li><li>• B cells proliferate</li><li>• differentiate</li><li>• mutate</li><li>• antibody genes</li><li>• immune response</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 144</li><li>• Ref</li><li>• : Histology, Text and Atlas Brijesh Kumar Page No. 144</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not a content of Space of Disse?", "options": [{"label": "A", "text": "Microvilli", "correct": false}, {"label": "B", "text": "Blood Plasma", "correct": false}, {"label": "C", "text": "Kupffer’s Cell", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Kupffer’s Cell", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture35.jpg"], "explanation": "<p><strong>Ans. C) Kupffer’s Cell</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Microvilli from hepatocytes protrude into the Space of Disse . The presence of microvilli in this space increases the surface area for the exchange of substances between the blood and liver cells .</li><li>• Option A.</li><li>• hepatocytes</li><li>• Space of Disse</li><li>• increases</li><li>• surface area</li><li>• exchange</li><li>• substances</li><li>• blood</li><li>• liver cells</li><li>• Option B . Blood plasma is present in the Space of Disse . This space allows for the transfer of metabolites , nutrients , and waste products between the blood plasma and hepatocytes . The permeability of the sinusoidal endothelium facilitates this exchange .</li><li>• Option B</li><li>• Space of Disse</li><li>• allows</li><li>• transfer</li><li>• metabolites</li><li>• nutrients</li><li>• waste products</li><li>• blood plasma</li><li>• hepatocytes</li><li>• permeability</li><li>• sinusoidal endothelium</li><li>• exchange</li><li>• Option D. This option would imply that all listed contents are found in the Space of Disse , which is not accurate given that Kupffer’s cells are not located in this space.</li><li>• Option D.</li><li>• all listed contents</li><li>• Space of Disse</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Kupffer’s cells are not found within the Space of Disse . Kupffer’s cells are specialized macrophages located in the liver , but they are situated along the lining of the sinusoids , not in the Space of Disse. They play a role in filtering blood and capturing and digesting bacteria , foreign particles , and damaged blood cells . The Space of Disse contains microvilli from hepatocytes and blood plasma , facilitating the exchange of substances between blood and liver cells .</li><li>• Kupffer’s cells are not found within the Space of Disse .</li><li>• not</li><li>• Space of</li><li>• Disse</li><li>• Kupffer’s cells are specialized macrophages located in the liver , but they are situated along the lining of the sinusoids , not in the Space of Disse.</li><li>• specialized macrophages</li><li>• liver</li><li>• lining</li><li>• sinusoids</li><li>• They play a role in filtering blood and capturing and digesting bacteria , foreign particles , and damaged blood cells .</li><li>• role</li><li>• filtering blood</li><li>• capturing</li><li>• digesting bacteria</li><li>• foreign particles</li><li>• damaged blood</li><li>• cells</li><li>• The Space of Disse contains microvilli from hepatocytes and blood plasma , facilitating the exchange of substances between blood and liver cells .</li><li>• Space of Disse</li><li>• microvilli</li><li>• hepatocytes</li><li>• blood plasma</li><li>• facilitating</li><li>• exchange</li><li>• blood</li><li>• liver cells</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 204</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 204</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man presents to the urology clinic with complaints of painful urination and a sensation of burning at the tip of his penis for the past week. He mentions no history of similar symptoms in the past and denies any recent sexual activity. A physical examination reveals slight redness at the external urethral meatus. A urine sample is collected for analysis, and a swab is taken from the urethral tip for microscopic examination. Which type of epithelium is most likely to be found lining the tip of the urethra in this patient?", "options": [{"label": "A", "text": "Stratified Columnar Epithelium", "correct": false}, {"label": "B", "text": "Pseudostratified Columnar Epithelium", "correct": false}, {"label": "C", "text": "Simple Columnar Epithelium", "correct": false}, {"label": "D", "text": "Stratified Squamous Epithelium", "correct": true}], "correct_answer": "D. Stratified Squamous Epithelium", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Stratified Squamous Epithelium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Stratified Columnar Epithelium is composed of several layers , with the topmost layer consisting of columnar cells . It's found in certain parts of the body, like some sections of the pharynx , the male urethra , and the conjunctiva of the eye . However, it is not typically found lining the tip of the urethra.</li><li>• Option A</li><li>• several layers</li><li>• topmost layer</li><li>• columnar cells</li><li>• pharynx</li><li>• male urethra</li><li>• conjunctiva</li><li>• eye</li><li>• Option B. Pseudostratified Columnar Epithelium appears to be stratified but is actually a single layer of cells of varying heights , giving it a stratified appearance . It's commonly found in the respiratory tract , where it helps trap and move particles out of the airways . This type of epithelium is not typically found at the tip of the urethra.</li><li>• Option B.</li><li>• stratified</li><li>• single layer</li><li>• cells</li><li>• heights</li><li>• stratified appearance</li><li>• respiratory tract</li><li>• trap</li><li>• out</li><li>• airways</li><li>• Option C. Comprising a single layer of tall , column-like cells , simple columnar epithelium is specialized for absorption and secretion . It is found in areas like the gastrointestinal tract and some parts of the uterus and fallopian tubes . However, it is not the epithelium that lines the tip of the urethra.</li><li>• Option C.</li><li>• single layer</li><li>• tall</li><li>• column-like cells</li><li>• absorption</li><li>• secretion</li><li>• gastrointestinal tract</li><li>• uterus</li><li>• fallopian tubes</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The tip of the urethra (particularly the external urethral orifice ) is lined by stratified squamous epithelium . This type of epithelium is characterized by multiple layers of cells , with the outermost cells being flat and squamous . Stratified squamous epithelium provides a protective barrier against friction and abrasion , which is essential for the opening of the urethra .</li><li>➤ The tip of the urethra (particularly the external urethral orifice ) is lined by stratified squamous epithelium .</li><li>➤ The tip of the urethra (particularly the external urethral orifice ) is lined by stratified squamous epithelium .</li><li>➤ tip</li><li>➤ urethra</li><li>➤ external urethral orifice</li><li>➤ stratified squamous epithelium</li><li>➤ This type of epithelium is characterized by multiple layers of cells , with the outermost cells being flat and squamous .</li><li>➤ This type of epithelium is characterized by multiple layers of cells , with the outermost cells being flat and squamous .</li><li>➤ multiple layers</li><li>➤ cells</li><li>➤ outermost cells</li><li>➤ flat</li><li>➤ squamous</li><li>➤ Stratified squamous epithelium provides a protective barrier against friction and abrasion , which is essential for the opening of the urethra .</li><li>➤ Stratified squamous epithelium provides a protective barrier against friction and abrasion , which is essential for the opening of the urethra .</li><li>➤ protective barrier</li><li>➤ against friction</li><li>➤ abrasion</li><li>➤ opening</li><li>➤ urethra</li><li>➤ Ref : Gray's Anatomy 42nd Edition Page 1284, Histology, Text and Atlas Brijesh Kumar Page No. 247</li><li>➤ Ref : Gray's Anatomy 42nd Edition Page 1284, Histology, Text and Atlas Brijesh Kumar Page No. 247</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where in the body is the tissue shown in the image typically found?", "options": [{"label": "A", "text": "Articular Disc", "correct": false}, {"label": "B", "text": "Intervertebral Disc", "correct": false}, {"label": "C", "text": "Epiphyseal Plates", "correct": true}, {"label": "D", "text": "Pinna of Ear", "correct": false}], "correct_answer": "C. Epiphyseal Plates", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture10_NsgE8fK.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture11_kSpdND1.jpg"], "explanation": "<p><strong>Ans. C) Epiphyseal Plates</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The articular disc is a type of fibrocartilaginous tissue found in certain joints, like the temporomandibular joint (TMJ) and the knee joint (meniscus) . This tissue helps in distributing loads and improving the fit between the bones .</li><li>• Option A</li><li>• fibrocartilaginous tissue</li><li>• temporomandibular joint (TMJ)</li><li>• knee joint (meniscus)</li><li>• loads</li><li>• improving</li><li>• fit</li><li>• bones</li><li>• Option B . Intervertebral discs are located between the vertebrae in the spine . They consist of an outer fibrous ring called the annulus fibrosus , which contains fibrocartilage , and an inner gel-like center called the nucleus pulposus . These discs act as shock absorbers and provide flexibility to the spine .</li><li>• Option B</li><li>• vertebrae</li><li>• spine</li><li>• outer fibrous ring</li><li>• annulus fibrosus</li><li>• fibrocartilage</li><li>• inner gel-like center</li><li>• nucleus pulposus</li><li>• shock absorbers</li><li>• flexibility</li><li>• spine</li><li>• Option D. The pinna, or the external part of the ear, contains elastic cartilage , not hyaline cartilage. Elastic cartilage provides flexibility and strength , allowing the pinna to maintain its shape while being able to bend .</li><li>• Option D.</li><li>• elastic cartilage</li><li>• flexibility</li><li>• strength</li><li>• allowing</li><li>• pinna</li><li>• shape</li><li>• able</li><li>• bend</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Epiphyseal plates, or growth plates , are found in long bones and are responsible for the longitudinal growth of bones in children and adolescents . They are made of hyaline cartilage . The specific arrangement of chondrocytes and the overall structure of the epiphyseal plate are unique , and histological images of these plates have distinctive features that can be identified by experts .</li><li>➤ Epiphyseal plates, or growth plates , are found in long bones and are responsible for the longitudinal growth of bones in children and adolescents .</li><li>➤ Epiphyseal plates, or growth plates , are found in long bones and are responsible for the longitudinal growth of bones in children and adolescents .</li><li>➤ growth plates</li><li>➤ long bones</li><li>➤ longitudinal growth</li><li>➤ bones</li><li>➤ children</li><li>➤ adolescents</li><li>➤ They are made of hyaline cartilage . The specific arrangement of chondrocytes and the overall structure of the epiphyseal plate are unique , and histological images of these plates have distinctive features that can be identified by experts .</li><li>➤ They are made of hyaline cartilage . The specific arrangement of chondrocytes and the overall structure of the epiphyseal plate are unique , and histological images of these plates have distinctive features that can be identified by experts .</li><li>➤ hyaline cartilage</li><li>➤ chondrocytes</li><li>➤ epiphyseal plate</li><li>➤ unique</li><li>➤ histological images</li><li>➤ distinctive features</li><li>➤ experts</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 62</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 62</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cells gives rise to Osteoclast?", "options": [{"label": "A", "text": "Osteoprogenitor Cells", "correct": false}, {"label": "B", "text": "Monocytes", "correct": true}, {"label": "C", "text": "Osteoblasts", "correct": false}, {"label": "D", "text": "Osteocytes", "correct": false}], "correct_answer": "B. Monocytes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture12_EZp59K5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture13_mXHs2Sl.jpg"], "explanation": "<p><strong>Ans. B) Monocytes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Osteoprogenitor cells are stem cells found in bone marrow that have the potential to differentiate into osteoblasts . Osteoblasts are cells responsible for bone formation . Osteoprogenitor cells do not directly give rise to osteoclasts, which are involved in bone resorption.</li><li>• Option A.</li><li>• stem cells</li><li>• bone marrow</li><li>• potential</li><li>• osteoblasts</li><li>• bone formation</li><li>• Option C. Osteoblasts are bone-forming cells that originate from osteoprogenitor cells . They are responsible for synthesizing and secreting the bone matrix and are involved in the mineralization process . Osteoblasts do not give rise to osteoclasts; instead, they play a role in regulating osteoclast activity through the secretion of RANKL and OPG ( Osteoprotegerin ).</li><li>• Option C.</li><li>• bone-forming cells</li><li>• osteoprogenitor cells</li><li>• synthesizing</li><li>• secreting</li><li>• bone matrix</li><li>• mineralization process</li><li>• regulating osteoclast activity</li><li>• secretion</li><li>• RANKL</li><li>• OPG</li><li>• Osteoprotegerin</li><li>• Option D . Osteocytes are mature bone cells that originate from osteoblasts . Once osteoblasts become embedded in the bone matrix , they differentiate into osteocytes . These cells are involved in maintaining the bone matrix and signaling to other bone cells. Like osteoblasts, osteocytes do not give rise to osteoclasts.</li><li>• Option D</li><li>• mature bone cells</li><li>• originate</li><li>• osteoblasts</li><li>• embedded</li><li>• bone matrix</li><li>• osteocytes</li><li>• maintaining</li><li>• bone matrix</li><li>• signaling</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Osteoclasts are derived from the monocyte/macrophage lineage . Monocytes are a type of white blood cell found in the blood . Forms of monocytes in different tissues: They can migrate from the blood into the bone tissue , where they differentiate into osteoclasts under the influence of various signaling molecules like RANKL (Receptor Activator of Nuclear factor Kappa-Β Ligand ) and M-CSF (Macrophage Colony-Stimulating Factor) .</li><li>➤ Osteoclasts are derived from the monocyte/macrophage lineage . Monocytes are a type of white blood cell found in the blood .</li><li>➤ Osteoclasts</li><li>➤ monocyte/macrophage lineage</li><li>➤ white blood cell</li><li>➤ blood</li><li>➤ Forms of monocytes in different tissues:</li><li>➤ They can migrate from the blood into the bone tissue , where they differentiate into osteoclasts under the influence of various signaling molecules like RANKL (Receptor Activator of Nuclear factor Kappa-Β Ligand ) and M-CSF (Macrophage Colony-Stimulating Factor) .</li><li>➤ migrate</li><li>➤ blood</li><li>➤ bone tissue</li><li>➤ differentiate</li><li>➤ osteoclasts</li><li>➤ RANKL (Receptor Activator of Nuclear factor Kappa-Β Ligand</li><li>➤ M-CSF (Macrophage Colony-Stimulating Factor)</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 71</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 71</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Dysfunction or loss of which of the following can lead to decreased testosterone levels, resulting in symptoms like reduced libido, infertility, and secondary sexual characteristic changes?", "options": [{"label": "A", "text": "Leydig Cells", "correct": true}, {"label": "B", "text": "Sertoli Cells", "correct": false}, {"label": "C", "text": "Vas Deferens", "correct": false}, {"label": "D", "text": "Epididymis", "correct": false}], "correct_answer": "A. Leydig Cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture14_hI43a0Z.jpg"], "explanation": "<p><strong>Ans. A) Leydig Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Sertoli cells are found within the seminiferous tubules of the testes . They do not secrete testosterone but Inhibin-B and rather support spermatogenesis, the process of sperm production. Sertoli cells provide nourishment to developing sperm cells and create a blood-testis barrier . They also respond to follicle-stimulating hormone (FSH) and are involved in the secretion of other substances, such as inhibin and androgen-binding protein , but not testosterone.</li><li>• Option B</li><li>• seminiferous tubules</li><li>• testes</li><li>• nourishment</li><li>• developing sperm cells</li><li>• create</li><li>• blood-testis barrier</li><li>• follicle-stimulating hormone (FSH)</li><li>• secretion</li><li>• inhibin</li><li>• androgen-binding protein</li><li>• Option C . The vas deferens is not a cell, but rather a muscular tube that transports sperm from the epididymis to the urethra . It is part of the male reproductive system but does not have endocrine functions and therefore does not secrete testosterone.</li><li>• Option C</li><li>• muscular tube</li><li>• transports</li><li>• sperm</li><li>• epididymis</li><li>• urethra</li><li>• male reproductive system</li><li>• Option D . Like the vas deferens, the epididymis is not a cell but a part of the male reproductive system. It is a long , coiled tube that connects the testes to the vas deferens and is the site where sperm mature and are stored . The epididymis does not produce testosterone.</li><li>• Option D</li><li>• long</li><li>• coiled tube</li><li>• connects</li><li>• testes</li><li>• vas deferens</li><li>• sperm mature</li><li>• stored</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ testes</li><li>➤ production</li><li>➤ testosterone</li><li>➤ stimulation</li><li>➤ luteinizing hormone</li><li>➤ Educational Objective:</li><li>➤ Educational Objective:</li><li>➤ Leydig cells, also known as interstitial cells , are located in the testes , specifically in the interstitial spaces between the seminiferous tubules .</li><li>➤ interstitial cells</li><li>➤ testes</li><li>➤ interstitial spaces</li><li>➤ seminiferous tubules</li><li>➤ These cells are responsible for producing testosterone in response to luteinizing hormone ( LH ) stimulation .</li><li>➤ testosterone</li><li>➤ luteinizing hormone</li><li>➤ LH</li><li>➤ stimulation</li><li>➤ Testosterone is the primary male sex hormone and plays a crucial role in the development of male reproductive tissues , the promotion of secondary sexual characteristics , and the maintenance of sexual function .</li><li>➤ Testosterone</li><li>➤ male sex hormone</li><li>➤ crucial role</li><li>➤ male reproductive tissues</li><li>➤ promotion</li><li>➤ secondary sexual characteristics</li><li>➤ maintenance</li><li>➤ sexual function</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 250</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 250</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female patient presents for a routine health check-up. She inquires about the structure and function of mammary glands. Which histological feature is characteristic of the mammary glands?", "options": [{"label": "A", "text": "They are composed primarily of Striated Muscle Fibers.", "correct": false}, {"label": "B", "text": "They contain Multiple Lobules connected by Ducts to the Nipple.", "correct": true}, {"label": "C", "text": "They are lined with Pseudostratified Columnar Epithelium.", "correct": false}, {"label": "D", "text": "They are predominantly made up of Adipose Tissue without Glandular structures.", "correct": false}], "correct_answer": "B. They contain Multiple Lobules connected by Ducts to the Nipple.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture39.jpg"], "explanation": "<p><strong>Ans. B) They contain Multiple Lobules connected by Ducts to the Nipple</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Composed primarily of striated muscle fibers, is incorrect . Mammary glands are not composed of striated muscle fibers; they are specialized exocrine glands with glandular and adipose tissue .</li><li>• Option A</li><li>• incorrect</li><li>• Mammary glands</li><li>• specialized exocrine glands</li><li>• glandular</li><li>• adipose tissue</li><li>• Option C . Lined with pseudostratified columnar epithelium, is incorrect . The ducts in the mammary glands are lined with a bilayer of cuboidal and myoepithelial cells , not pseudostratified columnar epithelium.</li><li>• Option C</li><li>• incorrect</li><li>• bilayer</li><li>• cuboidal</li><li>• myoepithelial cells</li><li>• Option D . Predominantly made up of adipose tissue without glandular structures, is incorrect . While mammary glands do contain a significant amount of adipose tissue , they also have glandular structures that are crucial for their function in milk production .</li><li>• Option D</li><li>• incorrect</li><li>• significant amount</li><li>• adipose tissue</li><li>• glandular structures</li><li>• crucial</li><li>• function</li><li>• milk production</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Containing multiple lobules connected by ducts to the nipple , is correct . Mammary glands are compound tubuloalveolar structures comprising multiple lobules . Each lobule contains smaller structures called alveoli , which produce milk . These lobules are connected by a system of ducts that converge at the nipple , allowing for the secretion of milk .</li><li>➤ Containing multiple lobules connected by ducts to the nipple , is correct .</li><li>➤ multiple lobules</li><li>➤ ducts</li><li>➤ nipple</li><li>➤ correct</li><li>➤ Mammary glands are compound tubuloalveolar structures comprising multiple lobules .</li><li>➤ compound tubuloalveolar structures</li><li>➤ multiple lobules</li><li>➤ Each lobule contains smaller structures called alveoli , which produce milk . These lobules are connected by a system of ducts that converge at the nipple , allowing for the secretion of milk .</li><li>➤ smaller structures</li><li>➤ alveoli</li><li>➤ milk</li><li>➤ system</li><li>➤ ducts</li><li>➤ nipple</li><li>➤ secretion</li><li>➤ milk</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 278.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 278.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman with a history of Diabetes Mellitus presents to the clinic complaining of difficulty in reading Braille characters, which she has been using for years due to her visual impairment. She reports that the tips of her fingers have become less sensitive, making it challenging to distinguish the Braille dots. On examination, you notice diminished fine touch sensation in her fingertips. Which of the following structures is most likely impaired in this patient, contributing to her difficulty in reading Braille characters?", "options": [{"label": "A", "text": "Meissner's Corpuscle", "correct": true}, {"label": "B", "text": "Merkel Cell", "correct": false}, {"label": "C", "text": "Pacinian Corpuscle", "correct": false}, {"label": "D", "text": "Ruffini Receptor", "correct": false}], "correct_answer": "A. Meissner's Corpuscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture20_9zUwx7C.jpg"], "explanation": "<p><strong>Ans. A) Meissner's Corpuscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Merkel cells are also involved in the sensation of touch , but they respond to sustained pressure and texture. While they are important for tactile sensation, they are not specifically associated with the perception of Braille characters. Merkel cells are slower to respond than Meissner's corpuscles and are more involved in the perception of continuous pressure and shape .</li><li>• Option B</li><li>• Merkel cells</li><li>• sensation</li><li>• touch</li><li>• Merkel cells</li><li>• slower</li><li>• Meissner's corpuscles</li><li>• continuous pressure</li><li>• shape</li><li>• Option C. Pacinian corpuscles respond to deep pressure and vibration . They are located deeper in the dermis and are not primarily responsible for the detection of fine touch or texture like Braille characters. Their structure allows them to detect rapid vibrations and deep pressure changes , which are different from the tactile requirements for reading Braille .</li><li>• Option C.</li><li>• Pacinian corpuscles</li><li>• deep pressure</li><li>• vibration</li><li>• deeper</li><li>• dermis</li><li>• allows</li><li>• detect</li><li>• rapid vibrations</li><li>• deep pressure changes</li><li>• tactile requirements</li><li>• reading Braille</li><li>• Option D. Ruffini receptors are involved in detecting skin stretch and sustained pressure . They are not particularly sensitive to light touch or the fine detail necessary for detecting Braille characters. Ruffini receptors provide important information about the position of the fingers and the shape of objects being held , but they do not have the same sensitivity to fine detail as Meissner's corpuscles.</li><li>• Option D.</li><li>• detecting skin stretch</li><li>• sustained pressure</li><li>• Ruffini receptors</li><li>• position</li><li>• fingers</li><li>• shape</li><li>• objects</li><li>• held</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Meissner's corpuscles are specialized nerve endings in the skin that are sensitive to light touch and texture . They are located in the upper dermis , particularly in areas like the fingertips and lips , where sensitivity to fine touch is crucial . They play a key role in the tactile recognition of objects , including reading Braille characters . The high density and sensitivity of Meissner's corpuscles in the fingertips make them especially adept at detecting the raised dots of Braille .</li><li>➤ Meissner's corpuscles are specialized nerve endings in the skin that are sensitive to light touch and texture .</li><li>➤ specialized nerve endings</li><li>➤ sensitive</li><li>➤ light touch</li><li>➤ texture</li><li>➤ They are located in the upper dermis , particularly in areas like the fingertips and lips , where sensitivity to fine touch is crucial .</li><li>➤ upper dermis</li><li>➤ fingertips</li><li>➤ lips</li><li>➤ sensitivity</li><li>➤ fine touch</li><li>➤ crucial</li><li>➤ They play a key role in the tactile recognition of objects , including reading Braille characters . The high density and sensitivity of Meissner's corpuscles in the fingertips make them especially adept at detecting the raised dots of Braille .</li><li>➤ tactile recognition</li><li>➤ objects</li><li>➤ Braille characters</li><li>➤ high density</li><li>➤ sensitivity</li><li>➤ Meissner's corpuscles</li><li>➤ fingertips</li><li>➤ adept</li><li>➤ detecting</li><li>➤ raised dots</li><li>➤ Braille</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 362</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 362</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What type of Gland is shown in the given image?", "options": [{"label": "A", "text": "Apocrine", "correct": false}, {"label": "B", "text": "Merocrine", "correct": false}, {"label": "C", "text": "Holocrine", "correct": true}, {"label": "D", "text": "Endocrine", "correct": false}], "correct_answer": "C. Holocrine", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture21_ZUV1yIJ.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture22_CdZ4slS.jpg"], "explanation": "<p><strong>Ans. C) Holocrine</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Apocrine glands are a type of sweat gland that are found in specific areas of the body like the armpits , groin , and areolae . They secrete their products into hair follicles and are activated at puberty . The secretion method involves a portion of the cell disintegrating to release its contents. Apocrine glands are innervated by Adrenergic Fibres.</li><li>• Option A.</li><li>• sweat gland</li><li>• armpits</li><li>• groin</li><li>• areolae</li><li>• hair follicles</li><li>• puberty</li><li>• portion</li><li>• cell</li><li>• release</li><li>• Apocrine glands are innervated by Adrenergic Fibres.</li><li>• Option B. Merocrine (Eccrine) glands, also known as eccrine glands , are the most common type of sweat gland found throughout the body. They secrete directly onto the skin surface . These glands are responsible for regulating body temperature through sweat secretion . The secretion process involves exocytosis , where the product is released from the cell without any loss of cellular material . Merocrine Glands are innervated by Cholinergic Adrenergic fibres</li><li>• Option B.</li><li>• eccrine glands</li><li>• sweat gland</li><li>• throughout</li><li>• directly</li><li>• skin surface</li><li>• sweat secretion</li><li>• exocytosis</li><li>• without</li><li>• any loss</li><li>• cellular material</li><li>• Merocrine Glands are innervated by Cholinergic Adrenergic fibres</li><li>• Option D . Endocrine glands secrete hormones directly into the bloodstream, not through a duct. They are part of the body's hormone regulation system and include glands like the thyroid , adrenal , and pituitary glands . Sebaceous glands do not function as part of the endocrine system as they do not secrete hormones into the blood, and they release their products ( sebum ) externally through ducts to the surface of the skin or into hair follicles .</li><li>• Option D</li><li>• bloodstream,</li><li>• hormone regulation system</li><li>• thyroid</li><li>• adrenal</li><li>• pituitary glands</li><li>• sebum</li><li>• externally</li><li>• ducts</li><li>• surface</li><li>• skin</li><li>• hair follicles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sebaceous glands are classified as holocrine glands . In holocrine secretion, the entire cell disintegrates to release its contents. The sebaceous glands are found in association with hair follicles and secrete sebum , an oily substance that helps to lubricate and protect the skin and hair . The cells of these glands accumulate sebum as they mature , and eventually, the entire cell ruptures to release the sebum . This process involves the loss of entire cells , which is characteristic of holocrine secretion .</li><li>➤ Sebaceous glands are classified as holocrine glands .</li><li>➤ Sebaceous glands are classified as holocrine glands .</li><li>➤ Sebaceous glands</li><li>➤ holocrine glands</li><li>➤ In holocrine secretion, the entire cell disintegrates to release its contents. The sebaceous glands are found in association with hair follicles and secrete sebum , an oily substance that helps to lubricate and protect the skin and hair .</li><li>➤ In holocrine secretion, the entire cell disintegrates to release its contents. The sebaceous glands are found in association with hair follicles and secrete sebum , an oily substance that helps to lubricate and protect the skin and hair .</li><li>➤ entire cell</li><li>➤ sebaceous glands</li><li>➤ hair follicles</li><li>➤ secrete sebum</li><li>➤ oily substance</li><li>➤ lubricate</li><li>➤ protect</li><li>➤ skin</li><li>➤ hair</li><li>➤ The cells of these glands accumulate sebum as they mature , and eventually, the entire cell ruptures to release the sebum . This process involves the loss of entire cells , which is characteristic of holocrine secretion .</li><li>➤ The cells of these glands accumulate sebum as they mature , and eventually, the entire cell ruptures to release the sebum . This process involves the loss of entire cells , which is characteristic of holocrine secretion .</li><li>➤ accumulate sebum</li><li>➤ mature</li><li>➤ ruptures</li><li>➤ release</li><li>➤ sebum</li><li>➤ loss</li><li>➤ entire cells</li><li>➤ holocrine secretion</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 39</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 39</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Identify the Organ in this given Slide.", "options": [{"label": "A", "text": "Gall Bladder", "correct": false}, {"label": "B", "text": "Urinary Bladder", "correct": true}, {"label": "C", "text": "Skin", "correct": false}, {"label": "D", "text": "Trachea", "correct": false}], "correct_answer": "B. Urinary Bladder", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture23_4Lrstzx.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture24_ZKTLtzZ.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture25_Yp6QCt1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/12/picture26_duvw8jF.jpg"], "explanation": "<p><strong>Ans. B) Urinary Bladder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Gallbladder:</li><li>• Option A. Gallbladder:</li><li>• Mucosa : The innermost layer, lined with simple columnar epithelium . This layer is highly absorptive and lacks villi , but it has microvilli . Lamina Propria : Underneath the epithelium, it contains connective tissue and blood vessels . Muscularis Externa : A relatively thin layer of smooth muscle fibers that contract to expel bile . Serosa/Adventitia : The outermost layer , which is a serosal layer in most areas but can be adventitia where it attaches to the liver .</li><li>• Mucosa : The innermost layer, lined with simple columnar epithelium . This layer is highly absorptive and lacks villi , but it has microvilli .</li><li>• Mucosa</li><li>• simple columnar epithelium</li><li>• absorptive</li><li>• villi</li><li>• microvilli</li><li>• Lamina Propria : Underneath the epithelium, it contains connective tissue and blood vessels .</li><li>• Lamina Propria</li><li>• connective tissue</li><li>• blood vessels</li><li>• Muscularis Externa : A relatively thin layer of smooth muscle fibers that contract to expel bile .</li><li>• Muscularis Externa</li><li>• thin layer</li><li>• smooth muscle fibers</li><li>• expel bile</li><li>• Serosa/Adventitia : The outermost layer , which is a serosal layer in most areas but can be adventitia where it attaches to the liver .</li><li>• Serosa/Adventitia</li><li>• outermost layer</li><li>• serosal layer</li><li>• adventitia</li><li>• attaches</li><li>• liver</li><li>• Option C. Skin:</li><li>• Option C. Skin:</li><li>• Epidermis : The outermost layer, comprising stratified squamous epithelium . Dermis : Made up of two layers - the papillary dermis and the reticular dermis . Hypodermis/Subcutaneous Layer : Not part of the skin technically but associated with it. It consists of loose connective tissue and fat cells , providing insulation and cushioning .</li><li>• Epidermis : The outermost layer, comprising stratified squamous epithelium .</li><li>• Epidermis</li><li>• stratified squamous epithelium</li><li>• Dermis : Made up of two layers - the papillary dermis and the reticular dermis .</li><li>• Dermis</li><li>• two layers</li><li>• papillary dermis</li><li>• reticular dermis</li><li>• Hypodermis/Subcutaneous Layer : Not part of the skin technically but associated with it. It consists of loose connective tissue and fat cells , providing insulation and cushioning .</li><li>• Hypodermis/Subcutaneous Layer</li><li>• loose connective tissue</li><li>• fat cells</li><li>• insulation</li><li>• cushioning</li><li>• Option D. Trachea:</li><li>• Option D. Trachea:</li><li>• Mucosa : Lined with pseudostratified ciliated columnar epithelium , containing goblet cells that secrete mucus . Submucosa : Contains seromucous glands and connective tissue . Hyaline Cartilage : C-shaped rings that provide structural support and prevent the trachea from collapsing . Adventitia : The outermost connective tissue layer that binds the trachea to surrounding tissues .</li><li>• Mucosa : Lined with pseudostratified ciliated columnar epithelium , containing goblet cells that secrete mucus .</li><li>• Mucosa</li><li>• pseudostratified ciliated columnar epithelium</li><li>• goblet cells</li><li>• mucus</li><li>• Submucosa : Contains seromucous glands and connective tissue .</li><li>• Submucosa</li><li>• seromucous glands</li><li>• connective tissue</li><li>• Hyaline Cartilage : C-shaped rings that provide structural support and prevent the trachea from collapsing .</li><li>• Hyaline Cartilage</li><li>• C-shaped rings</li><li>• structural support</li><li>• trachea</li><li>• collapsing</li><li>• Adventitia : The outermost connective tissue layer that binds the trachea to surrounding tissues .</li><li>• Adventitia</li><li>• outermost connective tissue layer</li><li>• trachea</li><li>• surrounding tissues</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Urinary Bladder :</li><li>➤ Urinary Bladder</li><li>➤ Mucosa : Lined by transitional epithelium ( urothelium ), which is unique to the urinary tract . This epithelium can stretch and appear thinner when the bladder is full and thicker when empty . Lamina Propria : A layer of loose connective tissue beneath the epithelium, containing blood vessels and nerves . Muscularis Propria : A thick layer of smooth muscle , known as the detrusor muscle , which contracts during urination .</li><li>➤ Mucosa : Lined by transitional epithelium ( urothelium ), which is unique to the urinary tract . This epithelium can stretch and appear thinner when the bladder is full and thicker when empty .</li><li>➤ Mucosa</li><li>➤ transitional epithelium</li><li>➤ urothelium</li><li>➤ urinary tract</li><li>➤ stretch</li><li>➤ thinner</li><li>➤ full</li><li>➤ thicker</li><li>➤ empty</li><li>➤ Lamina Propria : A layer of loose connective tissue beneath the epithelium, containing blood vessels and nerves .</li><li>➤ Lamina Propria</li><li>➤ loose connective tissue</li><li>➤ blood vessels</li><li>➤ nerves</li><li>➤ Muscularis Propria : A thick layer of smooth muscle , known as the detrusor muscle , which contracts during urination .</li><li>➤ Muscularis Propria</li><li>➤ smooth muscle</li><li>➤ detrusor muscle</li><li>➤ contracts</li><li>➤ urination</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 246</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 246</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following structures mucus secreting glands are absent?", "options": [{"label": "A", "text": "Vagina", "correct": true}, {"label": "B", "text": "Cervix", "correct": false}, {"label": "C", "text": "Duodenum", "correct": false}, {"label": "D", "text": "Esophagus", "correct": false}], "correct_answer": "A. Vagina", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. A) Vagina</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . The cervix contains mucus-secreting glands . These glands produce cervical mucus , which changes in consistency and quantity throughout the menstrual cycle . This mucus plays a critical role in either facilitating or inhibiting sperm passage into the uterus , depending on the stage of the cycle .</li><li>• Option B</li><li>• mucus-secreting glands</li><li>• cervical mucus</li><li>• consistency</li><li>• quantity</li><li>• menstrual cycle</li><li>• critical role</li><li>• either facilitating</li><li>• inhibiting sperm passage</li><li>• uterus</li><li>• stage</li><li>• cycle</li><li>• Option C . Duodenal glands include the Brunner's glands in the submucosa , which secrete an alkaline mucus . This mucus helps to neutralize the acidic chyme that is passed from the stomach into the duodenum , protecting the intestinal lining and aiding in digestion .</li><li>• Option C</li><li>• Brunner's glands</li><li>• submucosa</li><li>• secrete</li><li>• alkaline mucus</li><li>• neutralize</li><li>• acidic chyme</li><li>• stomach</li><li>• duodenum</li><li>• protecting</li><li>• intestinal lining</li><li>• aiding</li><li>• digestion</li><li>• Option D . The esophagus contains mucus-secreting glands , primarily located in the submucosa . These glands produce mucus to lubricate the esophagus , facilitating the passage of food to the stomach and protecting the esophageal lining from damage by food particles and gastric reflux .</li><li>• Option D</li><li>• mucus-secreting glands</li><li>• submucosa</li><li>• mucus</li><li>• lubricate</li><li>• esophagus</li><li>• passage</li><li>• food</li><li>• stomach</li><li>• protecting</li><li>• esophageal lining</li><li>• damage</li><li>• food particles</li><li>• gastric reflux</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vagina is lubricated by mucus produced by the cervix and Bartholin's glands , located near the vaginal opening. The vaginal wall itself is lined with a stratified squamous epithelium and does not contain mucus-secreting glands.</li><li>➤ Vagina is lubricated by mucus produced by the cervix and Bartholin's glands , located near the vaginal opening. The vaginal wall itself is lined with a stratified squamous epithelium and does not contain mucus-secreting glands.</li><li>➤ lubricated</li><li>➤ mucus</li><li>➤ cervix</li><li>➤ Bartholin's glands</li><li>➤ lined</li><li>➤ stratified squamous epithelium</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 279</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 279</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old man with a 30-year history of smoking presents to your clinic complaining of a persistent cough and shortness of breath. He mentions that these symptoms have been gradually worsening over the past few months. A chest X-ray reveals hyperinflation of the lungs and a CT scan shows emphysematous changes. Pulmonary function tests indicate obstructive lung disease. Considering the pathological changes observed in this patient's lungs, which of the following cells are not typically present in the lining cells of the alveoli?", "options": [{"label": "A", "text": "Kulchitsky Cells", "correct": false}, {"label": "B", "text": "Clara Cells", "correct": false}, {"label": "C", "text": "Brush Cells", "correct": false}, {"label": "D", "text": "Langerhans Cells", "correct": true}], "correct_answer": "D. Langerhans Cells", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Langerhans Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Kulchitsky cells, also known as neuroendocrine cells , are found in the respiratory tract , including the lining of the bronchi . They are part of the diffuse neuroendocrine system and can secrete a variety of substances including serotonin . However, they are not typically found in the lining of the alveoli, which is primarily composed of Type I and Type II pneumocytes .</li><li>• Option A</li><li>• neuroendocrine cells</li><li>• respiratory tract</li><li>• lining</li><li>• bronchi</li><li>• diffuse neuroendocrine system</li><li>• secrete</li><li>• serotonin</li><li>• Type I</li><li>• Type II</li><li>• pneumocytes</li><li>• Option B . Clara cells, now more commonly referred to as Club cells , are non-ciliated , secretory epithelial cells found in the bronchioles of the lungs , not in the alveoli. They secrete a variety of substances including components of surfactant , immunomodulatory proteins, and detoxifying enzymes . They also function in regenerating the bronchiolar epithelium .</li><li>• Option B</li><li>• Club cells</li><li>• non-ciliated</li><li>• secretory epithelial cells</li><li>• bronchioles</li><li>• lungs</li><li>• components</li><li>• surfactant</li><li>• immunomodulatory proteins,</li><li>• detoxifying enzymes</li><li>• regenerating</li><li>• bronchiolar epithelium</li><li>• Option C . Brush cells are a type of epithelial cell found in the respiratory tract . They are characterized by their microvilli , giving them a \"brush-like\" appearance . Brush cells are sensory cells and are thought to play a role in monitoring the composition of the airway surface liquid . While brush cells are found in the airways , they are not a feature of the alveolar lining.</li><li>• Option C</li><li>• epithelial cell</li><li>• respiratory tract</li><li>• microvilli</li><li>• \"brush-like\" appearance</li><li>• sensory cells</li><li>• monitoring</li><li>• composition</li><li>• airway surface liquid</li><li>• brush cells</li><li>• airways</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Langerhans cells are dendritic cells ( immune cells ) found in the skin and mucous membranes . They play a role in the immune response by presenting antigens to T-cells. Langerhans cells are not found in the alveolar lining. The alveoli are primarily lined with Type I and Type II pneumocytes . Type I cells facilitate gas exchange , and Type II cells produce surfactant .</li><li>➤ Langerhans cells are dendritic cells ( immune cells ) found in the skin and mucous membranes .</li><li>➤ dendritic cells</li><li>➤ immune cells</li><li>➤ skin</li><li>➤ mucous membranes</li><li>➤ They play a role in the immune response by presenting antigens to T-cells.</li><li>➤ immune response</li><li>➤ antigens</li><li>➤ Langerhans cells are not found in the alveolar lining. The alveoli are primarily lined with Type I and Type II pneumocytes .</li><li>➤ alveoli</li><li>➤ lined</li><li>➤ Type I</li><li>➤ Type II pneumocytes</li><li>➤ Type I cells facilitate gas exchange , and Type II cells produce surfactant .</li><li>➤ Type I cells</li><li>➤ gas exchange</li><li>➤ Type II</li><li>➤ cells</li><li>➤ surfactant</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 224</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 224</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman presents to the gastroenterology clinic with a history of chronic diarrhea and abdominal pain. She reports that her symptoms have been progressively worsening over the past year. A colonoscopy is performed, which reveals mild inflammation in the ileum but no significant abnormalities in the colon. Biopsies are taken for histological examination. In the context of normal intestinal mucosal turnover, which of the following cell types does not migrate from the base of the crypt to the ends of the villi, a process potentially disrupted in this patient's condition?", "options": [{"label": "A", "text": "Enterocyte", "correct": false}, {"label": "B", "text": "Endocrine Cell", "correct": false}, {"label": "C", "text": "Paneth Cell", "correct": true}, {"label": "D", "text": "Goblet Cell", "correct": false}], "correct_answer": "C. Paneth Cell", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Paneth Cell</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Enterocytes are the most abundant cell type in the intestinal epithelium . They are absorptive cells responsible for the uptake of nutrients . Enterocytes originate from stem cells located at the base of the intestinal crypts and migrate up the sides of the villi , where they perform their absorptive function . Eventually, they are shed off into the intestinal lumen at the tip of the villi .</li><li>• Option A</li><li>• most abundant cell type</li><li>• intestinal epithelium</li><li>• absorptive cells</li><li>• uptake</li><li>• nutrients</li><li>• stem cells</li><li>• base</li><li>• intestinal crypts</li><li>• migrate</li><li>• sides</li><li>• villi</li><li>• perform</li><li>• absorptive function</li><li>• shed off</li><li>• intestinal lumen</li><li>• tip</li><li>• villi</li><li>• Option B . Intestinal endocrine cells are part of the enteroendocrine system and are responsible for producing various hormones in response to different stimuli . Like enterocytes, they originate from stem cells at the base of the crypts and migrate towards the tips of the villi as they mature .</li><li>• Option B</li><li>• Intestinal endocrine cells</li><li>• enteroendocrine system</li><li>• hormones</li><li>• different stimuli</li><li>• originate</li><li>• stem cells</li><li>• base</li><li>• crypts</li><li>• migrate</li><li>• tips</li><li>• villi</li><li>• mature</li><li>• Option D . Goblet cells are mucus-secreting cells found throughout the intestine . They originate from stem cells at the base of the crypts and migrate upwards along the villi . Goblet cells play a crucial role in protecting and lubricating the intestinal lining by secreting mucus .</li><li>• Option D</li><li>• mucus-secreting cells</li><li>• throughout</li><li>• intestine</li><li>• originate</li><li>• stem cells</li><li>• base</li><li>• crypts</li><li>• migrate upwards</li><li>• villi</li><li>• crucial role</li><li>• protecting</li><li>• lubricating</li><li>• intestinal lining</li><li>• secreting mucus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Paneth cells are specialized epithelial cells located at the base of the intestinal crypts . They do not migrate up the villi. Instead, they remain at the crypt base and are involved in host defense by secreting antimicrobial peptides and enzymes like lysozyme . Paneth cell is also called zymogen cell , which contain zinc , rough endoplasmic reticulum . Goblet cells are rich in mucus which gives it a foamy appearance .</li><li>➤ Paneth cells are specialized epithelial cells located at the base of the intestinal crypts . They do not migrate up the villi. Instead, they remain at the crypt base and are involved in host defense by secreting antimicrobial peptides and enzymes like lysozyme .</li><li>➤ specialized epithelial cells</li><li>➤ base</li><li>➤ intestinal crypts</li><li>➤ remain</li><li>➤ crypt base</li><li>➤ host defense</li><li>➤ secreting antimicrobial peptides</li><li>➤ enzymes</li><li>➤ lysozyme</li><li>➤ Paneth cell is also called zymogen cell , which contain zinc , rough endoplasmic reticulum . Goblet cells are rich in mucus which gives it a foamy appearance .</li><li>➤ zymogen cell</li><li>➤ zinc</li><li>➤ rough endoplasmic reticulum</li><li>➤ rich</li><li>➤ mucus</li><li>➤ foamy appearance</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 188</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 188</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is true about Paneth Cells?", "options": [{"label": "A", "text": "Rich in Rough Endoplasmic Reticulum", "correct": false}, {"label": "B", "text": "High Zinc Content", "correct": false}, {"label": "C", "text": "Foamy Cytoplasm", "correct": false}, {"label": "D", "text": "Numerous Lysozyme Granules", "correct": true}], "correct_answer": "D. Numerous Lysozyme Granules", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Numerous Lysozyme Granules</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. While Paneth cells do have Rough Endoplasmic Reticulum (RER) , it is not their most distinguishing feature. The RER in Paneth cells is involved in the production of proteins , including enzymes and antimicrobial peptides , but it's not the most notable characteristic when identifying or describing these cells.</li><li>• Option A.</li><li>• Rough Endoplasmic Reticulum (RER)</li><li>• proteins</li><li>• enzymes</li><li>• antimicrobial peptides</li><li>• Option B . Paneth cells are not particularly characterized by their zinc content . Zinc is an essential mineral important for numerous biological processes and is found in various cell types throughout the body, but it's not a defining feature of Paneth cells.</li><li>• Option B</li><li>• not</li><li>• characterized</li><li>• zinc content</li><li>• Zinc</li><li>• essential mineral</li><li>• numerous biological processes</li><li>• cell</li><li>• types</li><li>• Option C . Paneth cells do not typically have a foamy cytoplasm . A foamy cytoplasm is generally indicative of lipid accumulation within cells, which is a characteristic of goblet cells .</li><li>• Option C</li><li>• do not</li><li>• foamy cytoplasm</li><li>• indicative</li><li>• lipid accumulation</li><li>• characteristic</li><li>• goblet cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Paneth cells are most notably characterized by their numerous lysozyme granules . These granules contain lysozyme , an enzyme that breaks down the cell walls of certain bacteria , playing a key role in the innate immune system of the gut . These granules also contain other antimicrobial peptides and proteins , which are part of the host defense mechanism of the intestinal mucosa .</li><li>➤ Paneth cells are most notably characterized by their numerous lysozyme granules .</li><li>➤ notably characterized</li><li>➤ numerous lysozyme granules</li><li>➤ These granules contain lysozyme , an enzyme that breaks down the cell walls of certain bacteria , playing a key role in the innate immune system of the gut .</li><li>➤ lysozyme</li><li>➤ breaks down</li><li>➤ cell walls</li><li>➤ bacteria</li><li>➤ innate immune system</li><li>➤ gut</li><li>➤ These granules also contain other antimicrobial peptides and proteins , which are part of the host defense mechanism of the intestinal mucosa .</li><li>➤ antimicrobial peptides</li><li>➤ proteins</li><li>➤ part</li><li>➤ host defense mechanism</li><li>➤ intestinal mucosa</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 182</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 182</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cells are not found in small intestine?", "options": [{"label": "A", "text": "Stem Cells", "correct": false}, {"label": "B", "text": "Goblet Cells", "correct": false}, {"label": "C", "text": "Neck Cells", "correct": true}, {"label": "D", "text": "Paneth Cells", "correct": false}], "correct_answer": "C. Neck Cells", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture7.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture8.jpg"], "explanation": "<p><strong>Ans. C) Neck Cells</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Option C:</li><li>• stomach</li><li>• Explanation:</li><li>• Option A . Stem cells are indeed present in the small intestine . They are located at the base of the intestinal crypts ( Crypts of Lieberkühn ) and play a crucial role in constantly regenerating the intestinal epithelium . These stem cells give rise to various types of cells that make up the lining of the intestine , including enterocytes , goblet cells , and Paneth cells .</li><li>• Option A</li><li>• small intestine</li><li>• base</li><li>• intestinal crypts</li><li>• Crypts of Lieberkühn</li><li>• crucial role</li><li>• regenerating</li><li>• intestinal epithelium</li><li>• lining</li><li>• intestine</li><li>• enterocytes</li><li>• goblet</li><li>• cells</li><li>• Paneth cells</li><li>• Option B . Goblet cells are also found in the small intestine . They are specialized cells that produce mucus , which lubricates the intestine and helps protect the lining from damage and erosion . The presence of goblet cells is essential for maintaining the health and function of the intestinal mucosa .</li><li>• Option B</li><li>• small intestine</li><li>• specialized cells</li><li>• mucus</li><li>• lubricates</li><li>• intestine</li><li>• protect</li><li>• lining</li><li>• damage</li><li>• erosion</li><li>• presence</li><li>• goblet cells</li><li>• maintaining</li><li>• health</li><li>• function</li><li>• intestinal mucosa</li><li>• Option D. Paneth cells are indeed present in the small intestine . They are located at the base of the intestinal crypts and are known for their role in innate immunity . Paneth cells secrete antimicrobial peptides and proteins , including lysozyme , to help regulate the intestinal microbiota and protect against bacterial infections .</li><li>• Option D.</li><li>• small intestine</li><li>• located</li><li>• base</li><li>• intestinal crypts</li><li>• innate immunity</li><li>• secrete antimicrobial peptides</li><li>• proteins</li><li>• lysozyme</li><li>• regulate</li><li>• intestinal microbiota</li><li>• against</li><li>• bacterial infections</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Neck cells, more commonly associated with the gastric glands of the stomach , are not found in the small intestine. In the stomach, neck cells secrete mucus and bicarbonate to protect the lining of the stomach from acidic gastric juice . Since the small intestine does not have gastric glands like the stomach, it does not contain neck cells.</li><li>➤ Neck cells, more commonly associated with the gastric glands of the stomach , are not found in the small intestine.</li><li>➤ gastric glands</li><li>➤ stomach</li><li>➤ In the stomach, neck cells secrete mucus and bicarbonate to protect the lining of the stomach from acidic gastric juice . Since the small intestine does not have gastric glands like the stomach, it does not contain neck cells.</li><li>➤ secrete mucus</li><li>➤ bicarbonate</li><li>➤ protect</li><li>➤ lining</li><li>➤ stomach</li><li>➤ acidic gastric</li><li>➤ juice</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 181</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 181</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is incorrect about heart muscle?", "options": [{"label": "A", "text": "Acts as Syncytium", "correct": false}, {"label": "B", "text": "Has Multiple Nuclei", "correct": true}, {"label": "C", "text": "Has Gap Junctions", "correct": false}, {"label": "D", "text": "Has Branching", "correct": false}], "correct_answer": "B. Has Multiple Nuclei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture12.jpg"], "explanation": "<p><strong>Ans. B) Has Multiple Nuclei</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Option B:</li><li>• centrally</li><li>• single nucleus per cell</li><li>• Explanation:</li><li>• Option A . Cardiac muscle acts as a functional syncytium . This means that the cardiac muscle cells are connected in a way that allows them to contract almost simultaneously . This is crucial for the effective pumping of blood . There are two types of syncytia in the heart: the atrial syncytium and the ventricular syncytium , allowing for coordinated contractions of atria and ventricles , respectively.</li><li>• Option A</li><li>• functional syncytium</li><li>• cardiac muscle cells</li><li>• allows</li><li>• contract</li><li>• simultaneously</li><li>• effective pumping</li><li>• blood</li><li>• two types</li><li>• atrial syncytium</li><li>• ventricular syncytium</li><li>• coordinated contractions</li><li>• atria</li><li>• ventricles</li><li>• Option C. Cardiac muscle cells are connected by intercalated discs , which contain gap junctions . These gap junctions are crucial for cardiac function as they allow for rapid electrical and chemical communication between cells . This connectivity ensures that the heart muscle contracts in a coordinated manner .</li><li>• Option C.</li><li>• connected</li><li>• intercalated discs</li><li>• gap junctions</li><li>• cardiac function</li><li>• allow</li><li>• rapid electrical</li><li>• chemical communication</li><li>• cells</li><li>• heart muscle</li><li>• coordinated manner</li><li>• Option D . Cardiac muscle cells have a branching structure . This branching allows the cells to interlock with each other , forming a strong and cohesive network . The branched structure is important for the contraction mechanics of the heart , facilitating the efficient transmission of contractile force throughout the heart muscle .</li><li>• Option D</li><li>• branching structure</li><li>• cells</li><li>• interlock</li><li>• each other</li><li>• strong</li><li>• cohesive network</li><li>• contraction mechanics</li><li>• heart</li><li>• efficient transmission</li><li>• contractile force</li><li>• heart muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cardiac muscle cells are generally uninucleated ; each cell typically has only one nucleus . This is in contrast to skeletal muscle fibers, which are multinucleated. The presence of a single nucleus in cardiac muscle cells is a distinct characteristic differentiating them from other muscle cell types .</li><li>➤ Cardiac muscle cells are generally uninucleated ; each cell typically has only one nucleus . This is in contrast to skeletal muscle fibers, which are multinucleated.</li><li>➤ generally uninucleated</li><li>➤ only one nucleus</li><li>➤ The presence of a single nucleus in cardiac muscle cells is a distinct characteristic differentiating them from other muscle cell types .</li><li>➤ single nucleus</li><li>➤ differentiating</li><li>➤ from</li><li>➤ other muscle cell types</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 119</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 119</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following organs Reticular Fibers are present?", "options": [{"label": "A", "text": "Thymus", "correct": false}, {"label": "B", "text": "Spleen", "correct": false}, {"label": "C", "text": "Lymph Node", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) All of the above</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The thymus contains reticular fibers . These fibers form a fine network that supports the lobules of the thymus , where T lymphocytes ( T cells ) mature . The reticular network in the thymus is essential for supporting the developing T cells and the stromal cells that educate them.</li><li>• Option A</li><li>• reticular fibers</li><li>• fine network</li><li>• lobules</li><li>• thymus</li><li>• T lymphocytes</li><li>• T cells</li><li>• mature</li><li>• developing T cells</li><li>• stromal cells</li><li>• educate</li><li>• Option B . The spleen also contains reticular fibers . They form a scaffold that supports the spleen's cellular components . The spleen is involved in filtering blood , immune responses , and recycling old red blood cells . Reticular fibers in the spleen help form the structure of the red pulp and white pulp , areas important for the spleen's functions .</li><li>• Option B</li><li>• reticular fibers</li><li>• scaffold</li><li>• supports</li><li>• spleen's cellular components</li><li>• filtering blood</li><li>• immune responses</li><li>• recycling old red blood cells</li><li>• Reticular fibers</li><li>• spleen</li><li>• red pulp</li><li>• white pulp</li><li>• spleen's functions</li><li>• Option C . Lymph nodes also contain reticular fibers . These fibers create a framework that supports the lymph node's architecture , including regions where lymphocytes are stored and areas where immune responses are initiated .</li><li>• Option C</li><li>• reticular fibers</li><li>• lymph node's architecture</li><li>• lymphocytes</li><li>• stored</li><li>• areas</li><li>• immune responses</li><li>• initiated</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Reticular fibers are present in all the organs listed: thymus , spleen , and lymph nodes . They play a crucial role in providing structural support and creating an environment conducive to the function of each organ , particularly in relation to the immune and hematopoietic systems .</li><li>➤ Reticular fibers are present in all the organs listed: thymus , spleen , and lymph nodes .</li><li>➤ Reticular fibers</li><li>➤ all</li><li>➤ thymus</li><li>➤ spleen</li><li>➤ lymph nodes</li><li>➤ They play a crucial role in providing structural support and creating an environment conducive to the function of each organ , particularly in relation to the immune and hematopoietic systems .</li><li>➤ crucial role</li><li>➤ structural support</li><li>➤ creating</li><li>➤ environment conducive</li><li>➤ function</li><li>➤ each organ</li><li>➤ immune</li><li>➤ hematopoietic systems</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 53</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 53</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old woman presents to the clinic with a history of chronic lower back pain radiating down her left leg. She describes the pain as sharp and shooting, worsening with prolonged sitting. Physical examination reveals decreased sensation along the lateral aspect of her left lower leg and the sole of her foot. Reflex testing shows diminished ankle reflex on the left side. A lumbar spine MRI suggests a herniated disc impinging on the spinal nerve roots. Considering this patient's neurological symptoms, in which location are pseudounipolar neurons, potentially affected in this patient's condition, most commonly found?", "options": [{"label": "A", "text": "Olfactory", "correct": false}, {"label": "B", "text": "Coeliac Ganglion", "correct": false}, {"label": "C", "text": "Dorsal Root Ganglion", "correct": true}, {"label": "D", "text": "Cochlea", "correct": false}], "correct_answer": "C. Dorsal Root Ganglion", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture13.jpg"], "explanation": "<p><strong>Ans. C) Dorsal Root Ganglion</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The olfactory system, responsible for the sense of smell , primarily consists of olfactory receptor neurons , which are bipolar neurons . These neurons have two extensions and are different from pseudounipolar neurons .</li><li>• Option A</li><li>• sense</li><li>• smell</li><li>• olfactory receptor neurons</li><li>• bipolar neurons</li><li>• two extensions</li><li>• pseudounipolar neurons</li><li>• Option B . The coeliac ganglion is part of the sympathetic nervous system and contains multipolar neurons , not pseudounipolar neurons. Multipolar neurons , with one axon and multiple dendrites , are commonly found in the autonomic ganglia , including the coeliac ganglion .</li><li>• Option B</li><li>• sympathetic nervous system</li><li>• multipolar neurons</li><li>• Multipolar neurons</li><li>• one axon</li><li>• multiple dendrites</li><li>• autonomic ganglia</li><li>• coeliac ganglion</li><li>• Option D . The cochlea, part of the inner ear , is involved in hearing and contains specialized sensory cells and neurons . However, the neurons associated with the cochlea are bipolar neurons , not pseudounipolar. These bipolar neurons are part of the spiral ganglion , which transmits auditory information from the cochlea to the brain .</li><li>• Option D</li><li>• part</li><li>• inner</li><li>• ear</li><li>• hearing</li><li>• specialized sensory cells</li><li>• neurons</li><li>• cochlea</li><li>• bipolar neurons</li><li>• bipolar neurons</li><li>• spiral ganglion</li><li>• transmits auditory information</li><li>• cochlea</li><li>• brain</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pseudounipolar neurons are most commonly found in the dorsal root ganglia of the spinal nerves . These neurons have a single process that divides into two branches : one branch runs to the periphery ( sensory receptors ), and the other runs into the spinal cord . They are involved in transmitting sensory information from the periphery to the spinal cord .</li><li>➤ Pseudounipolar neurons are most commonly found in the dorsal root ganglia of the spinal nerves .</li><li>➤ Pseudounipolar neurons</li><li>➤ dorsal root ganglia</li><li>➤ spinal nerves</li><li>➤ These neurons have a single process that divides into two branches : one branch runs to the periphery ( sensory receptors ), and the other runs into the spinal cord . They are involved in transmitting sensory information from the periphery to the spinal cord .</li><li>➤ single process</li><li>➤ two branches</li><li>➤ periphery</li><li>➤ sensory receptors</li><li>➤ other runs</li><li>➤ spinal cord</li><li>➤ transmitting sensory information</li><li>➤ periphery</li><li>➤ spinal cord</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 358</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 358</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old man presents to the clinic with a four-day history of lower back pain and fever. He has a history of intravenous drug use. On physical examination, his temperature is 38.5°C, and he has costovertebral angle tenderness on the right side. Laboratory results show elevated white blood cell count and urinalysis reveals the presence of leukocytes with specific types of cells that display abundant, refractile, lipid-containing vacuoles, giving them a sparkling appearance. These cells are typically associated with sterile pyuria and are indicative of an inflammatory response in the urinary tract. What is the most likely identity of these cells?", "options": [{"label": "A", "text": "Microglia", "correct": false}, {"label": "B", "text": "Modified Macrophages", "correct": false}, {"label": "C", "text": "Astrocytes", "correct": false}, {"label": "D", "text": "Neutrophils", "correct": true}], "correct_answer": "D. Neutrophils", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Neutrophils</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Microglia are a type of glial cell located throughout the brain and spinal cord . They act as the primary immune defense in the central nervous system and play a role in inflammation and response to injury .</li><li>• Option A.</li><li>• glial cell</li><li>• brain</li><li>• spinal cord</li><li>• primary immune defense</li><li>• central nervous system</li><li>• inflammation</li><li>• response</li><li>• injury</li><li>• Option B. While macrophages can exhibit different morphologies and functions depending on their location and the signals they receive , the term \"glitter cells\" does not typically refer to modified macrophages.</li><li>• Option B.</li><li>• exhibit different morphologies</li><li>• functions</li><li>• location</li><li>• signals</li><li>• receive</li><li>• Option C . Astrocytes are another type of glial cell in the central nervous system . They perform several functions, including biochemical support of endothelial cells that form the blood-brain barrier , provision of nutrients to nervous tissue , and maintenance of extracellular ion balance .</li><li>• Option C</li><li>• glial cell</li><li>• central nervous system</li><li>• biochemical support</li><li>• endothelial cells</li><li>• form</li><li>• blood-brain barrier</li><li>• nutrients</li><li>• nervous tissue</li><li>• maintenance</li><li>• extracellular ion balance</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Neutrophils is the correct identification of \" glitter cells .\" In the context of urine analysis , \"glitter cells\" refer to a specific appearance of neutrophils that exhibit a sparkling appearance due to their movement within the urine . This appearance is created by the movement of the cell's granules and lobed nucleus . The presence of glitter cells in urine can be an indicator of urinary tract infection or inflammation .</li><li>➤ Neutrophils is the correct identification of \" glitter cells .\"</li><li>➤ Neutrophils is the correct identification of \" glitter cells .\"</li><li>➤ glitter cells</li><li>➤ In the context of urine analysis , \"glitter cells\" refer to a specific appearance of neutrophils that exhibit a sparkling appearance due to their movement within the urine .</li><li>➤ In the context of urine analysis , \"glitter cells\" refer to a specific appearance of neutrophils that exhibit a sparkling appearance due to their movement within the urine .</li><li>➤ urine analysis</li><li>➤ specific appearance</li><li>➤ neutrophils</li><li>➤ exhibit</li><li>➤ sparkling appearance</li><li>➤ movement</li><li>➤ urine</li><li>➤ This appearance is created by the movement of the cell's granules and lobed nucleus . The presence of glitter cells in urine can be an indicator of urinary tract infection or inflammation .</li><li>➤ This appearance is created by the movement of the cell's granules and lobed nucleus . The presence of glitter cells in urine can be an indicator of urinary tract infection or inflammation .</li><li>➤ movement</li><li>➤ cell's granules</li><li>➤ lobed nucleus</li><li>➤ presence</li><li>➤ glitter cells</li><li>➤ urine</li><li>➤ indicator</li><li>➤ urinary tract infection</li><li>➤ inflammation</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 47</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 47</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents to the clinic with a one-week history of jaundice, itching, and dark urine. She has a history of gallstones. On examination, she is found to have mild right upper quadrant tenderness. Laboratory tests show elevated liver enzymes and bilirubin levels. An imaging study is planned to evaluate her biliary tract. Understanding the histology of the biliary tract is essential for interpreting these studies. What is the cell lining of the common bile duct?", "options": [{"label": "A", "text": "Stratified Columnar", "correct": false}, {"label": "B", "text": "Stratified Squamous", "correct": false}, {"label": "C", "text": "Simple Cuboidal", "correct": false}, {"label": "D", "text": "Simple Columnar", "correct": true}], "correct_answer": "D. Simple Columnar", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Simple Columnar</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Stratified Columnar is relatively rare and found in specific areas such as parts of the male urethra , some glandular ducts , and the conjunctiva of the eye . However, it is not the typical cell lining of the common bile duct.</li><li>• Option A</li><li>• rare</li><li>• male urethra</li><li>• glandular ducts</li><li>• conjunctiva</li><li>• eye</li><li>• Option B . Stratified squamous epithelium is composed of several layers of flat cells and is designed to protect against abrasion . It is found in areas subject to wear and tear , like the skin , mouth , and esophagus .</li><li>• Option B</li><li>• several layers</li><li>• flat cells</li><li>• protect against abrasion</li><li>• subject</li><li>• wear</li><li>• tear</li><li>• skin</li><li>• mouth</li><li>• esophagus</li><li>• Option C . Simple cuboidal epithelium, consisting of a single layer of cube-like cells , is found in many glands and ducts where it is involved in secretion and absorption .</li><li>• Option C</li><li>• single layer</li><li>• cube-like</li><li>• cells</li><li>• many glands</li><li>• ducts</li><li>• secretion</li><li>• absorption</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The common bile duct is typically lined with simple columnar epithelium . This type of epithelium consists of a single layer of tall , column-like cells . It is adapted for absorption and secretion , functions relevant to the common bile duct as it transports bile from the liver and gallbladder to the duodenum.</li><li>➤ The common bile duct is typically lined with simple columnar epithelium .</li><li>➤ simple columnar epithelium</li><li>➤ This type of epithelium consists of a single layer of tall , column-like cells . It is adapted for absorption and secretion , functions relevant to the common bile duct as it transports bile from the liver and gallbladder to the duodenum.</li><li>➤ single layer</li><li>➤ tall</li><li>➤ column-like cells</li><li>➤ absorption</li><li>➤ secretion</li><li>➤ common bile</li><li>➤ duct</li><li>➤ transports bile</li><li>➤ liver</li><li>➤ gallbladder</li><li>➤ duodenum.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 207</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 207</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not Macrophage?", "options": [{"label": "A", "text": "Hofbauers Cell", "correct": false}, {"label": "B", "text": "Kupffer's Cell", "correct": false}, {"label": "C", "text": "Stave Cell", "correct": true}, {"label": "D", "text": "Microglia", "correct": false}], "correct_answer": "C. Stave Cell", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Stave Cell</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hofbauer cells are indeed a type of macrophage . They are found in the placenta , particularly in the chorionic villi . These cells play a role in immune surveillance and the regulation of the placental environment , helping to protect the developing fetus .</li><li>• Option A.</li><li>• macrophage</li><li>• placenta</li><li>• chorionic villi</li><li>• role</li><li>• immune surveillance</li><li>• regulation</li><li>• placental environment</li><li>• protect</li><li>• developing fetus</li><li>• Option B . Kupffer cells are a type of macrophage located in the liver . They line the walls of the sinusoids in the liver and are involved in the breakdown and recycling of old red blood cells , in addition to playing a role in immune defense .</li><li>• Option B</li><li>• macrophage</li><li>• liver</li><li>• line</li><li>• walls</li><li>• sinusoids</li><li>• liver</li><li>• breakdown</li><li>• recycling</li><li>• old red blood cells</li><li>• playing</li><li>• role</li><li>• immune defense</li><li>• Option D . Microglia are the resident macrophages of the central nervous system . They become active in response to injury or disease , where they can remove debris and pathogens .</li><li>• Option D</li><li>• resident macrophages</li><li>• central nervous system</li><li>• active</li><li>• injury</li><li>• disease</li><li>• remove debris</li><li>• pathogens</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The endothelial cells being represented by wooden staves , hence known as Stave cells . Externally, the sinuses are encircled by reticular fibres in a transverse direction like the steel bands holding together the staves of the wooden barrel .</li><li>➤ The endothelial cells being represented by wooden staves , hence known as Stave cells .</li><li>➤ wooden staves</li><li>➤ Stave cells</li><li>➤ Externally, the sinuses are encircled by reticular fibres in a transverse direction like the steel bands holding together the staves of the wooden barrel .</li><li>➤ sinuses</li><li>➤ encircled</li><li>➤ reticular fibres</li><li>➤ transverse direction</li><li>➤ steel bands</li><li>➤ together</li><li>➤ staves</li><li>➤ wooden barrel</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 48</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 48</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old patient presents with persistent earache and hearing difficulties in their right ear following a recent upper respiratory tract infection. On examination, you suspect a dysfunction related to the ear's ventilation system. Which of the following anatomical structures, often associated with fibrocartilage, is least likely to be involved in this patient's condition?", "options": [{"label": "A", "text": "Intervertebral Disc", "correct": false}, {"label": "B", "text": "Glenoid Labrum", "correct": false}, {"label": "C", "text": "Medial Meniscus", "correct": false}, {"label": "D", "text": "Eustachian Tube", "correct": true}], "correct_answer": "D. Eustachian Tube", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Eustachian Tube</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Intervertebral discs, located between the vertebrae in the spine , are indeed made up of fibrocartilage . They consist of an outer annulus fibrosus , which is a tough , fibrous ring of fibrocartilage , and an inner nucleus pulposus . These discs act as shock absorbers and provide flexibility to the spine .</li><li>• Option A.</li><li>• vertebrae</li><li>• spine</li><li>• fibrocartilage</li><li>• outer annulus fibrosus</li><li>• tough</li><li>• fibrous ring</li><li>• fibrocartilage</li><li>• inner nucleus pulposus</li><li>• shock absorbers</li><li>• flexibility</li><li>• spine</li><li>• Option B . The glenoid labrum is a fibrocartilaginous structure that surrounds the glenoid cavity in the shoulder joint . It deepens the cavity and provides stability to the shoulder joint . Its fibrocartilaginous nature helps in cushioning and supporting the joint .</li><li>• Option B</li><li>• fibrocartilaginous structure</li><li>• surrounds</li><li>• glenoid cavity</li><li>• shoulder joint</li><li>• deepens</li><li>• cavity</li><li>• stability</li><li>• shoulder joint</li><li>• fibrocartilaginous nature</li><li>• cushioning</li><li>• supporting</li><li>• joint</li><li>• Option C . The medial meniscus, found in the knee joint , is also made up of fibrocartilage . It, along with the lateral meniscus , helps in load distribution , shock absorption , and stabilization of the knee joint . The menisci are crucial for the proper functioning of the knee .</li><li>• Option C</li><li>• knee joint</li><li>• fibrocartilage</li><li>• lateral meniscus</li><li>• load distribution</li><li>• shock absorption</li><li>• stabilization</li><li>• knee joint</li><li>• menisci</li><li>• crucial</li><li>• proper functioning</li><li>• knee</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Eustachian tube, which connects the middle ear to the nasopharynx , is not made up of fibrocartilage. It is lined with mucous membrane and has a bony and cartilaginous part , but the cartilage here is not fibrocartilage. Instead, it is primarily elastic cartilage . The Eustachian tube plays a role in equalizing air pressure on both sides of the eardrum .</li><li>➤ The Eustachian tube, which connects the middle ear to the nasopharynx , is not made up of fibrocartilage.</li><li>➤ connects</li><li>➤ middle ear</li><li>➤ nasopharynx</li><li>➤ It is lined with mucous membrane and has a bony and cartilaginous part , but the cartilage here is not fibrocartilage.</li><li>➤ mucous membrane</li><li>➤ bony</li><li>➤ cartilaginous part</li><li>➤ Instead, it is primarily elastic cartilage . The Eustachian tube plays a role in equalizing air pressure on both sides of the eardrum .</li><li>➤ primarily elastic cartilage</li><li>➤ role</li><li>➤ equalizing air pressure</li><li>➤ both sides</li><li>➤ eardrum</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 62</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 62</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following does NOT typically contain fenestrated capillaries?\"", "options": [{"label": "A", "text": "Endocrine glands", "correct": false}, {"label": "B", "text": "Kidney", "correct": false}, {"label": "C", "text": "Small intestine", "correct": false}, {"label": "D", "text": "Nervous tissue", "correct": true}], "correct_answer": "D. Nervous tissue", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) Nervous tissue</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Endocrine glands typically have fenestrated capillaries . These capillaries have pores (fenestrations) in their endothelial lining , which allow for efficient transfer of hormones into the bloodstream . The fenestrations facilitate the rapid exchange of molecules between the blood and the glandular cells , which is crucial for endocrine function .</li><li>• Option A</li><li>• fenestrated capillaries</li><li>• pores (fenestrations)</li><li>• endothelial lining</li><li>• allow</li><li>• efficient transfer</li><li>• hormones</li><li>• bloodstream</li><li>• rapid exchange</li><li>• molecules</li><li>• blood</li><li>• glandular cells</li><li>• crucial</li><li>• endocrine function</li><li>• Option B. The kidney also contains fenestrated capillaries , particularly in the glomeruli , which are part of the nephrons . These capillaries play a critical role in the filtration of blood , a key process in the formation of urine . The fenestrations allow for the passage of water and small solutes while retaining larger molecules like proteins in the bloodstream .</li><li>• Option B.</li><li>• fenestrated capillaries</li><li>• glomeruli</li><li>• nephrons</li><li>• critical role</li><li>• filtration</li><li>• blood</li><li>• formation</li><li>• urine</li><li>• fenestrations</li><li>• passage</li><li>• water</li><li>• small solutes</li><li>• retaining larger molecules</li><li>• proteins</li><li>• bloodstream</li><li>• Option C . Fenestrated capillaries are found in the small intestine as well. They are especially important here for the efficient absorption of nutrients . The fenestrations increase permeability , allowing for the transfer of nutrients from the digestive tract into the bloodstream .</li><li>• Option C</li><li>• Fenestrated capillaries</li><li>• small intestine</li><li>• efficient absorption</li><li>• nutrients</li><li>• fenestrations increase</li><li>• permeability</li><li>• transfer</li><li>• nutrients</li><li>• digestive tract</li><li>• bloodstream</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Nervous tissue, particularly the brain and spinal cord , typically does not have fenestrated capillaries. Instead, the capillaries in the central nervous system are part of the blood-brain barrier and have tight junctions without fenestrations . This barrier is crucial to protect the nervous tissue from potentially harmful substances in the blood and to maintain the specialized environment required for neural function .</li><li>➤ Nervous tissue, particularly the brain and spinal cord , typically does not have fenestrated capillaries.</li><li>➤ brain</li><li>➤ spinal cord</li><li>➤ Instead, the capillaries in the central nervous system are part of the blood-brain barrier and have tight junctions without fenestrations .</li><li>➤ capillaries</li><li>➤ central nervous system</li><li>➤ blood-brain barrier</li><li>➤ tight junctions</li><li>➤ without fenestrations</li><li>➤ This barrier is crucial to protect the nervous tissue from potentially harmful substances in the blood and to maintain the specialized environment required for neural function .</li><li>➤ crucial</li><li>➤ protect</li><li>➤ nervous tissue</li><li>➤ potentially harmful substances</li><li>➤ blood</li><li>➤ maintain</li><li>➤ specialized environment</li><li>➤ neural function</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 129</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 129</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the following structures paracortex is seen?", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Tonsil", "correct": false}, {"label": "C", "text": "Thymus", "correct": false}, {"label": "D", "text": "Lymph Node", "correct": true}], "correct_answer": "D. Lymph Node", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture18.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture20.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture21.jpg"], "explanation": "<p><strong>Ans. D) Lymph Node</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Option</li><li>➤ A</li><li>➤ Spleen</li><li>➤ white pulp</li><li>➤ red pulp</li><li>➤ differently</li><li>➤ lymphoid</li><li>➤ organs</li><li>➤ paracortex</li><li>➤ Option B.</li><li>➤ lymphoid tissues</li><li>➤ back</li><li>➤ throat</li><li>➤ body's immune system</li><li>➤ protecting</li><li>➤ against pathogens</li><li>➤ entering</li><li>➤ mouth</li><li>➤ nose</li><li>➤ Option C</li><li>➤ primary lymphoid organ</li><li>➤ T cells mature</li><li>➤ two main parts</li><li>➤ cortex</li><li>➤ medulla</li><li>➤ unique architecture</li><li>➤ development</li><li>➤ maturation</li><li>➤ T cells</li><li>➤ Educational Objective:</li><li>➤ The lymph node contains a region known as the paracortex , which lies between the outer cortex and the inner medulla . The paracortex is an area rich in T lymphocytes and is important for initiating immune responses . It is particularly active during immune reactions , such as when the body is fighting off an infection .</li><li>➤ The lymph node contains a region known as the paracortex , which lies between the outer cortex and the inner medulla .</li><li>➤ region</li><li>➤ paracortex</li><li>➤ between</li><li>➤ outer cortex</li><li>➤ inner medulla</li><li>➤ The paracortex is an area rich in T lymphocytes and is important for initiating immune responses . It is particularly active during immune reactions , such as when the body is fighting off an infection .</li><li>➤ paracortex</li><li>➤ area rich</li><li>➤ T lymphocytes</li><li>➤ initiating immune responses</li><li>➤ active</li><li>➤ immune reactions</li><li>➤ body</li><li>➤ fighting off</li><li>➤ infection</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 143</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 143</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the Brunner’s Gland seen in GIT?", "options": [{"label": "A", "text": "Oesophagus", "correct": false}, {"label": "B", "text": "Stomach", "correct": false}, {"label": "C", "text": "Duodenum", "correct": true}, {"label": "D", "text": "Jejunum", "correct": false}], "correct_answer": "C. Duodenum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture22.jpg"], "explanation": "<p><strong>Ans. C) Duodenum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The esophagus does not contain Brunner's glands. Instead, it is lined with stratified squamous epithelium and has mucus-secreting glands , but these are not the same as Brunner's glands.</li><li>• Option A</li><li>• lined</li><li>• stratified squamous epithelium</li><li>• mucus-secreting</li><li>• glands</li><li>• Option B . The stomach has its own specialized glands , such as gastric glands , but it does not contain Brunner's glands. Gastric glands secrete acid , various enzymes, and mucus , but their structure and function are different from Brunner's glands .</li><li>• Option B</li><li>• specialized glands</li><li>• gastric glands</li><li>• secrete acid</li><li>• mucus</li><li>• structure</li><li>• function</li><li>• different</li><li>• Brunner's glands</li><li>• Option D . Jejunum does not contain Brunner's glands. The jejunum's lining is specialized for absorption and has features like villi and microvilli but lacks the specific glands found in the duodenum .</li><li>• Option D</li><li>• jejunum's lining</li><li>• absorption</li><li>• villi</li><li>• microvilli</li><li>• lacks</li><li>• specific glands</li><li>• duodenum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Brunner’s glands are located in the submucosa layer of the duodenum and secrete an alkaline mucus . This secretion helps to neutralize the acidic chyme that enters the duodenum from the stomach, protecting the intestinal lining and providing an optimal pH for the function of digestive enzymes .</li><li>➤ Brunner’s glands are located in the submucosa layer of the duodenum and secrete an alkaline mucus .</li><li>➤ Brunner’s glands are located in the submucosa layer of the duodenum and secrete an alkaline mucus .</li><li>➤ Brunner’s glands</li><li>➤ submucosa layer</li><li>➤ duodenum</li><li>➤ alkaline mucus</li><li>➤ This secretion helps to neutralize the acidic chyme that enters the duodenum from the stomach, protecting the intestinal lining and providing an optimal pH for the function of digestive enzymes .</li><li>➤ This secretion helps to neutralize the acidic chyme that enters the duodenum from the stomach, protecting the intestinal lining and providing an optimal pH for the function of digestive enzymes .</li><li>➤ neutralize</li><li>➤ acidic chyme</li><li>➤ enters</li><li>➤ protecting</li><li>➤ intestinal lining</li><li>➤ providing</li><li>➤ optimal pH</li><li>➤ digestive enzymes</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 185</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 185</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Where does the Serous Demilunes are found?", "options": [{"label": "A", "text": "Parotid Gland", "correct": false}, {"label": "B", "text": "Thyroid Gland", "correct": false}, {"label": "C", "text": "Sublingual Gland", "correct": true}, {"label": "D", "text": "Lacrimal Gland", "correct": false}], "correct_answer": "C. Sublingual Gland", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Sublingual Gland</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The parotid gland is a predominantly serous salivary gland . While it mainly produces serous saliva , it does not typically feature serous demilunes, which are a specific histological feature seen in some other salivary glands.</li><li>• Option A.</li><li>• serous salivary gland</li><li>• saliva</li><li>• Option B. Thyroid Gland does not contain serous demilunes. The thyroid gland is composed of follicles filled with colloid , surrounded by follicular cells , but this structure is distinctly different from serous demilunes .</li><li>• Option B.</li><li>• follicles</li><li>• colloid</li><li>• follicular cells</li><li>• distinctly different</li><li>• serous demilunes</li><li>• Option D. The lacrimal gland produces tears , which are essential for keeping the surface of the eye moist and healthy . While it is a serous gland , the lacrimal gland does not contain serous demilunes. The structure of the lacrimal gland is more uniform , and it lacks the mixed glandular structure seen in some salivary glands .</li><li>• Option D.</li><li>• tears</li><li>• surface</li><li>• eye moist</li><li>• healthy</li><li>• serous gland</li><li>• more uniform</li><li>• lacks</li><li>• mixed glandular structure</li><li>• salivary glands</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Serous demilunes are commonly observed in the sublingual gland , which is a mixed salivary gland . Serous demilunes appear as cap-like structures at the ends of mucous acini and are believed to represent serous cells that secrete a watery fluid . The presence of serous demilunes is a distinctive feature of the histology of mixed salivary glands , like the sublingual gland .</li><li>➤ Serous demilunes are commonly observed in the sublingual gland , which is a mixed salivary gland .</li><li>➤ sublingual gland</li><li>➤ mixed salivary gland</li><li>➤ Serous demilunes appear as cap-like structures at the ends of mucous acini and are believed to represent serous cells that secrete a watery fluid .</li><li>➤ cap-like structures</li><li>➤ ends</li><li>➤ mucous acini</li><li>➤ serous cells</li><li>➤ secrete</li><li>➤ watery fluid</li><li>➤ The presence of serous demilunes is a distinctive feature of the histology of mixed salivary glands , like the sublingual gland .</li><li>➤ histology</li><li>➤ mixed salivary glands</li><li>➤ sublingual gland</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 198</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 198</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During which of the following phases of Uterus does the Saw Tooth Appearance of Uterine Glands is seen", "options": [{"label": "A", "text": "Proliferative Phase", "correct": false}, {"label": "B", "text": "Secretory Phase", "correct": true}, {"label": "C", "text": "Menstrual Phase", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Secretory Phase", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture27.jpg"], "explanation": "<p><strong>Ans. B) Secretory Phase</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The proliferative phase occurs after menstruation and is characterized by the regeneration and thickening of the endometrium (the lining of the uterus ) under the influence of estrogen . During this phase, the uterine glands are typically straight and tubular , and there is an increase in mitotic activity . The \"saw tooth\" appearance is not a characteristic of this phase.</li><li>• Option A</li><li>• after menstruation</li><li>• characterized</li><li>• regeneration</li><li>• thickening</li><li>• endometrium</li><li>• lining</li><li>• uterus</li><li>• influence</li><li>• estrogen</li><li>• uterine glands</li><li>• straight</li><li>• tubular</li><li>• increase</li><li>• mitotic activity</li><li>• Option C . The menstrual phase is marked by the shedding of the endometrial lining when pregnancy does not occur. The glands during this phase are breaking down along with the rest of the endometrial tissue , and the \"saw tooth\" appearance is not typical of this phase.</li><li>• Option C</li><li>• shedding</li><li>• endometrial lining</li><li>• breaking down</li><li>• rest</li><li>• endometrial tissue</li><li>• Option D. Based on the descriptions, the secretory phase is indeed the phase where the \" saw tooth \" appearance of uterine glands is observed.</li><li>• Option D.</li><li>• secretory phase</li><li>• phase</li><li>• saw tooth</li><li>• appearance</li><li>• uterine glands</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The secretory phase occurs after ovulation and is characterized by changes in the endometrium in preparation for potential implantation of a fertilized egg . Under the influence of progesterone from the corpus luteum , the uterine glands become more tortuous and coiled , giving them a characteristic \" saw tooth \" appearance in histological sections . The glands also begin to secrete a nutrient-rich fluid to support a potential pregnancy .</li><li>➤ The secretory phase occurs after ovulation and is characterized by changes in the endometrium in preparation for potential implantation of a fertilized egg .</li><li>➤ after ovulation</li><li>➤ changes</li><li>➤ endometrium</li><li>➤ potential implantation</li><li>➤ fertilized egg</li><li>➤ Under the influence of progesterone from the corpus luteum , the uterine glands become more tortuous and coiled , giving them a characteristic \" saw tooth \" appearance in histological sections .</li><li>➤ influence</li><li>➤ progesterone</li><li>➤ corpus luteum</li><li>➤ uterine glands</li><li>➤ tortuous</li><li>➤ coiled</li><li>➤ saw tooth</li><li>➤ appearance</li><li>➤ histological sections</li><li>➤ The glands also begin to secrete a nutrient-rich fluid to support a potential pregnancy .</li><li>➤ begin</li><li>➤ secrete</li><li>➤ nutrient-rich</li><li>➤ fluid</li><li>➤ potential pregnancy</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 277</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 277</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following cells secrete the Growth Hormone?", "options": [{"label": "A", "text": "Acidophils", "correct": true}, {"label": "B", "text": "Basophils", "correct": false}, {"label": "C", "text": "Chromophobes", "correct": false}, {"label": "D", "text": "Neurosecretory Cells in Hypothalamus", "correct": false}], "correct_answer": "A. Acidophils", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture28.jpg"], "explanation": "<p><strong>Ans. A) Acidophils</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Basophils include corticotrophs (which secrete adrenocorticotropic hormone ), thyrotrophs (which secrete thyroid-stimulating hormone ), and gonadotrophs (which secrete follicle-stimulating hormone and luteinizing hormone ). They do not secrete growth hormones.</li><li>• Option B</li><li>• corticotrophs</li><li>• adrenocorticotropic hormone</li><li>• thyroid-stimulating hormone</li><li>• follicle-stimulating hormone</li><li>• luteinizing hormone</li><li>• Option C. Chromophobes are cells in the anterior pituitary gland that do not stain strongly with either acid or basic dyes. Their function is less well understood compared to acidophils and basophils . They are not primarily responsible for the secretion of growth hormones.</li><li>• Option C.</li><li>• anterior pituitary gland</li><li>• less</li><li>• acidophils</li><li>• basophils</li><li>• Option D. While neurosecretory cells in the hypothalamus do produce and secrete hormones , they are not directly responsible for the secretion of growth hormones. Instead, they secrete hormones like growth hormone-releasing hormone (GHRH) , which stimulates the anterior pituitary to release growth hormone . The actual production and secretion of growth hormone occurs in the acidophils of the anterior pituitary .</li><li>• Option D.</li><li>• produce</li><li>• secrete hormones</li><li>• secrete hormones</li><li>• growth hormone-releasing hormone (GHRH)</li><li>• stimulates</li><li>• anterior pituitary</li><li>• release growth hormone</li><li>• actual production</li><li>• secretion</li><li>• growth hormone</li><li>• acidophils</li><li>• anterior pituitary</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the anterior pituitary gland , acidophils are cells that stain with acid dyes . Among the hormones they secrete , growth hormone (GH) is a primary one. Growth hormones are crucial for growth , cell reproduction , and regeneration in humans and other animals.</li><li>➤ In the anterior pituitary gland , acidophils are cells that stain with acid dyes .</li><li>➤ anterior pituitary gland</li><li>➤ stain</li><li>➤ acid dyes</li><li>➤ Among the hormones they secrete , growth hormone (GH) is a primary one. Growth hormones are crucial for growth , cell reproduction , and regeneration in humans and other animals.</li><li>➤ secrete</li><li>➤ growth hormone (GH)</li><li>➤ growth</li><li>➤ cell reproduction</li><li>➤ regeneration</li><li>➤ humans</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 301</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 301</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with complaints of Fatigue, Bone Pain, and frequent Headaches. Her medical history is significant for recurrent kidney stones. On examination, her blood pressure is elevated. Laboratory tests reveal hypercalcemia. Biopsy of the gland is done in which oxyphil cells increased in number. Where these oxyphil cells are found?", "options": [{"label": "A", "text": "Pituitary", "correct": false}, {"label": "B", "text": "Thyroid", "correct": false}, {"label": "C", "text": "Parathyroid", "correct": true}, {"label": "D", "text": "Pineal Gland", "correct": false}], "correct_answer": "C. Parathyroid", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture29.jpg"], "explanation": "<p><strong>Ans. C) Parathyroid</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The pituitary gland, or hypophysis , is a major endocrine gland involved in regulating various hormones. It contains cell types such as somatotrophs , lactotrophs , corticotrophs , thyrotrophs , and gonadotrophs , but oxyphil cells are not typically found in the pituitary gland.</li><li>• Option A.</li><li>• hypophysis</li><li>• major endocrine gland</li><li>• cell types</li><li>• somatotrophs</li><li>• lactotrophs</li><li>• corticotrophs</li><li>• thyrotrophs</li><li>• gonadotrophs</li><li>• Option B. The thyroid gland produces hormones like thyroxine (T4) and triiodothyronine (T3) that regulate metabolism . The thyroid contains follicular cells and parafollicular cells ( C cells ). Parafollicular cells secrete calcitonin , which is involved in calcium homeostasis .</li><li>• Option B.</li><li>• thyroxine</li><li>• triiodothyronine</li><li>• regulate metabolism</li><li>• thyroid</li><li>• follicular cells</li><li>• parafollicular cells</li><li>• C cells</li><li>• calcitonin</li><li>• calcium homeostasis</li><li>• Option D . The pineal gland produces melatonin , a hormone that regulates sleep patterns . The pineal gland is known for pineaocytes (cells that produce melatonin ) and other supporting cells, but it does not contain oxyphil cells.</li><li>• Option D</li><li>• melatonin</li><li>• regulates</li><li>• sleep patterns</li><li>• pineaocytes</li><li>• melatonin</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Oxyphil cells are found in the parathyroid glands . These glands are small endocrine glands in the neck that produce parathyroid hormone (PTH) , which regulates calcium levels in the blood . Oxyphil cells are distinct from the chief cells , which are the primary cells responsible for PTH production . The function of oxyphil cells is not entirely clear, but they increase in number with age.</li><li>➤ Oxyphil cells are found in the parathyroid glands . These glands are small endocrine glands in the neck that produce parathyroid hormone (PTH) , which regulates calcium levels in the blood .</li><li>➤ Oxyphil cells</li><li>➤ parathyroid glands</li><li>➤ small endocrine</li><li>➤ glands</li><li>➤ neck</li><li>➤ produce parathyroid hormone (PTH)</li><li>➤ regulates calcium levels</li><li>➤ blood</li><li>➤ Oxyphil cells are distinct from the chief cells , which are the primary cells responsible for PTH production . The function of oxyphil cells is not entirely clear, but they increase in number with age.</li><li>➤ chief cells</li><li>➤ primary cells</li><li>➤ PTH production</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 323</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 323</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In which of the layers of cerebral cortex does the outer band of Baillarger is found?", "options": [{"label": "A", "text": "Layer 1", "correct": false}, {"label": "B", "text": "Layer 4", "correct": true}, {"label": "C", "text": "Layer 6", "correct": false}, {"label": "D", "text": "Layer 2", "correct": false}], "correct_answer": "B. Layer 4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture30.jpg"], "explanation": "<p><strong>Ans. B) Layer 4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Layer 1 of the cerebral cortex, also known as the molecular layer , is the most superficial layer . It mainly contains dendrites and axons that form synapses , but it is not where the outer band of Baillarger is located. This layer has fewer cell bodies and is involved in modulating signals from other cortical layers and thalamic inputs .</li><li>• Option A. Layer 1</li><li>• molecular layer</li><li>• most superficial layer</li><li>• dendrites</li><li>• axons</li><li>• synapses</li><li>• fewer cell bodies</li><li>• modulating signals</li><li>• cortical layers</li><li>• thalamic inputs</li><li>• Option C. Layer 6 , the polymorphic or multiform layer, is the deepest layer of the cerebral cortex . It contains a variety of neuronal types, including pyramidal and fusiform cells , and plays a role in sending outputs from the cortex to the thalamus and other subcortical structures. The outer band of Baillarger is not a feature of this layer.</li><li>• Option C.</li><li>• Layer 6</li><li>• polymorphic</li><li>• multiform layer,</li><li>• deepest layer</li><li>• cerebral cortex</li><li>• pyramidal</li><li>• fusiform</li><li>• cells</li><li>• sending outputs</li><li>• cortex</li><li>• thalamus</li><li>• Option D . Layer 2 , the external granular layer , lies just beneath the molecular layer and contains small pyramidal cells and numerous stellate cells . While this layer is involved in intracortical connections , it is not where the outer band of Baillarger is found.</li><li>• Option D</li><li>• Layer 2</li><li>• external granular layer</li><li>• beneath</li><li>• molecular layer</li><li>• small pyramidal cells</li><li>• numerous stellate cells</li><li>• intracortical connections</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Layer 4 of the cerebral cortex , known as the internal granular layer , contains densely packed stellate and pyramidal cells . It is in this layer that the outer band of Baillarger is found. The bands of Baillarger are prominent in sensory areas of the cortex and consist of parallel arrays of thalamocortical axons and cortical dendrites , contributing to the processing of sensory information .</li><li>• Layer 4 of the cerebral cortex , known as the internal granular layer , contains densely packed stellate and pyramidal cells .</li><li>• cerebral cortex</li><li>• internal granular layer</li><li>• densely packed stellate</li><li>• pyramidal cells</li><li>• It is in this layer that the outer band of Baillarger is found.</li><li>• outer band</li><li>• Baillarger</li><li>• The bands of Baillarger are prominent in sensory areas of the cortex and consist of parallel arrays of thalamocortical axons and cortical dendrites , contributing to the processing of sensory information .</li><li>• sensory areas</li><li>• cortex</li><li>• parallel arrays</li><li>• thalamocortical axons</li><li>• cortical dendrites</li><li>• sensory information</li><li>• Ref : Histology, Text and Atlas Brijesh Kumar Page No. 323</li><li>• Ref</li><li>• : Histology, Text and Atlas Brijesh Kumar Page No. 323</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old man with a history alcohol abuse presents to your clinic complaining of fatigue and abdominal discomfort. In which organ are the stellate cells of von Kupffer, located in the sinusoids and involved in the immune response, typically found?", "options": [{"label": "A", "text": "Spleen", "correct": false}, {"label": "B", "text": "Liver", "correct": true}, {"label": "C", "text": "Bone Marrow", "correct": false}, {"label": "D", "text": "Adrenal", "correct": false}], "correct_answer": "B. Liver", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture38.jpg"], "explanation": "<p><strong>Ans. B) Liver</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Spleen contains sinusoids, known as splenic sinusoids , and various immune cells . Splenic sinusoids are lined by tall barrel shaped cells called stave cells .</li><li>• Option A.</li><li>• splenic sinusoids</li><li>• immune cells</li><li>• tall barrel shaped cells</li><li>• stave cells</li><li>• Option C. Bone Marrow has a rich vascular network , it does not contain Kupffer cells. The stellate cells of von Kupffer are unique to the liver .</li><li>• Option C.</li><li>• rich vascular network</li><li>• stellate cells</li><li>• von Kupffer</li><li>• liver</li><li>• Option D . Adrenal do not contain Kupffer cells. The structure and cell types of the adrenal glands are geared towards hormone production and secretion , not the filtration functions of Kupffer cells.</li><li>• Option D</li><li>• structure</li><li>• cell types</li><li>• adrenal glands</li><li>• geared</li><li>• hormone production</li><li>• secretion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The stellate cells of von Kupffer, also known as Kupffer cells , are found in the liver . Space of Disse in liver is perisinusoidal between endothelial cells lining hepatic sinusoids and hepatocytes . They are a type of macrophage located in the liver sinusoids and are responsible for phagocytosing bacteria , old red blood cells , and other debris in the blood . Kupffer cells play a crucial role in liver function and the body's immune defense.</li><li>➤ The stellate cells of von Kupffer, also known as Kupffer cells , are found in the liver .</li><li>➤ The stellate cells of von Kupffer, also known as Kupffer cells , are found in the liver .</li><li>➤ Kupffer cells</li><li>➤ liver</li><li>➤ Space of Disse in liver is perisinusoidal between endothelial cells lining hepatic sinusoids and hepatocytes .</li><li>➤ Space of Disse in liver is perisinusoidal between endothelial cells lining hepatic sinusoids and hepatocytes .</li><li>➤ Space of Disse</li><li>➤ perisinusoidal</li><li>➤ endothelial cells</li><li>➤ hepatic sinusoids</li><li>➤ hepatocytes</li><li>➤ They are a type of macrophage located in the liver sinusoids and are responsible for phagocytosing bacteria , old red blood cells , and other debris in the blood . Kupffer cells play a crucial role in liver function and the body's immune defense.</li><li>➤ They are a type of macrophage located in the liver sinusoids and are responsible for phagocytosing bacteria , old red blood cells , and other debris in the blood . Kupffer cells play a crucial role in liver function and the body's immune defense.</li><li>➤ macrophage</li><li>➤ liver sinusoids</li><li>➤ phagocytosing bacteria</li><li>➤ old red blood cells</li><li>➤ debris</li><li>➤ blood</li><li>➤ crucial role</li><li>➤ liver function</li><li>➤ body's immune defense.</li><li>➤ Ref: Histology, Text and Atlas Brijesh Kumar Page No. 207</li><li>➤ Ref: Histology, Text and Atlas Brijesh Kumar Page No. 207</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a lecture on the integumentary system, a medical student learns about the histological characteristics of various exocrine glands. Which of the following best describes the histology of ceruminous glands?", "options": [{"label": "A", "text": "Simple Tubular Glands that Secrete Sebum into Hair Follicles.", "correct": false}, {"label": "B", "text": "Coiled Tubular Glands that produce Sweat.", "correct": false}, {"label": "C", "text": "Modified Apocrine Glands that secrete Cerumen.", "correct": true}, {"label": "D", "text": "Branched Alveolar Glands that secrete Digestive Enzymes.", "correct": false}], "correct_answer": "C. Modified Apocrine Glands that secrete Cerumen.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture41.jpg"], "explanation": "<p><strong>Ans. C) Modified Apocrine Glands that secrete Cerumen.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Simple tubular glands that secrete sebum into hair follicles, is incorrect . These describe sebaceous glands , not ceruminous glands. Sebaceous glands are associated with hair follicles and secrete an oily substance called sebum .</li><li>• Option A.</li><li>• incorrect</li><li>• sebaceous glands</li><li>• hair follicles</li><li>• oily substance</li><li>• sebum</li><li>• Option B . Coiled tubular glands that produce sweat, is incorrect . This option describes eccrine sweat glands , which are found throughout the body and produce sweat to help regulate body temperature .</li><li>• Option B</li><li>• incorrect</li><li>• eccrine sweat glands</li><li>• produce sweat</li><li>• regulate body temperature</li><li>• Option D . Branched alveolar glands that secrete digestive enzymes, is incorrect . This description is more appropriate for certain glands found in the digestive system , such as the pancreas , and not for ceruminous glands.</li><li>• Option D</li><li>• incorrect</li><li>• digestive system</li><li>• pancreas</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ceruminous glands are specialized glands located in the external auditory canal . They are modified apocrine sweat glands that produce cerumen ( ear wax ), which helps to trap debris and provide a protective coating for the ear canal .</li><li>➤ Ceruminous glands are specialized glands located in the external auditory canal .</li><li>➤ glands</li><li>➤ external auditory canal</li><li>➤ They are modified apocrine sweat glands that produce cerumen ( ear wax ), which helps to trap debris and provide a protective coating for the ear canal .</li><li>➤ modified apocrine sweat glands</li><li>➤ cerumen</li><li>➤ ear wax</li><li>➤ trap debris</li><li>➤ protective coating</li><li>➤ ear canal</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 34.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 34.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pathology resident is reviewing a pancreatic biopsy under the microscope. She observes clusters of cells distinct from the exocrine pancreatic tissue. These clusters are best known for their role in endocrine function. What are these clusters of cells called?", "options": [{"label": "A", "text": "Acinar Cells", "correct": false}, {"label": "B", "text": "Brunner's Glands", "correct": false}, {"label": "C", "text": "Islets of Langerhans", "correct": true}, {"label": "D", "text": "Peyer's Patches", "correct": false}], "correct_answer": "C. Islets of Langerhans", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture42.jpg"], "explanation": "<p><strong>Ans. C) Islets of Langerhans</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Acinar cells is incorrect . Acinar cells are a part of the exocrine pancreas and are responsible for secreting digestive enzymes into the duodenum . They do not form part of the endocrine pancreas.</li><li>• Option A</li><li>• incorrect</li><li>• exocrine pancreas</li><li>• secreting digestive enzymes</li><li>• duodenum</li><li>• Option B . Brunner’s glands is incorrect . Brunner's glands are located in the submucosa of the duodenum and are not a component of the pancreas. They secrete an alkaline mucus to neutralize stomach acid entering the duodenum .</li><li>• Option B</li><li>• incorrect</li><li>• submucosa</li><li>• duodenum</li><li>• alkaline mucus</li><li>• neutralize stomach</li><li>• acid</li><li>• duodenum</li><li>• Option D . Peyer's patches, is incorrect . Peyer's patches are aggregates of lymphoid tissue found in the small intestine , particularly the ileum . They are part of the immune system and are not related to the pancreas or its functions.</li><li>• Option D</li><li>• incorrect</li><li>• aggregates</li><li>• lymphoid tissue</li><li>• small intestine</li><li>• ileum</li><li>• immune system</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Islets of Langerhans is correct. The Islets of Langerhans are the endocrine component of the pancreas . They are small , irregularly shaped clusters of cells that produce hormones like insulin, glucagon, somatostatin, and pancreatic polypeptide. These hormones play a crucial role in glucose metabolism and regulation .</li><li>➤ Islets of Langerhans is correct. The Islets of Langerhans are the endocrine component of the pancreas . They are small , irregularly shaped clusters of cells that produce hormones like insulin, glucagon, somatostatin, and pancreatic polypeptide. These hormones play a crucial role in glucose metabolism and regulation .</li><li>➤ endocrine</li><li>➤ pancreas</li><li>➤ small</li><li>➤ irregularly shaped clusters</li><li>➤ hormones</li><li>➤ glucose metabolism</li><li>➤ regulation</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 203.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 203.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pathology student is examining a biopsy specimen from a salivary gland under the microscope. Which of the following best characterizes the histological structure of a typical salivary gland?", "options": [{"label": "A", "text": "Composed primarily of Adipose Tissue with scattered Glandular Elements.", "correct": false}, {"label": "B", "text": "Contains predominantly Serous Acini with a few Mucous Cells.", "correct": false}, {"label": "C", "text": "Composed of Branching Tubuloalveolar Structures with Both Serous and Mucous Cells.", "correct": true}, {"label": "D", "text": "Characterized by the presence of Stratified Squamous Epithelium lining the Ducts.", "correct": false}], "correct_answer": "C. Composed of Branching Tubuloalveolar Structures with Both Serous and Mucous Cells.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture43.jpg"], "explanation": "<p><strong>Ans. C) Composed of Branching Tubuloalveolar Structures with Both Serous and Mucous Cells.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Composed primarily of adipose tissue with scattered glandular elements, is incorrect . Salivary glands are primarily glandular in structure, with a minimal amount of adipose tissue .</li><li>• Option A</li><li>• incorrect</li><li>• primarily glandular</li><li>• minimal amount</li><li>• adipose tissue</li><li>• Option B. Contains predominantly serous acini with a few mucous cells, is incorrect . This description partially applies to specific salivary glands like the parotid gland , which is predominantly serous . However, this does not accurately describe the histology of all salivary glands.</li><li>• Option B.</li><li>• incorrect</li><li>• applies</li><li>• specific salivary glands</li><li>• parotid gland</li><li>• serous</li><li>• Option D . Characterized by the presence of stratified squamous epithelium lining the ducts, is incorrect . The ducts of salivary glands are usually lined with a single layer of cuboidal or columnar epithelial cells , not stratified squamous epithelium.</li><li>• Option D</li><li>• incorrect</li><li>• ducts</li><li>• salivary glands</li><li>• lined</li><li>• single layer</li><li>• cuboidal</li><li>• columnar epithelial cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Salivary glands are classified as tubuloalveolar glands , and they typically contain both serous and mucous cells . The proportions of these cells vary among different salivary glands (e.g., parotid - predominantly serous , submandibular - mixed but primarily serous , sublingual - mixed but primarily mucous ).</li><li>➤ Salivary glands are classified as tubuloalveolar glands , and they typically contain both serous and mucous cells .</li><li>➤ tubuloalveolar glands</li><li>➤ both serous</li><li>➤ mucous cells</li><li>➤ The proportions of these cells vary among different salivary glands (e.g., parotid - predominantly serous , submandibular - mixed but primarily serous , sublingual - mixed but primarily mucous ).</li><li>➤ different salivary glands</li><li>➤ parotid - predominantly serous</li><li>➤ submandibular</li><li>➤ mixed</li><li>➤ serous</li><li>➤ sublingual - mixed</li><li>➤ primarily mucous</li><li>➤ Ref : Histology, Text and Atlas Brijesh kumar page no. 37.</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh kumar page no. 37.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is studying the histology of the kidney for an upcoming exam. Which of the following best describes the unique histological feature of the renal cortex?", "options": [{"label": "A", "text": "Presence of Densely Packed Renal Pyramids.", "correct": false}, {"label": "B", "text": "Abundance of Bowman's Capsules and Renal Corpuscles.", "correct": true}, {"label": "C", "text": "High Concentration of Loop of HenleS.", "correct": false}, {"label": "D", "text": "Predominance of Collecting Ducts.", "correct": false}], "correct_answer": "B. Abundance of Bowman's Capsules and Renal Corpuscles.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture44.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture45.jpg"], "explanation": "<p><strong>Ans. B) Abundance of Bowman's Capsules and Renal Corpuscles.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Presence of densely packed renal pyramids is incorrect . Renal pyramids are found in the renal medulla , not the cortex. They contain the loop of Henle and collecting ducts that are essential for urine concentration .</li><li>• Option A.</li><li>• incorrect</li><li>• Renal pyramids</li><li>• renal medulla</li><li>• loop of Henle</li><li>• collecting ducts</li><li>• essential</li><li>• urine concentration</li><li>• Option C. High concentration of loop of Henle segments, is incorrect . While the loop of Henle is an important part of the nephron , it primarily extends into the medulla , not the cortex. The medulla is where the loop of Henle plays a crucial role in the concentration of urine .</li><li>• Option C.</li><li>• incorrect</li><li>• loop of Henle</li><li>• nephron</li><li>• extends</li><li>• medulla</li><li>• loop of Henle</li><li>• concentration</li><li>• urine</li><li>• Option D. Predominance of collecting ducts, is incorrect . Collecting ducts are indeed a feature of kidney histology , but they are more prominent in the renal medulla where they converge to form the renal papillae , not the cortex.</li><li>• Option D.</li><li>• incorrect</li><li>• kidney histology</li><li>• prominent</li><li>• renal medulla</li><li>• converge</li><li>• renal papillae</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The renal cortex is characterized histologically by the presence of renal corpuscles , which include Bowman's capsules and glomeruli . These structures are key to the kidney's filtration function .</li><li>➤ The renal cortex is characterized histologically by the presence of renal corpuscles , which include Bowman's capsules and glomeruli . These structures are key to the kidney's filtration function .</li><li>➤ histologically</li><li>➤ presence</li><li>➤ renal corpuscles</li><li>➤ Bowman's capsules</li><li>➤ glomeruli</li><li>➤ kidney's filtration function</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 228.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 228.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A pathology resident is examining a biopsy of the suprarenal (adrenal) gland under the microscope. Which of the following best describes the histological structure of the adrenal gland?", "options": [{"label": "A", "text": "The Cortex consists predominantly of Follicular Cells that secrete Thyroid Hormones.", "correct": false}, {"label": "B", "text": "The Medulla is mainly composed of Chromaffin Cells that secrete Catecholamines.", "correct": true}, {"label": "C", "text": "The Cortex is characterized by the presence of Peyer's Patches.", "correct": false}, {"label": "D", "text": "The Medulla contains Hepatocytes that are involved in Bile Production.", "correct": false}], "correct_answer": "B. The Medulla is mainly composed of Chromaffin Cells that secrete Catecholamines.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture46.jpg"], "explanation": "<p><strong>Ans. B) The Medulla is mainly composed of Chromaffin Cells that secrete Catecholamines.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The cortex consists predominantly of follicular cells that secrete thyroid hormones, is incorrect . Follicular cells are characteristic of the thyroid gland , not the adrenal gland. The adrenal cortex is instead known for its layers ( zona glomerulosa , zona fasciculata , and zona reticularis ) that secrete different steroid hormones .</li><li>• Option A.</li><li>• incorrect</li><li>• Follicular cells</li><li>• thyroid gland</li><li>• layers</li><li>• zona glomerulosa</li><li>• zona fasciculata</li><li>• zona reticularis</li><li>• secrete</li><li>• steroid hormones</li><li>• Option C . The cortex is characterized by the presence of Peyer's patches, is incorrect . Peyer's patches are aggregates of lymphoid tissue found in the small intestine and are not related to the adrenal gland.</li><li>• Option C</li><li>• incorrect</li><li>• aggregates</li><li>• lymphoid tissue</li><li>• small intestine</li><li>• Option D. The medulla contains hepatocytes that are involved in bile production, is incorrect . Hepatocytes are liver cells involved in bile production , not cells found in the adrenal gland.</li><li>• Option D.</li><li>• incorrect</li><li>• Hepatocytes</li><li>• liver</li><li>• cells</li><li>• bile production</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The adrenal medulla contains chromaffin cells , which secrete catecholamines such as epinephrine ( adrenaline ) and norepinephrine ( noradrenaline ). These hormones play a crucial role in the body's fight - or-flight response .</li><li>➤ The adrenal medulla contains chromaffin cells , which secrete catecholamines such as epinephrine ( adrenaline ) and norepinephrine ( noradrenaline ). These hormones play a crucial role in the body's fight - or-flight response .</li><li>➤ chromaffin cells</li><li>➤ secrete catecholamines</li><li>➤ epinephrine</li><li>➤ adrenaline</li><li>➤ norepinephrine</li><li>➤ noradrenaline</li><li>➤ body's fight</li><li>➤ or-flight response</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 309.</li><li>➤ Ref</li><li>➤ : Histology, Text and Atlas Brijesh Kumar Page No. 309.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is examining a histological slide of adipose tissue during a pathology class. Which of the following features distinguishes brown adipose tissue from white adipose tissue?", "options": [{"label": "A", "text": "Large, Singular Lipid Droplet occupying most of the Cell.", "correct": false}, {"label": "B", "text": "Multilocular appearance with numerous Small Lipid Droplets.", "correct": true}, {"label": "C", "text": "Presence of Large, Centrally located Nuclei.", "correct": false}, {"label": "D", "text": "Sparse Vascularization and Innervation.", "correct": false}], "correct_answer": "B. Multilocular appearance with numerous Small Lipid Droplets.", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture47.jpg"], "explanation": "<p><strong>Ans. B) Multilocular appearance with numerous Small Lipid Droplets.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . Large, singular lipid droplet occupying most of the cell, is incorrect . This description is characteristic of white adipose tissue , not brown adipose tissue. White adipose cells typically contain a single large lipid droplet that pushes the nucleus to the periphery of the cell .</li><li>• Option A</li><li>• incorrect</li><li>• white adipose tissue</li><li>• single large lipid droplet</li><li>• pushes</li><li>• nucleus</li><li>• periphery</li><li>• cell</li><li>• Option C . Presence of large, centrally located nuclei, is incorrect . While the nuclei in brown adipose cells tend to be more centrally located than in white adipose cells , this is not a distinguishing feature, as the central location of nuclei can also occur in other cell types.</li><li>• Option C</li><li>• incorrect</li><li>• brown adipose cells</li><li>• centrally</li><li>• white adipose cells</li><li>• Option D . Sparse vascularization and innervation is incorrect . Brown adipose tissue is actually highly vascularized and innervated , which is essential for its role in heat production and energy metabolism . In contrast, white adipose tissue has relatively less vascularization and innervation .</li><li>• Option D</li><li>• incorrect</li><li>• Brown adipose tissue</li><li>• highly vascularized</li><li>• innervated</li><li>• role</li><li>• heat production</li><li>• energy metabolism</li><li>• white adipose tissue</li><li>• less vascularization</li><li>• innervation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Brown adipose tissue is characterized by its multilocular appearance , meaning the cells contain multiple small lipid droplets. This feature, along with a high density of mitochondria , contributes to the tissue's brown color and is crucial for its role in thermogenesis .</li><li>➤ Brown adipose tissue is characterized by its multilocular appearance , meaning the cells contain multiple small lipid droplets.</li><li>➤ Brown adipose tissue</li><li>➤ multilocular appearance</li><li>➤ This feature, along with a high density of mitochondria , contributes to the tissue's brown color and is crucial for its role in thermogenesis .</li><li>➤ high density</li><li>➤ mitochondria</li><li>➤ brown color</li><li>➤ role</li><li>➤ thermogenesis</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 49.</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 49.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A Medical Student is studying the Histological Structure of the Retina for her Ophthalmology Rotation. Which of the following layers of the Retina contains the Cell Bodies of the Rods and Cones?", "options": [{"label": "A", "text": "Ganglion Cell Layer", "correct": false}, {"label": "B", "text": "Outer Nuclear Layer", "correct": true}, {"label": "C", "text": "Inner Nuclear Layer", "correct": false}, {"label": "D", "text": "Outer Plexiform Layer", "correct": false}], "correct_answer": "B. Outer Nuclear Layer", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/13/picture48.jpg"], "explanation": "<p><strong>Ans. B) Outer Nuclear Layer</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The ganglion cell layer contains the cell bodies of the retinal ganglion cells , which are the output neurons of the retina . Their axons form the optic nerve .</li><li>• Option A</li><li>• cell bodies</li><li>• retinal ganglion cells</li><li>• output neurons</li><li>• retina</li><li>• optic nerve</li><li>• Option C. Inner nuclear layer is incorrect . The inner nuclear layer contains the cell bodies of bipolar cells , horizontal cells , and amacrine cells . These cells are involved in processing visual information before it reaches the ganglion cells .</li><li>• Option C.</li><li>• incorrect</li><li>• cell bodies</li><li>• bipolar cells</li><li>• horizontal cells</li><li>• amacrine cells</li><li>• before it</li><li>• reaches</li><li>• ganglion cells</li><li>• Option D. Outer plexiform layer is incorrect . The outer plexiform layer contains the synapses between the photoreceptors ( rods and cones ) and the bipolar cells . It is not where the cell bodies of the rods and cones are located.</li><li>• Option D.</li><li>• incorrect</li><li>• synapses between</li><li>• photoreceptors</li><li>• rods</li><li>• cones</li><li>• bipolar cells</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The outer nuclear layer of the retina contains the cell bodies of the photoreceptors , which are the rods and cones . These cells are responsible for converting light into electrical signals , the first step in the visual pathway .</li><li>➤ The outer nuclear layer of the retina contains the cell bodies of the photoreceptors , which are the rods and cones . These cells are responsible for converting light into electrical signals , the first step in the visual pathway .</li><li>➤ cell bodies</li><li>➤ photoreceptors</li><li>➤ rods</li><li>➤ cones</li><li>➤ converting light</li><li>➤ electrical signals</li><li>➤ first step</li><li>➤ visual pathway</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 350</li><li>➤ Ref : Histology, Text and Atlas Brijesh Kumar Page No. 350</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 85 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 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<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 67-year-old female told her physician that she could walk only 60 yards per day, following which she developed a cramp like pain, fatigue, heaviness in her left side lower thigh and calf. Unable to continue her walk, she was forced to rest. After a thorough physical examination, a diagnosis of severe intermittent claudication of the left lower limb was made. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Femoral Pulse Normal in Both Limbs", "correct": false}, {"label": "B", "text": "The Popliteal, Posterior Tibial, and Dorsalis Pedis pulses were present in the Right Leg and completely absent in the Left Leg", "correct": false}, {"label": "C", "text": "Arteriography revealed a Blockage of the Left Femoral Artery at the level of the Adductor Tubercle", "correct": false}, {"label": "D", "text": "The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery", "correct": true}], "correct_answer": "D. The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture14_vg54P80.jpg"], "explanation": "<p><strong>Ans. D) The Perforating Branches of the Profunda Femoris Artery did not participate in the Collateral Circulation around the Blocked Femoral Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. In cases of intermittent claudication , the femoral pulse may still be palpable if the blockage is distal to the site where the pulse is assessed . The presence of a normal femoral pulse does not exclude the possibility of arterial blockages in more distal areas of the leg.</li><li>• Option A.</li><li>• intermittent claudication</li><li>• femoral pulse</li><li>• palpable</li><li>• blockage</li><li>• distal</li><li>• pulse</li><li>• assessed</li><li>• Option B. The absence of pulses in the popliteal , posterior tibial , and dorsalis pedis arteries in the left leg suggests a significant obstruction in the arterial supply to this limb , while their presence in the right leg indicates normal blood flow there.</li><li>• Option B.</li><li>• absence</li><li>• pulses</li><li>• popliteal</li><li>• posterior tibial</li><li>• dorsalis pedis arteries</li><li>• left leg</li><li>• significant obstruction</li><li>• arterial supply</li><li>• limb</li><li>• presence</li><li>• right leg</li><li>• Option C . A blockage in the left femoral artery at the level of the adductor tubercle could lead to reduced blood flow to the left lower limb , resulting in pain and cramping due to intermittent claudication.</li><li>• Option C</li><li>• left femoral artery</li><li>• adductor tubercle</li><li>• lead</li><li>• reduced blood flow</li><li>• left lower limb</li><li>• pain</li><li>• cramping</li><li>• intermittent claudication.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In cases of arterial blockage , collateral circulation often develops to bypass the obstruction . The profunda femoris artery , particularly its perforating branches , plays a crucial role in forming collateral circulation around a blocked femoral artery . These branches provide alternative pathways for blood flow , potentially reducing the severity of symptoms.</li><li>• arterial blockage</li><li>• collateral circulation</li><li>• bypass</li><li>• obstruction</li><li>• profunda femoris artery</li><li>• perforating</li><li>• branches</li><li>• collateral circulation</li><li>• blocked femoral artery</li><li>• alternative pathways</li><li>• blood flow</li><li>• reducing</li><li>• severity</li><li>• symptoms.</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1367</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg No. 1367</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During routine dissection classes of the first year of MBBS, in the region of popliteal fossa, a thick fascial ballooning existed on the posteromedial side, between the medial head of gastrocnemius and semimembranosus. This cystic swelling was noted to be in continuation with the capsule of the knee joint. Which one of the following statements is not true?", "options": [{"label": "A", "text": "Baker Cysts are Asymptomatic", "correct": false}, {"label": "B", "text": "Can compress Common Peroneal Nerve", "correct": true}, {"label": "C", "text": "Occur as a complication of Chronic Knee Joint Effusion", "correct": false}, {"label": "D", "text": "May communicate with Joint Cavity", "correct": false}], "correct_answer": "B. Can compress Common Peroneal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture15_rEz8vzL.jpg"], "explanation": "<p><strong>Ans. B) Can compress Common Peroneal Nerve</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The common peroneal nerve runs laterally around the neck of the fibula , whereas Baker's cysts are located in the medial aspect of the popliteal fossa . Compression or entrapment syndromes involving Baker's cysts more commonly affect structures like the popliteal vein or artery .</li><li>➤ The common peroneal nerve runs laterally around the neck of the fibula , whereas Baker's cysts are located in the medial aspect of the popliteal fossa .</li><li>➤ laterally</li><li>➤ neck</li><li>➤ fibula</li><li>➤ Baker's cysts</li><li>➤ medial aspect</li><li>➤ popliteal fossa</li><li>➤ Compression or entrapment syndromes involving Baker's cysts more commonly affect structures like the popliteal vein or artery .</li><li>➤ Compression</li><li>➤ entrapment syndromes</li><li>➤ affect structures</li><li>➤ popliteal vein</li><li>➤ artery</li><li>➤ Ref : Gray’s Anatomy 41 st Edition, Pg No. 1383</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st Edition, Pg No. 1383</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old man with a sedentary lifestyle presents with chronic lower extremity edema. On examination, his calf muscles appear underdeveloped. The physician explains the importance of a particular lower limb muscle in venous blood return from the lower extremities. Which muscle is often referred to as the \"peripheral heart\" due to its role in facilitating venous return?", "options": [{"label": "A", "text": "Gastrocnemius", "correct": false}, {"label": "B", "text": "Soleus", "correct": true}, {"label": "C", "text": "Tibialis Anterior", "correct": false}, {"label": "D", "text": "Peroneus Longus", "correct": false}], "correct_answer": "B. Soleus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture57.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture58.jpg"], "explanation": "<p><strong>Ans. B) Soleus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Although the gastrocnemius muscle assists in venous return by pumping blood towards the heart during movement, it is not typically referred to as the \"peripheral heart.\" This term is more specifically associated with the soleus muscle .</li><li>• Option A</li><li>• gastrocnemius muscle</li><li>• venous return</li><li>• pumping blood</li><li>• heart</li><li>• soleus muscle</li><li>• Option C. The tibialis anterior is primarily involved in dorsiflexion of the foot and does not have a major role in facilitating venous return.</li><li>• Option C.</li><li>• dorsiflexion</li><li>• foot</li><li>• Option D. The primary function of the peroneus longus is to evert the foot and stabilize the ankle during walking . It is not significantly involved in aiding venous return.</li><li>• Option D.</li><li>• evert</li><li>• foot</li><li>• stabilize</li><li>• ankle</li><li>• walking</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The soleus muscle, due to its continuous slow-twitch muscle contractions , plays a significant role in pumping venous blood from the lower extremities back to the heart . This function is crucial , especially in individuals who are sedentary , to prevent venous stasis and related complications like edema .</li><li>➤ The soleus muscle, due to its continuous slow-twitch muscle contractions , plays a significant role in pumping venous blood from the lower extremities back to the heart . This function is crucial , especially in individuals who are sedentary , to prevent venous stasis and related complications like edema .</li><li>➤ continuous slow-twitch muscle contractions</li><li>➤ pumping venous blood</li><li>➤ lower extremities</li><li>➤ heart</li><li>➤ crucial</li><li>➤ sedentary</li><li>➤ prevent venous stasis</li><li>➤ edema</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 411.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 411.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old woman after an automobile accident was found to have an unstable right knee joint. On examination, it was possible to pull the Tibia excessively forward on the Femur. A diagnosis of Ruptured Anterior Cruciate Ligament was made. The following statements concerning this patient are correct except:", "options": [{"label": "A", "text": "Anterior Cruciate Ligament (ACL) is attached to Anterior part of Intercondylar Area of Tibia", "correct": false}, {"label": "B", "text": "It extends Upwards Backwards and Medially to attach to Medial Condyle of Femur", "correct": true}, {"label": "C", "text": "It forms a Vertical Axis for Femur rotation on Tibia", "correct": false}, {"label": "D", "text": "It is taut during Extension of Knee Joint", "correct": false}], "correct_answer": "B. It extends Upwards Backwards and Medially to attach to Medial Condyle of Femur", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture16_nC3rHyo.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture17_85wiqWz.jpg"], "explanation": "<p><strong>Ans. B) It extends Upwards Backwards and Medially to attach to Medial Condyle of Femur</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterior Cruciate Ligament (ACL) is Attached to Anterior Part of Intercondylar Area of Tibia: The ACL originates from the anterior intercondylar area of the tibia . It plays a crucial role in stabilizing the knee by preventing the tibia from sliding out in front of the femur . Cruciate ligaments are intracapsular .</li><li>• Option A. Anterior Cruciate Ligament (ACL) is Attached to Anterior Part of Intercondylar Area of Tibia:</li><li>• originates</li><li>• anterior intercondylar area</li><li>• tibia</li><li>• stabilizing</li><li>• knee</li><li>• preventing</li><li>• tibia</li><li>• sliding out</li><li>• front</li><li>• femur</li><li>• Cruciate ligaments</li><li>• intracapsular</li><li>• Option C. It Forms a Vertical Axis for Femur Rotation on Tibia: While the ACL does play a role in the rotational stability of the knee , describing it as forming a \" vertical axis \" for femur rotation on the tibia might be a bit misleading . The ACL primarily prevents anterior translation of the tibia relative to the femur . It also helps to limit rotation , but this is not its primary function.</li><li>• Option C. It Forms a Vertical Axis for Femur Rotation on Tibia:</li><li>• rotational stability</li><li>• knee</li><li>• vertical axis</li><li>• femur rotation</li><li>• misleading</li><li>• anterior translation</li><li>• tibia</li><li>• femur</li><li>• limit rotation</li><li>• Option D. It is Taut During Extension of Knee Joint: The ACL is indeed taut during knee extension . This tension is important for stabilizing the knee , especially in activities that involve straightening the leg , like walking or kicking . When the knee is extended , the ACL helps prevent hyperextension and anterior translation of the tibia .</li><li>• Option D. It is Taut During Extension of Knee Joint:</li><li>• taut</li><li>• knee</li><li>• extension</li><li>• stabilizing</li><li>• knee</li><li>• straightening</li><li>• leg</li><li>• walking</li><li>• kicking</li><li>• extended</li><li>• hyperextension</li><li>• anterior translation</li><li>• tibia</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The ACL actually extends upwards, backwards , and laterally to attach to the lateral femoral condyle . Its pathway is crucial for its function in controlling the movements of the tibia and femur .</li><li>• The ACL actually extends upwards, backwards , and laterally to attach to the lateral femoral condyle .</li><li>• upwards, backwards</li><li>• laterally</li><li>• attach</li><li>• lateral femoral condyle</li><li>• Its pathway is crucial for its function in controlling the movements of the tibia and femur .</li><li>• controlling</li><li>• movements</li><li>• tibia</li><li>• femur</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1390</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1390</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old female experienced severe pain over the anteromedial aspect of her right knee for the past three months. When the pain got aggravated by her routine activities, she fixed an appointment with her orthopedician, who after examining her, suggested her to take a CT scan. The given image is the CT scan report of the right knee of this patient. Which among the following statements is true about the structure pointed in the given image?", "options": [{"label": "A", "text": "It is Narrow Anteriorly and wide Posteriorly", "correct": false}, {"label": "B", "text": "The Anterior Horn of Lateral Meniscus is the Anterior most structure attached here", "correct": false}, {"label": "C", "text": "The Posterior Cruciate Ligament is the Posterior most structure attached here", "correct": true}, {"label": "D", "text": "The Maximum Transverse Diameter is in the Middle", "correct": false}], "correct_answer": "C. The Posterior Cruciate Ligament is the Posterior most structure attached here", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture18_xdZJedw.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture20_rO5mKsn.jpg"], "explanation": "<p><strong>Ans. C) The Posterior Cruciate Ligament is the Posterior most structure attached here</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. This statement is incorrect as the intercondylar area is wide anteriorly and narrow posteriorly .</li><li>• Option A.</li><li>• incorrect</li><li>• intercondylar area</li><li>• wide anteriorly</li><li>• narrow posteriorly</li><li>• Option B . This statement is also incorrect as the anterior horn of medial meniscus is the anterior most structure attached here.</li><li>• Option B</li><li>• incorrect</li><li>• anterior horn</li><li>• medial meniscus</li><li>• anterior</li><li>• Option D. The maximum transverse diameter of the intercondylar area is in the posterior part of the area , not in the middle. The intercondylar eminence , a bony prominence within this area , contributes to this posterior width .</li><li>• Option D.</li><li>• intercondylar area</li><li>• posterior</li><li>• area</li><li>• intercondylar eminence</li><li>• bony prominence</li><li>• area</li><li>• posterior width</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The posterior cruciate ligament (PCL) attaches to the posterior intercondylar area of the tibia and to the femur above. The PCL is indeed one of the posteriors most structures in the knee joint , particularly in its attachment to the tibia .</li><li>➤ The posterior cruciate ligament (PCL) attaches to the posterior intercondylar area of the tibia and to the femur above.</li><li>➤ posterior intercondylar area</li><li>➤ tibia</li><li>➤ femur</li><li>➤ The PCL is indeed one of the posteriors most structures in the knee joint , particularly in its attachment to the tibia .</li><li>➤ posteriors</li><li>➤ knee joint</li><li>➤ tibia</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male patient presents with a complaint of difficulty in walking. On observation, he exhibits a distinctive gait where he sways from side to side, with his torso shifting over the stance leg during walking. This Gait pattern is most likely indicative of Weakness in which of the following Muscle Groups?", "options": [{"label": "A", "text": "Hip Flexors", "correct": false}, {"label": "B", "text": "Hip Abductors", "correct": true}, {"label": "C", "text": "Hip Extensors", "correct": false}, {"label": "D", "text": "Ankle Dorsiflexors", "correct": false}], "correct_answer": "B. Hip Abductors", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture54.jpg"], "explanation": "<p><strong>Ans. B) Hip Abductors</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Weakness in the hip flexors usually results in an inability to lift the knee adequately during the swing phase of gait , leading to a \" steppage\" gait , not a lurching or waddling gait.</li><li>• Option A</li><li>• Weakness</li><li>• results</li><li>• inability</li><li>• lift</li><li>• knee adequately</li><li>• swing phase</li><li>• gait</li><li>• steppage\" gait</li><li>• Option C . Weakness in the hip extensors , like the gluteus maximus , would lead to difficulty in propelling the body forward during the stance phase of gait but would not typically result in a waddling or lurching gait.</li><li>• Option C</li><li>• hip extensors</li><li>• gluteus maximus</li><li>• difficulty</li><li>• propelling</li><li>• stance phase</li><li>• gait</li><li>• Option D . Weakness in the ankle dorsiflexors leads to foot drop , characterized by a high-stepping type of gait to prevent the toes from dragging , not a waddling gait.</li><li>• Option D</li><li>• ankle dorsiflexors</li><li>• foot drop</li><li>• high-stepping</li><li>• gait</li><li>• prevent</li><li>• toes</li><li>• dragging</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Weakness in the hip abductors, particularly the gluteus medius and minimus , leads to a waddling gait , where the patient shifts the body weight over the stance leg to compensate for the instability . This is also seen in bilateral Trendelenburg gait .</li><li>➤ Weakness in the hip abductors, particularly the gluteus medius and minimus , leads to a waddling gait , where the patient shifts the body weight over the stance leg to compensate for the instability . This is also seen in bilateral Trendelenburg gait .</li><li>➤ Weakness</li><li>➤ gluteus medius</li><li>➤ minimus</li><li>➤ leads</li><li>➤ waddling gait</li><li>➤ shifts</li><li>➤ body weight</li><li>➤ stance leg</li><li>➤ compensate</li><li>➤ instability</li><li>➤ bilateral Trendelenburg gait</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 360.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 360.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30 year old female presented to the orthopedician with complaints of pain behind the right knee and pain over the right leg. She said that pain increased with ambulation, forward flexion and on ascending stairs. On examination of the right knee in semiflexed position, a palpable pulsatile mass was felt at the level of the knee joint. The patient was diagnosed with popliteal artery aneurysm after seeing its features in an MRI. Surgery was planned. Which of the following statements is true pertaining to this case?", "options": [{"label": "A", "text": "The Popliteal Artery divides at the Inferior Angle of Popliteal Fossa into its Terminal Branches", "correct": false}, {"label": "B", "text": "The Artery lies in Close Contact with the Roof of the Popliteal Fossa", "correct": false}, {"label": "C", "text": "The Popliteal Vein intervenes between the Popliteal Artery &amp; Tibial Nerve", "correct": true}, {"label": "D", "text": "Cutaneous Branches from Popliteal Artery supply Lower part of Back of Thigh", "correct": false}], "correct_answer": "C. The Popliteal Vein intervenes between the Popliteal Artery & Tibial Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture21_m84n6zl.jpg"], "explanation": "<p><strong>Ans. C) The Popliteal Vein intervenes between the Popliteal Artery &amp; Tibial Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The Popliteal Artery Divides at the Inferior Angle of Popliteal Fossa into its Terminal Branches: It is the continuation of femoral artery . It begins at the adductor hiatus , crosses the floor of popliteal fossa from the medial to lateral side to reach the lower border of the popliteus where it terminates by dividing into anterior and posterior tibial arteries .</li><li>• Option A</li><li>• femoral artery</li><li>• adductor hiatus</li><li>• popliteal fossa</li><li>• medial</li><li>• lateral side</li><li>• lower border</li><li>• popliteus</li><li>• terminates</li><li>• anterior and posterior tibial arteries</li><li>• Option B. The Artery Lies in Close Contact with the Roof of the Popliteal Fossa: The popliteal fossa is a diamond-shaped space at the back of the knee . The popliteal artery lies deep in the popliteal fossa , closer to the floor rather than the roof. The roof of the popliteal fossa is formed by skin and fascia , and the artery is located deeper , beneath muscles and near the joint capsule .</li><li>• Option B.</li><li>• diamond-shaped space</li><li>• back</li><li>• knee</li><li>• popliteal artery</li><li>• deep</li><li>• popliteal fossa</li><li>• closer</li><li>• floor</li><li>• roof</li><li>• skin</li><li>• fascia</li><li>• deeper</li><li>• muscles</li><li>• joint capsule</li><li>• Option D. Cutaneous Branches from Popliteal Artery Supply Lower Part of Back of Thigh: Cutaneous branches supply skin , and the popliteal artery primarily supplies deeper structures . The popliteal artery does not give off cutaneous branches for the skin of the thigh. The skin of the thigh is mainly supplied by other arteries, such as branches from the femoral artery .</li><li>• Option D.</li><li>• Cutaneous branches</li><li>• skin</li><li>• popliteal artery</li><li>• supplies deeper structures</li><li>• skin</li><li>• thigh</li><li>• branches</li><li>• femoral artery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The popliteal fossa contains the popliteal artery , vein , and the tibial nerve , among other structures. In the popliteal fossa , the popliteal vein typically lies superficial to the popliteal artery , and the tibial nerve is the most superficial of the three. So, the vein does intervene between the artery and the nerve.</li><li>• The popliteal fossa contains the popliteal artery , vein , and the tibial nerve , among other structures.</li><li>• popliteal artery</li><li>• vein</li><li>• tibial nerve</li><li>• In the popliteal fossa , the popliteal vein typically lies superficial to the popliteal artery , and the tibial nerve is the most superficial of the three. So, the vein does intervene between the artery and the nerve.</li><li>• popliteal fossa</li><li>• popliteal vein</li><li>• superficial</li><li>• popliteal artery</li><li>• tibial nerve</li><li>• most superficial</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 363</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 363</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man presents with a complaint of dragging his foot while walking. On examination, he demonstrates difficulty in dorsiflexing his foot at the ankle. This clinical presentation is most likely due to a lesion affecting which nerve?", "options": [{"label": "A", "text": "Sciatic Nerve", "correct": false}, {"label": "B", "text": "Deep Peroneal (Fibular) Nerve", "correct": true}, {"label": "C", "text": "Tibial Nerve", "correct": false}, {"label": "D", "text": "Sural Nerve", "correct": false}], "correct_answer": "B. Deep Peroneal (Fibular) Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture61.jpg"], "explanation": "<p><strong>Ans. B) Deep Peroneal (Fibular) Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A . While the sciatic nerve is a major nerve of the lower limb , a lesion to this nerve would likely cause more extensive deficits , including weakness in the muscles of the thigh and possibly the lower leg , not isolated foot drop.</li><li>• Option A</li><li>• major nerve</li><li>• lower limb</li><li>• more extensive deficits</li><li>• weakness</li><li>• muscles</li><li>• thigh</li><li>• lower leg</li><li>• Option C . The tibial nerve primarily innervates the plantar flexors of the foot . A lesion here would more likely affect plantar flexion , not dorsiflexion.</li><li>• Option C</li><li>• innervates</li><li>• plantar flexors</li><li>• foot</li><li>• affect plantar flexion</li><li>• Option D. The sural nerve is a sensory nerve and does not innervate the muscles of the foot. A lesion of the sural nerve would cause sensory deficits , not motor deficits like foot drop.</li><li>• Option D.</li><li>• sensory nerve</li><li>• sensory deficits</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The deep peroneal (fibular) nerve innervates the dorsiflexors of the foot , including the tibialis anterior muscle . A lesion to this nerve can result in foot drop , characterized by the inability to dorsiflex the foot .</li><li>➤ The deep peroneal (fibular) nerve innervates the dorsiflexors of the foot , including the tibialis anterior muscle .</li><li>➤ dorsiflexors</li><li>➤ foot</li><li>➤ tibialis anterior muscle</li><li>➤ A lesion to this nerve can result in foot drop , characterized by the inability to dorsiflex the foot .</li><li>➤ result</li><li>➤ foot drop</li><li>➤ inability</li><li>➤ dorsiflex the foot</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 473.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 473.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old professional football player presents with difficulty in kicking a ball. He reports a recent history of decreased strength during knee extension. Additionally, in a separate case, a child with a history of poliomyelitis is observed using his hand to push against his knee to assist in walking. Which muscle group is primarily responsible for knee extension and is likely affected in both cases?", "options": [{"label": "A", "text": "Hamstrings", "correct": false}, {"label": "B", "text": "Gastrocnemius", "correct": false}, {"label": "C", "text": "Quadriceps Femoris", "correct": true}, {"label": "D", "text": "Tibialis Anterior", "correct": false}], "correct_answer": "C. Quadriceps Femoris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture55_SxvCf4K.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture56.jpg"], "explanation": "<p><strong>Ans. C) Quadriceps Femoris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. The hamstrings are primarily responsible for knee flexion and hip extension , not knee extension. Weakness in the hamstrings would not typically result in difficulty with knee extension or a hand-to-knee gait.</li><li>• Option A.</li><li>• knee flexion</li><li>• hip extension</li><li>• Option B . The gastrocnemius muscle is a calf muscle that contributes to plantarflexion of the ankle , not knee extension. It would not be the primary muscle involved in the described symptoms.</li><li>• Option B</li><li>• calf muscle</li><li>• plantarflexion</li><li>• ankle</li><li>• Option D. Tibialis Anterior muscle primarily facilitates dorsiflexion of the foot . While important for normal gait , it is not involved in knee extension.</li><li>• Option D.</li><li>• facilitates dorsiflexion</li><li>• foot</li><li>• normal gait</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The quadriceps femoris is the main muscle group responsible for knee extension . In athletes like footballers , quadriceps strength is crucial for actions like kicking . In poliomyelitis , weakness of the quadriceps can lead to difficulty in knee extension , necessitating compensatory maneuvers like the hand-to-knee gait to assist in walking .</li><li>➤ main muscle group</li><li>➤ knee extension</li><li>➤ footballers</li><li>➤ crucial</li><li>➤ actions</li><li>➤ kicking</li><li>➤ poliomyelitis</li><li>➤ weakness</li><li>➤ difficulty</li><li>➤ knee extension</li><li>➤ compensatory</li><li>➤ maneuvers</li><li>➤ hand-to-knee gait</li><li>➤ assist</li><li>➤ walking</li><li>➤ Hand to knee gait : seen in Poliomyelitis due to involvement of Quadriceps femoris .</li><li>➤ Hand to knee gait</li><li>➤ Poliomyelitis</li><li>➤ Quadriceps femoris</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 44-year-old man presented to the emergency department with a history of roadside accident after suddenly applying brakes in a high velocity car. There was no history suggestive of chest, abdominal, facial, head, or spinal injury, ear, or nose bleeding. The vital signs were stable, and the main complaints were pain, gross swelling and painful restriction of movements of knee joints. Clinical examination on admission revealed a healthy male, who was fully conscious and oriented with a GCS score of 15. Clinical examination of the head and neck, chest, abdomen and spine, and pelvis showed normal results. The lower limb examination revealed grossly swollen knee joints with abrasions over both knees. There was a transverse lacerated wound in the right knee that was stitched at the primary health centre where the patient took first aid after trauma before being referred to our institute. Distal circulation and neurology in both lower limbs were normal. X-rays on bilateral knee joints showed transverse fracture of right patella and Comminuted fracture of left patella. Which of the following statements is true pertaining to the above case?", "options": [{"label": "A", "text": "Apex of the Patella is directed above gives attachment to Quadriceps", "correct": false}, {"label": "B", "text": "Medial Border of Patella gives attachment to Medial Patellar Retinaculum in its Lower 2/3", "correct": false}, {"label": "C", "text": "Suprapatellar Bursa separates Anterior Surface of Patella from the Overlying Skin", "correct": false}, {"label": "D", "text": "The Hoffa’s Fat Pad is situated under and behind the Patella Bone", "correct": true}], "correct_answer": "D. The Hoffa’s Fat Pad is situated under and behind the Patella Bone", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture22_kFyV0D6.jpg"], "explanation": "<p><strong>Ans. D) The Hoffa’s Fat Pad is situated under and behind the Patella Bone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Apex of the patella is directed above gives attachment to quadriceps: The apex of the patella is the pointed , inferior portion of the patella . The superior , broader portion of the patella is called the base . The quadriceps tendon attaches to the base of the patella , not the apex. The apex of the patella gives attachment to the patellar ligament , which continues down to attach to the tibial tuberosity .</li><li>• Option A</li><li>• pointed</li><li>• inferior portion</li><li>• patella</li><li>• superior</li><li>• broader portion</li><li>• base</li><li>• quadriceps tendon</li><li>• base</li><li>• patella</li><li>• apex</li><li>• patellar ligament</li><li>• continues down</li><li>• tibial tuberosity</li><li>• Option B . Medial border of patella gives attachment to medial patellar retinaculum in its lower 2/3: The medial patellar retinaculum is a fibrous expansion that helps to stabilize the patella , preventing it from lateral dislocation . It attaches to the medial border of the patella . However, it's not limited to the lower 2/3 but attaches along the entire length of the medial border.</li><li>• Option B</li><li>• medial patellar retinaculum</li><li>• fibrous expansion</li><li>• stabilize</li><li>• patella</li><li>• lateral dislocation</li><li>• medial border</li><li>• patella</li><li>• Option C. Suprapatellar bursa separates anterior surface of patella from the overlying skin : The suprapatellar bursa is an extension of the knee joint capsule and is located superior to the patella . It facilitates smooth movement between the quadriceps tendon and the underlying femoral condyles . The structure that separates the anterior surface of the patella from the overlying skin is the prepatellar bursa .</li><li>• Option C.</li><li>• suprapatellar bursa</li><li>• extension</li><li>• knee joint capsule</li><li>• superior</li><li>• patella</li><li>• facilitates smooth movement</li><li>• quadriceps tendon</li><li>• underlying femoral condyles</li><li>• separates</li><li>• anterior surface</li><li>• patella</li><li>• overlying skin</li><li>• prepatellar bursa</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The Hoffa’s fat pad, also known as the infrapatellar fat pad , is a fatty tissue located underneath (inferior to) the patella and posterior to the patellar ligament . It acts as a cushion , protecting the knee joint and reducing friction during knee movements. In the given case scenario, injuries to the patella might have implications on the Hoffa's fat pad , depending on the severity and exact location of the fractures.</li><li>• The Hoffa’s fat pad, also known as the infrapatellar fat pad , is a fatty tissue located underneath (inferior to) the patella and posterior to the patellar ligament .</li><li>• infrapatellar fat pad</li><li>• fatty tissue</li><li>• underneath</li><li>• patella</li><li>• posterior</li><li>• patellar ligament</li><li>• It acts as a cushion , protecting the knee joint and reducing friction during knee movements. In the given case scenario, injuries to the patella might have implications on the Hoffa's fat pad , depending on the severity and exact location of the fractures.</li><li>• cushion</li><li>• protecting</li><li>• knee joint</li><li>• reducing friction</li><li>• injuries</li><li>• patella</li><li>• Hoffa's fat pad</li><li>• severity</li><li>• exact location</li><li>• fractures.</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 300</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 300</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old woman suffered from pain in the sole of her right foot, which was aggravated by active plantar flexion or passive extension of the ankle. Computed tomography and magnetic resonance imaging revealed a hypertrophic lesion in the right popliteus muscle. The tibial nerve was pushed posteriorly by the lesion and compressed by the arch of the soleus. The arch of the soleus was divided surgically. Pain was resolved immediately after the surgery, and significant neurologic recovery was observed 1 year after the surgical treatment. Which of the following statements is true pertaining to the above case?", "options": [{"label": "A", "text": "Soleus arises from Middle 1/3rd Shaft of Fibula", "correct": false}, {"label": "B", "text": "Soleus arises from Anterior Border of Tibia", "correct": false}, {"label": "C", "text": "In this case, the Tibial Nerve is compressed below the Tendinous Arch between Tibial &amp; Fibular Origin of Soleus", "correct": true}, {"label": "D", "text": "The Peroneal Vessels accompany the Tibial Nerve beneath the Tendinous Arch", "correct": false}], "correct_answer": "C. In this case, the Tibial Nerve is compressed below the Tendinous Arch between Tibial & Fibular Origin of Soleus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture23_O10aLj8.jpg"], "explanation": "<p><strong>Ans. C) In this case, the Tibial Nerve is compressed below the Tendinous Arch between Tibial &amp; Fibular Origin of Soleus.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Soleus Arises from Middle 1/3rd Shaft of Fibula: The soleus muscle is one of the muscles in the posterior compartment of the leg , playing a key role in plantarflexion of the foot . The soleus muscle does originate from the fibula , but not exclusively from the middle third. It arises from the head and upper quarter of the posterior surface of the fibula and also from the soleal line and the middle third of the medial border of the tibia .</li><li>• Option A.</li><li>• soleus muscle</li><li>• posterior</li><li>• leg</li><li>• plantarflexion</li><li>• foot</li><li>• originate</li><li>• fibula</li><li>• head</li><li>• upper quarter</li><li>• posterior surface</li><li>• fibula</li><li>• soleal line</li><li>• middle third</li><li>• medial border</li><li>• tibia</li><li>• Option B. Soleus Arises from Anterior Border of Tibia : The soleus does not arise from the anterior border of the tibia. It originates from the posterior aspect of the tibia , specifically from the soleal line and the middle third of the medial border .</li><li>• Option B.</li><li>• :</li><li>• originates</li><li>• posterior aspect</li><li>• tibia</li><li>• soleal line</li><li>• middle third</li><li>• medial border</li><li>• Option D. The Peroneal Vessels Accompany the Tibial Nerve Beneath the Tendinous Arch: The peroneal vessels (fibular vessels) do not accompany the tibial nerve beneath the tendinous arch of the soleus. The tibial nerve runs in close proximity to the posterior tibial vessels in the posterior compartment of the leg .</li><li>• Option D.</li><li>• tibial nerve</li><li>• close proximity</li><li>• posterior tibial</li><li>• vessels</li><li>• posterior compartment</li><li>• leg</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The anatomical relationship between the soleus muscle and the tibial nerve is important in this case. In this clinical scenario, the tibial nerve was compressed below the tendinous arch (also known as the soleus arch or the tendinous arch of the soleus ), which is formed at the junction of the tibial and fibular origins of the soleus muscle .</li><li>• The anatomical relationship between the soleus muscle and the tibial nerve is important in this case.</li><li>• anatomical relationship</li><li>• soleus muscle</li><li>• tibial nerve</li><li>• In this clinical scenario, the tibial nerve was compressed below the tendinous arch (also known as the soleus arch or the tendinous arch of the soleus ), which is formed at the junction of the tibial and fibular origins of the soleus muscle .</li><li>• compressed</li><li>• below</li><li>• tendinous arch</li><li>• soleus arch</li><li>• tendinous arch</li><li>• soleus</li><li>• junction</li><li>• tibial</li><li>• fibular origins</li><li>• soleus muscle</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male presented with bilateral mechanical knee pain with the right knee being worse. Functionally, he could not climb stairs and could not sit on the floor with crossed legs. On physical examination, there was medial joint line tenderness. The range of motion (ROM) was 5° to 100° with palpable crepitus. X-rays of the knees showed advanced osteoarthritic changes. Having failed conservative therapy, TKA was offered and was agreed upon after informed consent. Which of the following is not true pertaining to the above case?", "options": [{"label": "A", "text": "Extension of Knee Joint is caused by the Contraction of Quadriceps Femoris", "correct": false}, {"label": "B", "text": "Flexion at Knee Joint is initiated by Popliteus", "correct": false}, {"label": "C", "text": "Lateral Rotation by Lateral Head of Gastrocnemius", "correct": true}, {"label": "D", "text": "Medial Rotation by Semimembranosus", "correct": false}], "correct_answer": "C. Lateral Rotation by Lateral Head of Gastrocnemius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture24_jyeCf5x.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture25_xrxhp74.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture26_U6dPM1q.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture27_V9ltffw.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture28_xaZXa9Y.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-174559.jpg"], "explanation": "<p><strong>Ans. C) Lateral Rotation by Lateral Head of Gastrocnemius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Extension of Knee Joint is Caused by the Contraction of Quadriceps Femoris: The quadriceps femoris muscle is a key muscle group in the anterior compartment of the thigh . The quadriceps femoris, consisting of four muscles ( rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius ), is the primary extensor of the knee. Its contraction leads to the extension of the knee joint.</li><li>• Option A.</li><li>• quadriceps femoris muscle</li><li>• anterior compartment</li><li>• thigh</li><li>• four muscles</li><li>• rectus femoris, vastus lateralis, vastus medialis,</li><li>• vastus intermedius</li><li>• primary extensor</li><li>• contraction</li><li>• extension</li><li>• Option B. Flexion at Knee Joint is Initiated by Popliteus: The popliteus is a small muscle located at the back of the knee. The popliteus muscle plays an important role in initiating knee flexion , especially when the knee is fully extended . It \" unlocks \" the knee by laterally rotating the femur on the tibia when the foot is fixed , allowing flexion to start.</li><li>• Option B.</li><li>• small muscle</li><li>• back</li><li>• initiating knee flexion</li><li>• knee</li><li>• fully extended</li><li>• unlocks</li><li>• knee</li><li>• laterally rotating</li><li>• femur</li><li>• tibia</li><li>• foot</li><li>• fixed</li><li>• flexion</li><li>• Option D. Medial Rotation by Semimembranosus: The semimembranosus is one of the hamstring muscles , located in the posterior compartment of the thigh . The semimembranosus muscle contributes to medial rotation ( internal rotation ) of the knee when the knee is flexed . It is one of the muscles that help in stabilizing the knee and controlling its movements.</li><li>• Option D.</li><li>• hamstring muscles</li><li>• posterior compartment</li><li>• thigh</li><li>• medial rotation</li><li>• internal rotation</li><li>• knee</li><li>• flexed</li><li>• stabilizing</li><li>• knee</li><li>• controlling</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The gastrocnemius muscle has two heads and is part of the calf muscle group .</li><li>➤ The gastrocnemius muscle has two heads and is part of the calf muscle group .</li><li>➤ two heads</li><li>➤ calf muscle group</li><li>➤ The gastrocnemius assists in knee flexion and plantar flexion of the ankle , but it is not a primary muscle for lateral rotation of the knee. The lateral head of the gastrocnemius does not significantly contribute to lateral rotation of the knee joint.</li><li>➤ The gastrocnemius assists in knee flexion and plantar flexion of the ankle , but it is not a primary muscle for lateral rotation of the knee. The lateral head of the gastrocnemius does not significantly contribute to lateral rotation of the knee joint.</li><li>➤ gastrocnemius</li><li>➤ knee flexion</li><li>➤ plantar flexion</li><li>➤ ankle</li><li>➤ Knee joint</li><li>➤ Knee joint</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old male complained of a 6-year history of bilateral retropatellar pain. Symptoms had developed insidiously over months, remained unchanged for many years and were not associated with trauma or injury. The symptoms were intermittent, but ascending and descending stairs, rising from a chair, sitting for longer than 30 minutes and walking were consistently painful. Symptoms eased with rest, providing he didn’t sit for longer than 30 minutes with his knees in a flexed position. Prior to developing the knee pain, the patient participated in a variety of sports activities, which he gradually withdrew from over the following 6 years. Observation of the patient revealed mild to moderate retro-patellar pain towards the end of physiological flexion. Following the examination process, it was felt that the patient’s signs and symptoms were consistent with Patello-Femoral Pain (PFP). He complained of pain when the patellofemoral joint was loaded. The patellar tendon was not painful when palpated and he reported signs of fear and anxiety of movement and physical activity. The patient was taught to perform exercises twice daily, one uncomfortable/painful exercise as part of his rehabilitation programme. All the following will cause PFP except?", "options": [{"label": "A", "text": "IT Band Syndrome", "correct": false}, {"label": "B", "text": "Prepatellar Bursitis", "correct": false}, {"label": "C", "text": "Patellar Subluxation", "correct": false}, {"label": "D", "text": "Baker’s Cyst", "correct": true}], "correct_answer": "D. Baker’s Cyst", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture29_Sh1r4tq.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture30_cbq18KG.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture31_IBKhfvn.jpg"], "explanation": "<p><strong>Ans. D) Baker’s Cyst</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. IT Band Syndrome: The iliotibial band is a thick band of fascia that runs down the outside of the thigh from the hip to the knee . Iliotibial band syndrome can cause PFP . It occurs when the Iliotibial band becomes tight or inflamed . This tightness can lead to friction where the band crosses over the lateral epicondyle of the knee , contributing to pain around the patella , especially with activities like running or cycling.</li><li>• Option A.</li><li>• thick band</li><li>• fascia</li><li>• outside</li><li>• thigh</li><li>• hip</li><li>• knee</li><li>• PFP</li><li>• Iliotibial band</li><li>• tight</li><li>• inflamed</li><li>• friction</li><li>• crosses over</li><li>• lateral epicondyle</li><li>• knee</li><li>• pain</li><li>• patella</li><li>• Option B. Prepatellar Bursitis : Bursitis is the inflammation of a bursa , a small fluid-filled sac that reduces friction between moving structures. Prepatellar bursitis can lead to pain in the front of the knee but is typically localized over the patella itself rather than causing retro patellar pain . It's associated with swelling and tenderness directly over the kneecap , and while it can be uncomfortable , it generally does not cause PFP in the traditional sense.</li><li>• Option B.</li><li>• :</li><li>• inflammation</li><li>• bursa</li><li>• small fluid-filled sac</li><li>• reduces friction</li><li>• pain</li><li>• front</li><li>• knee</li><li>• localized</li><li>• patella</li><li>• causing retro patellar pain</li><li>• swelling</li><li>• tenderness</li><li>• kneecap</li><li>• uncomfortable</li><li>• Clergyman’s knee : It is also known as Infra patellar bursitis :</li><li>• Clergyman’s knee</li><li>• Infra patellar bursitis</li><li>• Option C. Patellar subluxation refers to partial dislocation of the patella out of its normal position in the trochlear groove of the femur . Patellar subluxation can definitely cause PFP . When the patella doesn't track correctly in the femoral groove, it can lead to increased stress and pain in the patellofemoral joint , especially during activities that load the joint like squatting or stair climbing .</li><li>• Option C.</li><li>• partial dislocation</li><li>• patella</li><li>• out</li><li>• normal position</li><li>• trochlear groove</li><li>• femur</li><li>• PFP</li><li>• increased stress</li><li>• pain</li><li>• patellofemoral joint</li><li>• load</li><li>• joint</li><li>• squatting</li><li>• stair climbing</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Baker’s Cyst, also known as a popliteal cyst , is a fluid-filled cyst that causes a bulge and a feeling of tightness behind the knee . Baker's cyst typically does not cause PFP. It's usually a result of a problem with the knee joint , such as arthritis or a cartilage tear . While it can cause discomfort and restrict movement , it does not usually contribute to patellofemoral pain, as it affects the posterior aspect of the knee.</li><li>• Baker’s Cyst, also known as a popliteal cyst , is a fluid-filled cyst that causes a bulge and a feeling of tightness behind the knee .</li><li>• popliteal cyst</li><li>• fluid-filled cyst</li><li>• bulge</li><li>• feeling</li><li>• tightness behind</li><li>• knee</li><li>• Baker's cyst typically does not cause PFP. It's usually a result of a problem with the knee joint , such as arthritis or a cartilage tear . While it can cause discomfort and restrict movement , it does not usually contribute to patellofemoral pain, as it affects the posterior aspect of the knee.</li><li>• knee joint</li><li>• arthritis</li><li>• cartilage tear</li><li>• discomfort</li><li>• restrict movement</li><li>• affects</li><li>• posterior aspect</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 439</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 439</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old woman presents with a complaint of unsteady gait. During examination, when asked to stand on her right leg, her left hip drops. This finding is not observed when she stands on her left leg. This clinical sign indicates weakness in which of the following muscles?", "options": [{"label": "A", "text": "Right Gluteus Medius", "correct": true}, {"label": "B", "text": "Left Gluteus Medius", "correct": false}, {"label": "C", "text": "Right Gluteus Maximus", "correct": false}, {"label": "D", "text": "Left Gluteus Maximus", "correct": false}], "correct_answer": "A. Right Gluteus Medius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture53.jpg"], "explanation": "<p><strong>Ans. A) Right Gluteus Medius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . While the gluteus medius muscle is involved in stabilizing the hip during single-leg stance , weakness in the left gluteus medius would cause the hip to drop on the opposite side (right) when standing on the left leg . In this case, the patient's right hip drops when standing on her left leg , which points to weakness on the contralateral side .</li><li>• Option B</li><li>• gluteus medius muscle</li><li>• stabilizing</li><li>• hip</li><li>• single-leg stance</li><li>• weakness</li><li>• left gluteus medius</li><li>• hip</li><li>• drop</li><li>• opposite side (right)</li><li>• standing</li><li>• left leg</li><li>• patient's right hip drops</li><li>• standing</li><li>• left leg</li><li>• weakness</li><li>• contralateral side</li><li>• Option C. The gluteus maximus muscle is primarily involved in hip extension and does not play a major role in stabilizing the pelvis during single-leg stance.</li><li>• Option C.</li><li>• hip extension</li><li>• Option D . The gluteus maximus, regardless of the side , is not the primary muscle involved in stabilizing the pelvis during single-leg stance.</li><li>• Option D</li><li>• regardless</li><li>• side</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Trendelenburg sign is positive when there is weakness of the gluteus medius muscle on the contralateral side of the hip drop . In this case, when the patient stands on her right leg and the left hip drops , it indicates weakness in the right gluteus medius .</li><li>➤ Trendelenburg sign is positive when there is weakness of the gluteus medius muscle on the contralateral side of the hip drop .</li><li>➤ Trendelenburg sign</li><li>➤ positive</li><li>➤ weakness</li><li>➤ gluteus medius muscle</li><li>➤ contralateral side</li><li>➤ hip drop</li><li>➤ In this case, when the patient stands on her right leg and the left hip drops , it indicates weakness in the right gluteus medius .</li><li>➤ stands</li><li>➤ right leg</li><li>➤ left hip drops</li><li>➤ weakness</li><li>➤ right gluteus medius</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 360.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 360.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All the given statements are causative factors for increase in Q Angle except?", "options": [{"label": "A", "text": "Genu Valgum", "correct": false}, {"label": "B", "text": "Short ITB", "correct": false}, {"label": "C", "text": "Tight Medial Patellar Retinaculum", "correct": true}, {"label": "D", "text": "Flat Foot", "correct": false}], "correct_answer": "C. Tight Medial Patellar Retinaculum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture32_iJmPqq1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture33_FhDWTPj.jpg"], "explanation": "<p><strong>Ans. C) Tight Medial Patellar Retinaculum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Genu Valgum , also known as \" knock-knee \", is a condition where the knees angle in and touch one another when the legs are straightened . Genu valgum can indeed increase the Q angle . When the knees are angled inward , the line from the hip to the patella is more lateral, which increases the Q angle . This change in alignment can contribute to patellar maltracking and related knee problems .</li><li>• Option A. Genu Valgum</li><li>• knock-knee</li><li>• knees angle</li><li>• touch one another</li><li>• straightened</li><li>• increase</li><li>• Q angle</li><li>• angled inward</li><li>• hip</li><li>• patella</li><li>• more lateral,</li><li>• increases</li><li>• Q angle</li><li>• alignment</li><li>• patellar maltracking</li><li>• knee problems</li><li>• Option B. Short ITB : The iliotibial band (ITB) is a band of tissue that runs along the outside of the thigh from the hip to the knee . A short or tight ITB can contribute to an increased Q angle . When the ITB is tight , it can pull the patella laterally (outwards) , thus increasing the angle between the line from the hip to the patella and the line from the patella to the tibial tubercle .</li><li>• Option B.</li><li>• :</li><li>• iliotibial band (ITB)</li><li>• outside</li><li>• thigh</li><li>• hip</li><li>• knee</li><li>• increased Q angle</li><li>• tight</li><li>• pull</li><li>• patella laterally (outwards)</li><li>• increasing</li><li>• angle</li><li>• hip</li><li>• patella</li><li>• patella</li><li>• tibial tubercle</li><li>• Option D. Flat Foot , or pes planus , is a condition where the arches on the inside of the feet are flattened , allowing the entire sole to touch the floor when standing . Flat foot can lead to an increased Q angle . The collapse of the arch can result in excessive pronation of the foot, which affects the alignment of the entire leg , leading to internal rotation of the tibia and an increase in the Q angle .</li><li>• Option D. Flat Foot</li><li>• pes planus</li><li>• arches</li><li>• inside</li><li>• feet</li><li>• flattened</li><li>• entire sole</li><li>• touch</li><li>• floor</li><li>• standing</li><li>• increased Q angle</li><li>• collapse</li><li>• arch</li><li>• excessive pronation</li><li>• affects</li><li>• alignment</li><li>• entire leg</li><li>• internal rotation</li><li>• tibia</li><li>• increase</li><li>• Q angle</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The medial patellar retinaculum is a band of connective tissue that attaches the medial side of the patella to the tibia . A tight medial patellar retinaculum would decrease , rather than increase , the Q angle . Tightness in this structure would pull the patella medially ( towards the inside of the knee ), which would reduce the Q angle .</li><li>• The medial patellar retinaculum is a band of connective tissue that attaches the medial side of the patella to the tibia .</li><li>• band</li><li>• connective tissue</li><li>• attaches</li><li>• medial side</li><li>• patella</li><li>• tibia</li><li>• A tight medial patellar retinaculum would decrease , rather than increase , the Q angle . Tightness in this structure would pull the patella medially ( towards the inside of the knee ), which would reduce the Q angle .</li><li>• decrease</li><li>• increase</li><li>• Q angle</li><li>• Tightness</li><li>• pull</li><li>• patella medially</li><li>• towards</li><li>• inside</li><li>• knee</li><li>• reduce</li><li>• Q angle</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 297</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 297</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old female visited the neurologist with complaints of pain, tingling sensation and numbness over the upper thigh. The neurologist on examination, found that there was no motor weakness of the lower limb and noticed that the pain told by the patient was confined to the upper anterolateral aspect of the thigh. He told the patient that she had meralgia paresthetica. Which of the following statements is true about the nerve responsible for this condition?", "options": [{"label": "A", "text": "It arises from Sacral Plexus", "correct": false}, {"label": "B", "text": "Emerges from the Medial Border of Psoas Major", "correct": false}, {"label": "C", "text": "Passes beneath Fascia Iliaca", "correct": false}, {"label": "D", "text": "The Anterior Branch of this nerve contributes to Patellar Plexus", "correct": true}], "correct_answer": "D. The Anterior Branch of this nerve contributes to Patellar Plexus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture34_BjUJXvr.jpg"], "explanation": "<p><strong>Ans. D) The Anterior Branch of this nerve contributes to Patellar Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It Arises from Sacral Plexus: The lateral femoral cutaneous nerve arises from the lumbar plexus , specifically from the L2 and L3 nerve roots , not the sacral plexus.</li><li>• Option A</li><li>• lateral femoral cutaneous nerve</li><li>• lumbar plexus</li><li>• L2</li><li>• L3 nerve roots</li><li>• Option B. Emerges from the Medial Border of Psoas Major: The lateral femoral cutaneous nerve indeed emerges from the lateral border of the psoas major muscle , not the medial border. It then crosses the iliacus muscle towards the anterior superior iliac spine .</li><li>• Option B.</li><li>• lateral femoral cutaneous nerve</li><li>• emerges</li><li>• lateral border</li><li>• psoas major muscle</li><li>• crosses</li><li>• iliacus muscle</li><li>• anterior superior iliac spine</li><li>• Option C. Passes Beneath Fascia Iliaca: The lateral femoral cutaneous nerve actually passes under the inguinal ligament and over the fascia iliaca , not beneath it. This is the common site where it may become compressed or entrapped, leading to meralgia paresthetica .</li><li>• Option C.</li><li>• lateral femoral cutaneous nerve</li><li>• under</li><li>• inguinal ligament</li><li>• over</li><li>• fascia iliaca</li><li>• meralgia paresthetica</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Meralgia paresthetica is due to compression of lateral femoral cutaneous nerve within a fibrous tunnel in inguinal ligament . It arises from the lumbar plexus - dorsal branches of ventral rami of L2, L3 .</li><li>• Meralgia paresthetica is due to compression of lateral femoral cutaneous nerve within a fibrous tunnel in inguinal ligament . It arises from the lumbar plexus - dorsal branches of ventral rami of L2, L3 .</li><li>• Meralgia paresthetica</li><li>• lateral femoral cutaneous nerve</li><li>• fibrous tunnel</li><li>• inguinal ligament</li><li>• arises</li><li>• lumbar plexus</li><li>• dorsal branches</li><li>• ventral rami</li><li>• L2, L3</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg No. 1371</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg No. 1371</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32-year-old female runner presents with localized pain in the sole of her foot, particularly after long-distance running. Physical examination reveals tenderness on palpation of the medial aspect of the sole. Which muscle is most likely responsible for her symptoms?", "options": [{"label": "A", "text": "Abductor Hallucis", "correct": true}, {"label": "B", "text": "Flexor Digitorum Brevis", "correct": false}, {"label": "C", "text": "Quadratus Plantae", "correct": false}, {"label": "D", "text": "Adductor Hallucis", "correct": false}], "correct_answer": "A. Abductor Hallucis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture52.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-175535.jpg"], "explanation": "<p><strong>Ans. A) Abductor Hallucis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Flexor Digitorum Brevis muscle is involved in flexing the middle phalanges of the lesser toes and is located more centrally in the sole of the foot . While it can be involved in foot pain , the localization in this patient's case is not consistent with the symptoms of flexor digitorum brevis strain.</li><li>• Option B.</li><li>• flexing</li><li>• middle phalanges</li><li>• lesser toes</li><li>• centrally</li><li>• sole</li><li>• foot</li><li>• foot pain</li><li>• Option C. Quadratus Plantae muscle assists in toe flexion but is located deeper in the sole and is not typically associated with localized tenderness on the medial aspect of the sole.</li><li>• Option C.</li><li>• assists</li><li>• toe flexion</li><li>• deeper</li><li>• sole</li><li>• Option D. Adductor Hallucis muscle is involved in the abduction of the big toe and is located in the sole of the foot , it is more laterally placed compared to the abductor hallucis and is not the primary muscle involved in medial sole tenderness.</li><li>• Option D.</li><li>• abduction</li><li>• big toe</li><li>• sole</li><li>• foot</li><li>• more laterally</li><li>• abductor hallucis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Abductor Hallucis muscle is located in the medial aspect of the sole and plays a role in the abduction and flexion of the big toe . Overuse, as seen in long-distance running , can lead to pain and tenderness in this area, typical of the patient's symptoms .</li><li>➤ Abductor Hallucis muscle is located in the medial aspect of the sole and plays a role in the abduction and flexion of the big toe .</li><li>➤ medial aspect</li><li>➤ sole</li><li>➤ plays</li><li>➤ role</li><li>➤ abduction</li><li>➤ flexion</li><li>➤ big toe</li><li>➤ Overuse, as seen in long-distance running , can lead to pain and tenderness in this area, typical of the patient's symptoms .</li><li>➤ long-distance running</li><li>➤ pain</li><li>➤ tenderness</li><li>➤ patient's symptoms</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 425.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 425.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female in a vegetable market entered into a quarrel with her drunkard husband. During the brawl, she received a deep knife wound to the front of her left thigh. After a thorough examination in the emergency department of the local hospital, it was determined that the knife point had severed the trunk of the right femoral nerve just below the inguinal ligament. Which of the following findings will NOT be present in the given case?", "options": [{"label": "A", "text": "Skin Sensation was lost over the Anterior and Medial Sides of the Thigh", "correct": false}, {"label": "B", "text": "Skin Sensation was lost along the Medial Border of the Big Toe", "correct": true}, {"label": "C", "text": "Skin Sensation was lost on the Lower Part of the Leg and the Medial Border of the Foot as far as the Ball of the Big Toe", "correct": false}, {"label": "D", "text": "The Right Quadriceps Femoris Muscle failed to contract when the patient was asked to Extend her Right Knee Joint", "correct": false}], "correct_answer": "B. Skin Sensation was lost along the Medial Border of the Big Toe", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture35_ANb2ZcH.jpg"], "explanation": "<p><strong>Ans. B) Skin Sensation was lost along the Medial Border of the Big Toe</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Skin sensation lost over the anterior and medial sides of the thigh: The femoral nerve provides sensory innervation to the anterior and medial aspects of the thigh . It also innervates the quadriceps femoris muscle , which is crucial for knee extension .</li><li>• Option A</li><li>• femoral nerve</li><li>• sensory innervation</li><li>• anterior</li><li>• medial aspects</li><li>• thigh</li><li>• quadriceps femoris muscle</li><li>• crucial</li><li>• knee extension</li><li>• Option C. Skin sensation lost on the lower part of the leg and the medial border of the foot as far as the ball of the big toe: The lower part of the leg and the medial side of the foot are primarily innervated by nerves originating from the sacral plexus (like the tibial nerve ), not the lumbar plexus.</li><li>• Option C.</li><li>• lower part</li><li>• leg</li><li>• medial side</li><li>• foot</li><li>• innervated</li><li>• nerves</li><li>• sacral plexus</li><li>• tibial nerve</li><li>• Option D. The right quadriceps femoris muscle failed to contract when the patient was asked to extend her right knee joint: The femoral nerve innervates the quadriceps femoris muscle , which is responsible for knee extension . If the femoral nerve is severed , there would be a failure in knee extension due to paralysis of the quadriceps muscle .</li><li>• Option D.</li><li>• femoral nerve</li><li>• quadriceps femoris muscle</li><li>• knee extension</li><li>• femoral nerve</li><li>• severed</li><li>• failure</li><li>• knee extension</li><li>• paralysis</li><li>• quadriceps muscle</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Skin sensation lost along the medial border of the big toe . The saphenous nerve , a branch of the femoral nerve , innervates the skin along the medial side of the leg and extends to the medial border of the foot and the big toe . If the injury to the femoral nerve is proximal enough ( below the inguinal ligament as mentioned), it could impact the saphenous nerve . The saphenous nerve, being a branch of the femoral nerve , would be affected , leading to loss of sensation along the medial border of the big toe .</li><li>• Skin sensation lost along the medial border of the big toe .</li><li>• Skin sensation lost</li><li>• medial border</li><li>• big toe</li><li>• The saphenous nerve , a branch of the femoral nerve , innervates the skin along the medial side of the leg and extends to the medial border of the foot and the big toe .</li><li>• saphenous nerve</li><li>• branch</li><li>• femoral nerve</li><li>• innervates</li><li>• skin</li><li>• medial side</li><li>• leg</li><li>• extends</li><li>• medial border</li><li>• foot</li><li>• big toe</li><li>• If the injury to the femoral nerve is proximal enough ( below the inguinal ligament as mentioned), it could impact the saphenous nerve .</li><li>• injury</li><li>• femoral nerve</li><li>• proximal enough</li><li>• below</li><li>• inguinal ligament</li><li>• impact</li><li>• saphenous nerve</li><li>• The saphenous nerve, being a branch of the femoral nerve , would be affected , leading to loss of sensation along the medial border of the big toe .</li><li>• branch</li><li>• femoral nerve</li><li>• affected</li><li>• loss</li><li>• sensation</li><li>• medial border</li><li>• big toe</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1372</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg no. 1372</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of medical residents is discussing the formation of major nerves of the Lower Limb. They focus on the Sciatic Nerve, the largest nerve in the human body. Which of the following options correctly describes the formation of the Sciatic Nerve?", "options": [{"label": "A", "text": "Formed by the Union of L4-S3 Nerve Roots", "correct": true}, {"label": "B", "text": "Formed by the Union of L2-L4 Nerve Roots", "correct": false}, {"label": "C", "text": "Formed by the Union of L5-S2 Nerve Roots", "correct": false}, {"label": "D", "text": "Formed by the Union of L4-S2 Nerve Roots", "correct": false}], "correct_answer": "A. Formed by the Union of L4-S3 Nerve Roots", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture46.jpg"], "explanation": "<p><strong>Ans. A) Formed by the Union of L4-S3 Nerve Roots.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Formed by the union of L2-L4 nerve roots: This is incorrect . L2-L4 nerve roots contribute to the formation of the femoral and obturator nerves , not the sciatic nerve.</li><li>• Option B.</li><li>• incorrect</li><li>• formation</li><li>• femoral</li><li>• obturator nerves</li><li>• Option C. Formed by the union of L5-S2 nerve roots: This option is partially correct , as it includes some of the nerve roots that contribute to the sciatic nerve , but it misses L4 and S3 .</li><li>• Option C.</li><li>• partially correct</li><li>• contribute</li><li>• sciatic nerve</li><li>• misses L4</li><li>• S3</li><li>• Option D. Formed by the union of L4-S2 nerve roots: This option also partially identifies the correct nerve roots but excludes the S3 nerve root .</li><li>• Option D.</li><li>• partially identifies</li><li>• correct nerve roots</li><li>• excludes</li><li>• S3 nerve root</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sciatic nerve is formed by the union of nerve roots from L4 to S3 . It emerges from the lower part of the sacral plexus and runs through the pelvis and into the posterior compartment of the thigh .</li><li>➤ The sciatic nerve is formed by the union of nerve roots from L4 to S3 .</li><li>➤ sciatic nerve</li><li>➤ union</li><li>➤ nerve roots</li><li>➤ L4 to S3</li><li>➤ It emerges from the lower part of the sacral plexus and runs through the pelvis and into the posterior compartment of the thigh .</li><li>➤ emerges</li><li>➤ lower part</li><li>➤ sacral plexus</li><li>➤ pelvis</li><li>➤ posterior compartment</li><li>➤ thigh</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 368.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 368.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the given image, which of the following statements is not true about the marked structure?", "options": [{"label": "A", "text": "The Marked structure is innervated by Femoral Nerve", "correct": true}, {"label": "B", "text": "The Entire Medial Surface of Tibia is devoid of any attachment except the Upper Part close to its Medial Border receives the insertion of the Pointed Structure", "correct": false}, {"label": "C", "text": "Their Combined Action stabilizes the Bony Pelvis by acting as Guy Ropes", "correct": false}, {"label": "D", "text": "A Bursa separates it from the Knee Joint", "correct": false}], "correct_answer": "A. The Marked structure is innervated by Femoral Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture37_XU90PX6.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-191032.jpg"], "explanation": "<p><strong>Ans. A) The Marked structure is innervated by Femoral Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The entire medial surface of the tibia is devoid of any attachment except the upper part close to its medial border receives the insertion of the pointed structure: This describes the anatomical attachment of the pes anserinus . The sartorius, gracilis , and semitendinosus muscles insert into the upper part of the medial surface of the tibia , forming the pes anserinus .</li><li>• Option B.</li><li>• anatomical attachment</li><li>• pes anserinus</li><li>• sartorius, gracilis</li><li>• semitendinosus</li><li>• muscles</li><li>• upper part</li><li>• medial surface</li><li>• tibia</li><li>• pes anserinus</li><li>• Option C. Their combined action stabilizes the bony pelvis by acting as guy ropes: The muscles forming the pes anserinus ( sartorius, gracilis , and semitendinosus ) play roles in stabilizing the pelvis . The sartorius assists in hip flexion and abduction , the gracilis in hip adduction , and the semitendinosus in hip extension and internal rotation .</li><li>• Option C.</li><li>• muscles</li><li>• pes anserinus</li><li>• sartorius, gracilis</li><li>• semitendinosus</li><li>• stabilizing</li><li>• pelvis</li><li>• sartorius</li><li>• hip flexion</li><li>• abduction</li><li>• gracilis</li><li>• hip adduction</li><li>• semitendinosus</li><li>• hip extension</li><li>• internal rotation</li><li>• Option D. A bursa separates it from the knee joint: The pes anserinus bursa separates it from the posteromedial aspect of the knee joint capsule .</li><li>• Option D.</li><li>• pes anserinus bursa</li><li>• posteromedial aspect</li><li>• knee joint capsule</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The pointed structure is innervated by the femoral nerve The pes anserinus is formed by the conjoined tendons of three muscles: sartorius , gracilis , and semitendinosus . The sartorius is innervated by the femoral nerve , but the gracilis and semitendinosus are innervated by the obturator nerve and the tibial portion of the sciatic nerve , respectively. Therefore, stating that the entire pes anserinus is innervated by the femoral nerve is incorrect .</li><li>• The pointed structure is innervated by the femoral nerve</li><li>• pointed structure</li><li>• femoral nerve</li><li>• The pes anserinus is formed by the conjoined tendons of three muscles: sartorius , gracilis , and semitendinosus .</li><li>• pes anserinus</li><li>• conjoined tendons</li><li>• sartorius</li><li>• gracilis</li><li>• semitendinosus</li><li>• The sartorius is innervated by the femoral nerve , but the gracilis and semitendinosus are innervated by the obturator nerve and the tibial portion of the sciatic nerve , respectively.</li><li>• femoral nerve</li><li>• gracilis</li><li>• semitendinosus</li><li>• innervated</li><li>• obturator nerve</li><li>• tibial portion</li><li>• sciatic nerve</li><li>• Therefore, stating that the entire pes anserinus is innervated by the femoral nerve is incorrect .</li><li>• entire pes anserinus</li><li>• femoral nerve</li><li>• incorrect</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325, 341</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325, 341</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presented to ortho OPD with complaints of spasmodic pain over her right thigh for the past two weeks. She was currently working in a school as a physical education staff. She recalled that she had been experiencing this pain after the practice session for the school sports day. The given image is the CT scan of the right thigh of the patient 20 cm below the trochanter. The quadriceps muscle is highlighted in the scan. Which of the following statements is true about the highlighted structure in the given image?", "options": [{"label": "A", "text": "It is a Multipennate Muscle", "correct": false}, {"label": "B", "text": "It is supplied by Branch from Anterior Division of Femoral Nerve", "correct": false}, {"label": "C", "text": "It is a Flexor of Hip Joint", "correct": true}, {"label": "D", "text": "It is inserted into the Upper Border of Patella", "correct": false}], "correct_answer": "C. It is a Flexor of Hip Joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture33.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) It is a Flexor of Hip Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. It is a multipennate muscle: The quadriceps femoris is a group of four muscles located in the anterior compartment of the thigh . These muscles are the rectus femoris , vastus lateralis , vastus medialis , and vastus intermedius . Only the rectus femoris has a bipennate structure , but the others are unipennate .</li><li>• Option A.</li><li>• quadriceps femoris</li><li>• four muscles</li><li>• anterior compartment</li><li>• thigh</li><li>• rectus femoris</li><li>• vastus lateralis</li><li>• vastus medialis</li><li>• vastus intermedius</li><li>• rectus femoris</li><li>• bipennate structure</li><li>• unipennate</li><li>• Option B. It is supplied by a branch from the anterior division of the femoral nerve: The quadriceps muscle is indeed innervated by the femoral nerve . The posterior division of the femoral nerve gives rise to branches that supply these muscles .</li><li>• Option B.</li><li>• quadriceps muscle</li><li>• innervated</li><li>• femoral nerve</li><li>• posterior division</li><li>• femoral nerve</li><li>• branches</li><li>• supply</li><li>• muscles</li><li>• Option D. It is inserted into the upper border of the patella: The quadriceps muscle attaches to the patella via the quadriceps tendon . The quadriceps tendon inserts into the base of the patella .</li><li>• Option D.</li><li>• quadriceps muscle</li><li>• patella</li><li>• quadriceps tendon</li><li>• quadriceps tendon</li><li>• base</li><li>• patella</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• It is a flexor of the hip joint The quadriceps muscle is primarily known for extending the knee joint . However, one of its components, the rectus femoris , also acts as a flexor of the hip joint .</li><li>• It is a flexor of the hip joint</li><li>• flexor</li><li>• hip joint</li><li>• The quadriceps muscle is primarily known for extending the knee joint . However, one of its components, the rectus femoris , also acts as a flexor of the hip joint .</li><li>• quadriceps muscle</li><li>• extending</li><li>• knee joint</li><li>• rectus femoris</li><li>• acts</li><li>• flexor</li><li>• hip joint</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 325</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 325</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman presents with numbness and a tingling sensation in her foot. On examination, the sensation is diminished over the dorsal aspect of the foot and the first web space between the toes. Which nerve is most likely responsible for the sensory changes in this patient?", "options": [{"label": "A", "text": "Deep Peroneal Nerve", "correct": true}, {"label": "B", "text": "Sural Nerve", "correct": false}, {"label": "C", "text": "Saphenous Nerve", "correct": false}, {"label": "D", "text": "Tibial Nerve", "correct": false}], "correct_answer": "A. Deep Peroneal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture50.jpg"], "explanation": "<p><strong>Ans. A) Deep Peroneal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Sural Nerve provides sensation to the lateral aspect of the foot and the lower ankle . The patient's symptoms do not correspond to the sural nerve's dermatome.</li><li>• Option B.</li><li>• sensation</li><li>• lateral aspect</li><li>• foot</li><li>• lower</li><li>• ankle</li><li>• Option C. The Saphenous Nerve, a branch of the Femoral Nerve , innervates the medial side of the leg and foot . The sensory deficit described does not match the distribution of the saphenous nerve.</li><li>• Option C.</li><li>• Femoral Nerve</li><li>• innervates</li><li>• medial side</li><li>• leg</li><li>• foot</li><li>• Option D. The Tibial Nerve generally innervates the plantar aspect of the foot . The sensory changes described in the dorsal foot and first web space do not align with the tibial nerve's sensory distribution.</li><li>• Option D.</li><li>• innervates</li><li>• plantar aspect</li><li>• foot</li><li>• sensory changes</li><li>• dorsal foot</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Deep Peroneal Nerve innervates the Dorsal Aspect of the Foot and the Area between the First and Second Toes . Sensory changes in this area, especially Numbness, and Tingling , indicates Deep Peroneal Nerve involvement . Superficial Peroneal Nerve Supplies the entire dorsum of foot except: A) 1st Webspace: by Deep Peroneal Nerve B) Lateral aspect of Dorsum of foot: by Sural Nerve</li><li>➤ The Deep Peroneal Nerve innervates the Dorsal Aspect of the Foot and the Area between the First and Second Toes . Sensory changes in this area, especially Numbness, and Tingling , indicates Deep Peroneal Nerve involvement .</li><li>➤ Deep</li><li>➤ Dorsal Aspect</li><li>➤ Foot</li><li>➤ Area between the First and Second Toes</li><li>➤ Numbness,</li><li>➤ Tingling</li><li>➤ Deep Peroneal Nerve involvement</li><li>➤ Superficial Peroneal Nerve Supplies the entire dorsum of foot except: A) 1st Webspace: by Deep Peroneal Nerve B) Lateral aspect of Dorsum of foot: by Sural Nerve</li><li>➤ Superficial</li><li>➤ entire dorsum of foot except:</li><li>➤ A) 1st Webspace: by Deep Peroneal Nerve B) Lateral aspect of Dorsum of foot: by Sural Nerve</li><li>➤ A) 1st Webspace: by Deep Peroneal Nerve</li><li>➤ B) Lateral aspect of Dorsum of foot: by Sural Nerve</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 396.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 396.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old female diagnosed with a popliteal artery aneurysm was posted for surgery. The popliteal artery was approached through the space marked in the image given below (MRI scan of right thigh). Which of the following statements is not true pertaining to the marked space in the given image?", "options": [{"label": "A", "text": "B is Sartorius", "correct": false}, {"label": "B", "text": "C is Adductor Longus", "correct": false}, {"label": "C", "text": "It lies on the Middle Third of Medial Aspect of Thigh", "correct": false}, {"label": "D", "text": "Femoral Nerve is a content of this space", "correct": true}], "correct_answer": "D. Femoral Nerve is a content of this space", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture34.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture38_my6aMBr.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture39_eV8K3hR.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture40_HH1JR20.jpg"], "explanation": "<p><strong>Ans. D) Femoral nerve is a content of this space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . B is Sartorius: The sartorius muscle is a long, thin , superficial muscle in the anterior compartment of the thigh . The adductor canal itself is an aponeurotic tunnel in the middle third of the thigh , lying between the vastus medialis and adductor longus and magnus .</li><li>• Option A</li><li>• sartorius muscle</li><li>• long, thin</li><li>• superficial muscle</li><li>• anterior compartment</li><li>• thigh</li><li>• adductor canal</li><li>• aponeurotic tunnel</li><li>• middle third</li><li>• thigh</li><li>• vastus medialis</li><li>• adductor longus</li><li>• magnus</li><li>• Option B . C is adductor longus: The adductor longus is one of the adductor muscles of the thigh , and it forms the medial wall of the adductor canal . This muscle is significant as it aids in thigh adduction and plays a role in stabilizing the leg during surgical approaches to the thigh and knee .</li><li>• Option B</li><li>• adductor muscles</li><li>• thigh</li><li>• medial wall</li><li>• adductor canal</li><li>• aids</li><li>• thigh adduction</li><li>• stabilizing</li><li>• leg</li><li>• surgical</li><li>• thigh</li><li>• knee</li><li>• Option D. It lies on the middle third of the medial aspect of thigh: The adductor canal actually extends from the apex of the femoral triangle to the adductor hiatus in the distal part of the thigh . It is situated in the middle third of the thigh but involves more than just the medial aspect , covering a pathway that transitions from an anterior to a medial position on the thigh .</li><li>• Option D.</li><li>• adductor canal</li><li>• extends</li><li>• apex</li><li>• femoral triangle</li><li>• adductor hiatus</li><li>• distal part</li><li>• thigh</li><li>• middle third</li><li>• thigh</li><li>• more</li><li>• medial aspect</li><li>• pathway</li><li>• transitions</li><li>• anterior</li><li>• medial position</li><li>• thigh</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The main contents of the adductor canal are the femoral artery , femoral vein , and the saphenous nerve , which is a branch of the femoral nerve . The femoral nerve itself does not travel through the adductor canal; it lies more laterally in the thigh , within the femoral triangle . In the context of surgery for a popliteal artery aneurysm , understanding the anatomy of the adductor canal is crucial for accessing the popliteal artery safely . The surgeon must navigate these anatomical structures carefully to avoid complications and ensure successful access to the aneurysm site .</li><li>• The main contents of the adductor canal are the femoral artery , femoral vein , and the saphenous nerve , which is a branch of the femoral nerve . The femoral nerve itself does not travel through the adductor canal; it lies more laterally in the thigh , within the femoral triangle .</li><li>• adductor canal</li><li>• femoral artery</li><li>• femoral vein</li><li>• saphenous nerve</li><li>• branch</li><li>• femoral nerve</li><li>• lies</li><li>• laterally</li><li>• thigh</li><li>• within</li><li>• femoral triangle</li><li>• In the context of surgery for a popliteal artery aneurysm , understanding the anatomy of the adductor canal is crucial for accessing the popliteal artery safely . The surgeon must navigate these anatomical structures carefully to avoid complications and ensure successful access to the aneurysm site .</li><li>• popliteal artery aneurysm</li><li>• anatomy</li><li>• adductor canal</li><li>• accessing</li><li>• popliteal artery safely</li><li>• surgeon</li><li>• navigate</li><li>• anatomical structures</li><li>• avoid complications</li><li>• ensure successful</li><li>• access</li><li>• aneurysm site</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 325</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In the above question, if the structure labelled “L” is Semi-Tendinosus, then the structure labelled “K” will be?", "options": [{"label": "A", "text": "Semimembranosus", "correct": false}, {"label": "B", "text": "Adductor Magnus", "correct": false}, {"label": "C", "text": "Long Head of Biceps Femoris", "correct": true}, {"label": "D", "text": "Short Head of Biceps Femoris", "correct": false}], "correct_answer": "C. Long Head of Biceps Femoris", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture41_fytSezA.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture42_hiR7Xi8.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/screenshot-2024-02-02-192619.jpg"], "explanation": "<p><strong>Ans. C) Long Head of Biceps Femoris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Semimembranosus arises from the upper lateral part of the quadrilateral area of ischial tuberosity .</li><li>• Option A.</li><li>• upper lateral part</li><li>• quadrilateral area</li><li>• ischial tuberosity</li><li>• Option B . Ischial part of the adductor magnus arises from the inferolateral aspect of ischial tuberosity .</li><li>• Option B</li><li>• inferolateral aspect</li><li>• ischial tuberosity</li><li>• Option D. Short head of biceps femoris arises from the lateral lip of linea aspera .</li><li>• Option D.</li><li>• lateral lip</li><li>• linea aspera</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Long head , arises from lower medial part of the upper quadrilateral area of the ischial tuberosity in common with the semitendinosus and also from the lower part of the sacrotuberous ligament .</li><li>• Long head</li><li>• arises</li><li>• lower medial</li><li>• upper quadrilateral area</li><li>• ischial tuberosity</li><li>• semitendinosus</li><li>• lower part</li><li>• sacrotuberous ligament</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 363</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 363</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male presents with difficulty in both hip flexion and knee extension. Electromyography (EMG) shows impaired function in a muscle that is involved in both movements. Which muscle is likely to be affected in this patient?", "options": [{"label": "A", "text": "Biceps Femoris", "correct": false}, {"label": "B", "text": "Sartorius", "correct": false}, {"label": "C", "text": "Rectus Femoris", "correct": true}, {"label": "D", "text": "Gracilis", "correct": false}], "correct_answer": "C. Rectus Femoris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture55.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-181912.jpg"], "explanation": "<p><strong>Ans. C) Rectus Femoris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The biceps femoris is a part of the hamstrings group , primarily involved in knee flexion and hip extension . It does not contribute to hip flexion or knee extension.</li><li>• Option A</li><li>• hamstrings group</li><li>• involved</li><li>• knee flexion</li><li>• hip extension</li><li>• Option B . Although the sartorius assists in hip flexion and knee flexion , it is not a significant contributor to knee extension. Sartorius also causes medial rotation of Knee Joint.</li><li>• Option B</li><li>• hip flexion</li><li>• knee flexion</li><li>• Option D . The gracilis primarily contributes to hip adduction and knee flexion . It does not play a significant role in knee extension.</li><li>• Option D</li><li>• hip adduction</li><li>• knee flexion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The rectus femoris, part of the quadriceps femoris group , is unique in that it crosses two joints and is involved in both hip flexion and knee extension . Dysfunction in this muscle can lead to difficulties in both these movements .</li><li>➤ The rectus femoris, part of the quadriceps femoris group , is unique in that it crosses two joints and is involved in both hip flexion and knee extension . Dysfunction in this muscle can lead to difficulties in both these movements .</li><li>➤ quadriceps femoris group</li><li>➤ crosses</li><li>➤ two joints</li><li>➤ both hip flexion</li><li>➤ knee extension</li><li>➤ Dysfunction</li><li>➤ difficulties</li><li>➤ both these movements</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male was attending a call on his mobile phone and at the same time, he tried to take a U-turn in his car. Unfortunately, he didn’t concentrate on the road much and his car was hit by a truck coming from the opposite side. He was not wearing his seat belt; hence a head-on collision caused his knee to strike the dashboard. He was rushed to the ER. He complained of severe pain over his lower limbs. On examination, there was shortening &amp; medial rotation of his left thigh. He was unable to flex his knee and sensory loss was noted over the posterolateral aspect of his leg and much of the dorsum of foot. On a plain x-ray, the femoral head was missing in the acetabular fossa. The patient was immediately transferred to the operating room where the wound was thoroughly debrided, and the femoral head was relocated within 5 hours of sustaining the trauma.Which of the following statements is true pertaining to this case?", "options": [{"label": "A", "text": "Anteroinferior Dislocation of Femoral Head is the Commonest", "correct": false}, {"label": "B", "text": "The Obturator Nerve has been injured in this case", "correct": false}, {"label": "C", "text": "Ischiofemoral Ligament is the strongest", "correct": false}, {"label": "D", "text": "Sensory Loss seen in the Dorsum of Foot is due to involvement of Superficial Peroneal Nerve", "correct": true}], "correct_answer": "D. Sensory Loss seen in the Dorsum of Foot is due to involvement of Superficial Peroneal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture43_sWpk4aF.jpg"], "explanation": "<p><strong>Ans. D) Sensory Loss seen in the Dorsum of Foot is due to involvement of Superficial Peroneal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Anteroinferior dislocation of femoral head is the commonest: The most common type of hip dislocation is posterior (not anteroinferior). Posterior dislocations of the hip account for over 90% of all hip dislocations. This type of dislocation often results from dashboard injuries in motor vehicle collisions , where the knee impacts the dashboard, driving the femoral head out of the acetabulum posteriorly . Clinical presentation often includes the leg being shortened and medially (internally) rotated , as described in the case.</li><li>• Option A</li><li>• hip dislocation</li><li>• posterior</li><li>• Posterior dislocations</li><li>• hip account</li><li>• over 90%</li><li>• dashboard injuries</li><li>• motor vehicle collisions</li><li>• acetabulum posteriorly</li><li>• shortened</li><li>• medially (internally)</li><li>• rotated</li><li>• Option B. The obturator nerve has been injured in this case : The obturator nerve typically supplies the medial thigh muscles and provides sensation to a small patch of skin on the medial aspect of the thigh . An injury to the obturator nerve would not account for the sensory loss on the dorsum of the foot and the inability to flex the knee.</li><li>• Option B.</li><li>• obturator nerve</li><li>• medial thigh muscles</li><li>• sensation</li><li>• small patch</li><li>• skin</li><li>• medial aspect</li><li>• thigh</li><li>• Option C . Ischiofemoral ligament is the strongest: The iliofemoral ligament is the strongest of the three major ligaments of the hip joint (the others being the pubofemoral and the ischiofemoral ligaments ). The iliofemoral ligament plays a crucial role in preventing hyperextension of the hip joint . The strength of this ligament also helps to maintain the stability of the hip joint .</li><li>• Option C</li><li>• iliofemoral ligament</li><li>• strongest</li><li>• three major ligaments</li><li>• hip joint</li><li>• pubofemoral</li><li>• ischiofemoral ligaments</li><li>• hyperextension</li><li>• hip joint</li><li>• strength</li><li>• maintain</li><li>• stability</li><li>• hip joint</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The superficial peroneal nerve provides sensory innervation to the dorsal aspect of the foot ( excluding the web space between the first and second toes , which is supplied by the deep peroneal nerve ) and also supplies the peroneus longus and brevis muscles in the lateral compartment of the leg . Injury or involvement of the superficial peroneal nerve can lead to sensory loss in its distribution on the dorsum of the foot , as described in the case.</li><li>• The superficial peroneal nerve provides sensory innervation to the dorsal aspect of the foot ( excluding the web space between the first and second toes , which is supplied by the deep peroneal nerve ) and also supplies the peroneus longus and brevis muscles in the lateral compartment of the leg .</li><li>• superficial peroneal nerve</li><li>• dorsal aspect</li><li>• foot</li><li>• excluding</li><li>• web space</li><li>• first</li><li>• second toes</li><li>• supplied</li><li>• deep peroneal nerve</li><li>• supplies</li><li>• peroneus longus</li><li>• brevis</li><li>• muscles</li><li>• lateral compartment</li><li>• leg</li><li>• Injury or involvement of the superficial peroneal nerve can lead to sensory loss in its distribution on the dorsum of the foot , as described in the case.</li><li>• Injury</li><li>• involvement</li><li>• superficial peroneal nerve</li><li>• sensory loss</li><li>• distribution</li><li>• dorsum</li><li>• foot</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 375</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 375</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Assertation (A): Obturator Internus lies in the Medial Side of the Thigh. Reason (R): Obturator Internus is a Lateral Rotator of the Thigh.", "options": [{"label": "A", "text": "A is Right but R is Wrong", "correct": false}, {"label": "B", "text": "A &amp; R are Right but R is not the Correct Explanation of A", "correct": false}, {"label": "C", "text": "Both A &amp; R are Wrong", "correct": false}, {"label": "D", "text": "A is Wrong &amp; R is Right", "correct": true}], "correct_answer": "D. A is Wrong & R is Right", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture44_agXC8iG.jpg"], "explanation": "<p><strong>Ans. D) A is Wrong &amp; R is Right</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Assertion (A): Obturator internus lies in the medial side of the thigh.</li><li>• Assertion (A):</li><li>• This statement is incorrect . The obturator internus muscle is actually located in the pelvis, not in the thigh. It originates inside the pelvis from the inner surface of the obturator membrane and the surrounding bones . It then exits the pelvis through the lesser sciatic foramen and inserts on the greater trochanter of the femur . Its position and course are more related to the hip joint rather than the medial side of the thigh .</li><li>• This statement is incorrect .</li><li>• incorrect</li><li>• The obturator internus muscle is actually located in the pelvis, not in the thigh. It originates inside the pelvis from the inner surface of the obturator membrane and the surrounding bones . It then exits the pelvis through the lesser sciatic foramen and inserts on the greater trochanter of the femur . Its position and course are more related to the hip joint rather than the medial side of the thigh .</li><li>• inside</li><li>• pelvis</li><li>• inner surface</li><li>• obturator membrane</li><li>• surrounding bones</li><li>• exits</li><li>• pelvis</li><li>• lesser sciatic foramen</li><li>• inserts</li><li>• greater trochanter</li><li>• femur</li><li>• position</li><li>• hip joint</li><li>• medial side</li><li>• thigh</li><li>• Reason (R): Obturator internus is a lateral rotator of the thigh.</li><li>• Reason (R):</li><li>• This statement is correct . The obturator internus, along with other muscles like the piriformis , gemellus superior , gemellus inferior , and quadratus femoris , is part of the deep lateral rotators of the hip . These muscles act to laterally rotate the thigh at the hip joint . Their action is crucial for many movements involving the hip , including walking and maintaining posture .</li><li>• This statement is correct .</li><li>• correct</li><li>• The obturator internus, along with other muscles like the piriformis , gemellus superior , gemellus inferior , and quadratus femoris , is part of the deep lateral rotators of the hip . These muscles act to laterally rotate the thigh at the hip joint . Their action is crucial for many movements involving the hip , including walking and maintaining posture .</li><li>• piriformis</li><li>• gemellus superior</li><li>• gemellus inferior</li><li>• quadratus femoris</li><li>• deep lateral rotators</li><li>• hip</li><li>• laterally rotate</li><li>• thigh</li><li>• hip joint</li><li>• crucial</li><li>• hip</li><li>• walking</li><li>• maintaining posture</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The obturator internus is indeed a lateral rotator of the thigh . The prime muscle for Lateral Rotation of Hip Joint is the Gluteus Maximus.</li><li>• The obturator internus is indeed a lateral rotator of the thigh .</li><li>• lateral rotator</li><li>• thigh</li><li>• The prime muscle for Lateral Rotation of Hip Joint is the Gluteus Maximus.</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Pg. 25, 356</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Pg. 25, 356</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents with pain in the medial aspect of his foot. On examination, the pain exacerbates with activity and is relieved with rest. Imaging studies reveal a deformity in one of the arches of the foot. Which bone is most likely to be involved in maintaining the integrity of the medial longitudinal arch, which when affected, can lead to such symptoms?", "options": [{"label": "A", "text": "Calcaneus", "correct": false}, {"label": "B", "text": "Talus", "correct": true}, {"label": "C", "text": "Cuboid", "correct": false}, {"label": "D", "text": "Metatarsal", "correct": false}], "correct_answer": "B. Talus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-174544.jpg"], "explanation": "<p><strong>Ans. B) Talus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The calcaneus , also known as the heel bone , is an important part of the foot, but it primarily supports the hindfoot and forms the heel . It's not the primary bone responsible for maintaining the medial longitudinal arch.</li><li>• Option A</li><li>• calcaneus</li><li>• heel bone</li><li>• supports</li><li>• hindfoot</li><li>• forms</li><li>• heel</li><li>• Option C . The cuboid is one of the tarsal bones in the foot , but it's not a primary contributor to the medial longitudinal arch's integrity. It provides stability to the lateral aspect of the foot .</li><li>• Option C</li><li>• tarsal bones</li><li>• foot</li><li>• stability</li><li>• lateral aspect</li><li>• foot</li><li>• Option D . The metatarsals are the long bones in the middle part of the foot and are more involved in the transverse arch of the foot rather than the medial longitudinal arch.</li><li>• Option D</li><li>• metatarsals</li><li>• long bones</li><li>• middle part</li><li>• foot</li><li>• transverse arch</li><li>• foot</li><li>• Education Objective :</li><li>• Education Objective</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li><li>• Ref</li><li>• : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 434.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 16-year-old boy was diagnosed with urethral stricture. He underwent visual internal urethrotomy in the lithotomy position with stirrups supporting both popliteal fossa and proximal parts of tibia. No ankle support was used. On the first postoperative day, the patient complained of decreased sensation on the lateral aspect of right leg, the lateral border of his right foot and difficulty in dorsiflexion of the right foot due to compression of a particular nerve of the lower limb. Which of the following muscles is supplied by the nerve involved in this scenario?", "options": [{"label": "A", "text": "Flexor Hallucis Longus", "correct": false}, {"label": "B", "text": "Abductor Hallucis", "correct": false}, {"label": "C", "text": "Extensor Digitorum Longus", "correct": true}, {"label": "D", "text": "Semi-Membranosus", "correct": false}], "correct_answer": "C. Extensor Digitorum Longus", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Extensor Digitorum Longus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The flexor hallucis longus muscle is involved in flexing the big toe and plantar flexing the ankle . It is innervated by the tibial nerve , not the common peroneal nerve. Therefore, this muscle is not related to the symptoms, or the nerve involved in this scenario.</li><li>• Option A</li><li>• flexing</li><li>• big toe</li><li>• plantar flexing</li><li>• ankle</li><li>• innervated</li><li>• tibial nerve</li><li>• Option B. Abductor hallucis muscle is responsible for the abduction of the big toe and supports the arch of the foot . It is innervated by the medial plantar nerve , a branch of the tibial nerve . Like the flexor hallucis longus, it is not associated with the common peroneal nerve and thus is not related to the patient's symptoms.</li><li>• Option B.</li><li>• abduction</li><li>• big toe</li><li>• arch</li><li>• foot</li><li>• innervated</li><li>• medial plantar nerve</li><li>• branch</li><li>• tibial nerve</li><li>• Option D. The semimembranosus is one of the hamstring muscles involved in extending the thigh and flexing the knee . It is innervated by the tibial portion of the sciatic nerve . This muscle is not supplied by the common peroneal nerve and is not related to the patient's symptoms of decreased sensation and difficulty in dorsiflexion.</li><li>• Option D.</li><li>• hamstring muscles</li><li>• extending</li><li>• thigh</li><li>• flexing</li><li>• knee</li><li>• innervated</li><li>• tibial portion</li><li>• sciatic</li><li>• nerve</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The extensor digitorum longus muscle extends the toes and dorsiflexes the foot . It is innervated by the deep peroneal nerve , a branch of the common peroneal nerve. The symptoms described in the patient – difficulty in dorsiflexion of the foot and sensory loss in the nerve's distribution – align with an issue involving the common peroneal nerve .</li><li>• The extensor digitorum longus muscle extends the toes and dorsiflexes the foot . It is innervated by the deep peroneal nerve , a branch of the common peroneal nerve.</li><li>• extends</li><li>• toes</li><li>• dorsiflexes</li><li>• foot</li><li>• innervated</li><li>• deep peroneal</li><li>• nerve</li><li>• The symptoms described in the patient – difficulty in dorsiflexion of the foot and sensory loss in the nerve's distribution – align with an issue involving the common peroneal nerve .</li><li>• difficulty</li><li>• dorsiflexion</li><li>• foot</li><li>• sensory loss</li><li>• nerve's distribution</li><li>• align</li><li>• issue</li><li>• common peroneal nerve</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1446</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1446</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old traffic constable experienced severe pain in the region of his heel and had great difficulty in walking. His family doctor examined his foot and noted severe tenderness in the heel region. He diagnosed the condition as plantar fasciitis (policeman's heel) and advised him to reduce weight and to restrict walking. The following are all true except:", "options": [{"label": "A", "text": "Inflammation of plantar aponeurosis is called plantar fasciitis", "correct": false}, {"label": "B", "text": "Plantar aponeurosis acts as a strong tie beam for maintaining longitudinal arch", "correct": false}, {"label": "C", "text": "Common in individuals whose profession requires a long period of standing", "correct": false}, {"label": "D", "text": "Inflammation of plantar aponeurosis usually occurs at its base", "correct": true}], "correct_answer": "D. Inflammation of plantar aponeurosis usually occurs at its base", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/02/picture45_uyWuKkF.jpg"], "explanation": "<p><strong>Ans. D) Inflammation of plantar aponeurosis usually occurs at its base</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Inflammation of plantar aponeurosis is called plantar fasciitis: Plantar fasciitis is characterized by inflammation of the plantar fascia , also known as plantar aponeurosis . The plantar fascia is a thick band of tissue that runs along the bottom of the foot , connecting the heel bone to the toes . Inflammation in this area leads to the pain typically associated with plantar fasciitis , often felt in the heel .</li><li>• Option A</li><li>• Plantar fasciitis</li><li>• inflammation</li><li>• plantar fascia</li><li>• plantar aponeurosis</li><li>• thick band</li><li>• tissue</li><li>• bottom</li><li>• foot</li><li>• connecting</li><li>• heel bone</li><li>• toes</li><li>• pain</li><li>• plantar fasciitis</li><li>• heel</li><li>• Option B . Plantar aponeurosis acts as a strong tie beam for maintaining longitudinal arch: Plantar aponeurosis plays a critical role in maintaining the structural integrity of the foot's arch . It supports the longitudinal arch and absorbs the stresses placed on the foot during walking and standing .</li><li>• Option B</li><li>• Plantar aponeurosis</li><li>• maintaining</li><li>• structural integrity</li><li>• foot's arch</li><li>• longitudinal arch</li><li>• absorbs</li><li>• stresses</li><li>• foot</li><li>• walking</li><li>• standing</li><li>• Option C. Common in individuals whose profession requires a long period of standing: Plantar fasciitis is commonly seen in individuals whose occupations involve prolonged periods of standing or walking . This includes jobs like traffic constables , teachers , factory workers , etc. The constant pressure and strain on the plantar fascia can lead to its inflammation.</li><li>• Option C.</li><li>• prolonged periods</li><li>• standing</li><li>• walking</li><li>• traffic constables</li><li>• teachers</li><li>• factory</li><li>• workers</li><li>• constant pressure</li><li>• strain</li><li>• plantar fascia</li><li>• lead</li><li>• inflammation.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Inflammation of plantar aponeurosis usually occurs at its apex . Inflammation in plantar aponeurosis typically occurs at the insertion of the plantar fascia on the medial process of the calcaneal tuberosity (the heel bone ), not at its base. This point of attachment is where the highest stress occurs when standing or walking , making it the most common site for inflammation in plantar aponeurosis .</li><li>• Inflammation of plantar aponeurosis usually occurs at its apex .</li><li>• Inflammation</li><li>• Inflammation in plantar aponeurosis typically occurs at the insertion of the plantar fascia on the medial process of the calcaneal tuberosity (the heel bone ), not at its base.</li><li>• insertion</li><li>• plantar fascia</li><li>• medial process</li><li>• calcaneal tuberosity</li><li>• heel bone</li><li>• This point of attachment is where the highest stress occurs when standing or walking , making it the most common site for inflammation in plantar aponeurosis .</li><li>• highest stress</li><li>• standing</li><li>• walking</li><li>• most common site</li><li>• inflammation</li><li>• plantar</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1419</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1419</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male with a history of chronic venous insufficiency presents with pain and swelling in the posterior aspect of his right leg. He reports that the symptoms have been progressively worsening over several months. On examination, there are visibly dilated veins near the surface of his skin, predominantly localized to the posterior aspect of his calf. Which vein is most likely affected in this patient?", "options": [{"label": "A", "text": "Great Saphenous Vein", "correct": false}, {"label": "B", "text": "Short Saphenous Vein", "correct": true}, {"label": "C", "text": "Femoral Vein", "correct": false}, {"label": "D", "text": "Anterior Tibial Vein", "correct": false}], "correct_answer": "B. Short Saphenous Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture49.jpg"], "explanation": "<p><strong>Ans. B) Short Saphenous Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Great Saphenous Vein: It is incorrect . The great saphenous vein primarily runs along the medial aspect of the leg and thigh , not the posterior aspect of the calf, which is the site of symptoms in this patient.</li><li>• Option A</li><li>• incorrect</li><li>• medial aspect</li><li>• leg</li><li>• thigh</li><li>• site</li><li>• symptoms</li><li>• Option C. Femoral Vein: The femoral vein is a deep vein located in the thigh , not typically associated with visible varicosities and not located in the posterior aspect of the calf.</li><li>• Option C.</li><li>• deep vein</li><li>• thigh</li><li>• Option D . Anterior Tibial Vein: This vein is part of the deep venous system of the lower leg and is not typically associated with superficial varicosities. Its location also does not correspond with the patient's symptoms.</li><li>• Option D</li><li>• deep venous system</li><li>• lower leg</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The short saphenous vein runs along the posterior aspect of the leg and is commonly involved in venous insufficiency presenting with symptoms and signs localized to this area, as described in the patient.</li><li>➤ The short saphenous vein runs along the posterior aspect of the leg and is commonly involved in venous insufficiency presenting with symptoms and signs localized to this area, as described in the patient.</li><li>➤ posterior aspect</li><li>➤ leg</li><li>➤ venous insufficiency</li><li>➤ symptoms</li><li>➤ signs localized</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 461.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 461.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What is not true about the Patellar Tendon Reflex?", "options": [{"label": "A", "text": "Monosynaptic Reflex Arc", "correct": false}, {"label": "B", "text": "Absence of this Reflex is called Westphal’s Sign", "correct": false}, {"label": "C", "text": "It is exaggerated in Upper Motor Neuron Lesions", "correct": false}, {"label": "D", "text": "It tests the L1, L2 Segments of the Spinal Cord", "correct": true}], "correct_answer": "D. It tests the L1, L2 Segments of the Spinal Cord", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture1.jpg"], "explanation": "<p><strong>Ans. D) It tests the L1, L2 Segments of the Spinal Cord</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Monosynaptic reflex arc: The patellar tendon reflex is a classic example of a monosynaptic reflex arc. In this reflex, a tap on the patellar tendon slightly stretches the quadriceps muscle in the thigh . This stretch is detected by sensory neurons , which directly synapse with motor neurons in the spinal cord . These motor neurons then cause the quadriceps muscle to contract , leading to knee-jerk movement . This direct connection between sensory and motor neurons , without any interneurons, is what makes it a monosynaptic reflex .</li><li>• Option A</li><li>• patellar tendon reflex</li><li>• tap</li><li>• patellar tendon</li><li>• stretches</li><li>• quadriceps muscle</li><li>• thigh</li><li>• sensory neurons</li><li>• directly synapse</li><li>• motor neurons</li><li>• spinal cord</li><li>• quadriceps muscle</li><li>• contract</li><li>• knee-jerk movement</li><li>• sensory</li><li>• motor neurons</li><li>• monosynaptic reflex</li><li>• Option B. Absence of this reflex is called Westphal’s sign: Westphal’s sign refers to the absence or decrease of the patellar tendon reflex and can indicate damage to the components of the reflex arc , including the sensory and motor neurons , or the synaptic connection in the spinal cord . It is often associated with lower motor neuron lesions .</li><li>• Option B.</li><li>• Westphal’s sign</li><li>• absence</li><li>• decrease</li><li>• patellar tendon reflex</li><li>• damage</li><li>• reflex arc</li><li>• sensory</li><li>• motor neurons</li><li>• synaptic connection</li><li>• spinal cord</li><li>• lower motor neuron lesions</li><li>• Option C . It is exaggerated in upper motor neuron lesions: An exaggerated patellar tendon reflex can be a sign of upper motor neuron lesions . Upper motor neuron lesions can lead to increased muscle tone and hyperreflexia due to the loss of inhibitory signals from the brain to the spinal reflex arcs . Therefore, patients with such lesions often exhibit a heightened patellar tendon reflex .</li><li>• Option C</li><li>• upper motor neuron lesions</li><li>• increased muscle tone</li><li>• hyperreflexia</li><li>• loss</li><li>• inhibitory signals</li><li>• brain</li><li>• spinal reflex arcs</li><li>• exhibit</li><li>• heightened patellar tendon</li><li>• reflex</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The patellar tendon reflex actually tests the L2, L3 , and L4 segments of the spinal cord , not the L1, L2 segments. The sensory and motor neurons involved in this reflex are located in these segments, and tapping the patellar tendon helps to assess the integrity of these specific parts of the spinal cord .</li><li>• The patellar tendon reflex actually tests the L2, L3 , and L4 segments of the spinal cord , not the L1, L2 segments.</li><li>• patellar tendon reflex</li><li>• tests</li><li>• L2, L3</li><li>• L4 segments</li><li>• spinal cord</li><li>• The sensory and motor neurons involved in this reflex are located in these segments, and tapping the patellar tendon helps to assess the integrity of these specific parts of the spinal cord .</li><li>• sensory</li><li>• motor neurons</li><li>• tapping</li><li>• patellar tendon</li><li>• assess</li><li>• integrity</li><li>• spinal cord</li><li>• Ref: Gray’s Anatomy 41 st Edition, Pg no. 1379</li><li>• Ref: Gray’s Anatomy 41 st Edition, Pg no. 1379</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 47-year-old obese man felt a snap in his right lower leg while playing squash and couldn’t continue the game further. He reached the emergency department with complaints of acute severe pain in his right lower leg and heel. The physician confirmed a diagnosis of an acute right Achilles tendon rupture, and the patient was immediately posted for open reparative surgery. Which of the following statements is correct?", "options": [{"label": "A", "text": "It causes Dorsiflexion of Foot at the Ankle Joint", "correct": false}, {"label": "B", "text": "It is supplied by Superficial Peroneal Nerve", "correct": false}, {"label": "C", "text": "It is the Strongest Tendon of the Human Body", "correct": true}, {"label": "D", "text": "Its inserts into the Upper Third of Calcaneus", "correct": false}], "correct_answer": "C. It is the Strongest Tendon of the Human Body", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture2.jpg"], "explanation": "<p><strong>Ans. C) It is the Strongest Tendon of the Human Body</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It causes dorsiflexion of foot at the ankle joint: The Achilles tendon , formed by the confluence of the gastrocnemius and soleus muscles , is actually responsible for plantarflexion of the foot at the ankle joint , not dorsiflexion. Plantarflexion is the movement that points the toes downward , which is essential for actions like pushing off while walking or standing on tiptoes.</li><li>• Option A</li><li>• Achilles tendon</li><li>• confluence</li><li>• gastrocnemius</li><li>• soleus muscles</li><li>• plantarflexion</li><li>• foot</li><li>• ankle joint</li><li>• Plantarflexion</li><li>• points</li><li>• toes downward</li><li>• essential</li><li>• actions</li><li>• pushing off</li><li>• walking</li><li>• standing</li><li>• tiptoes.</li><li>• Option B . It is supplied by superficial peroneal nerve: The muscles that form the Achilles tendon , namely the gastrocnemius and soleus muscles , are innervated by the tibial nerve , a branch of the sciatic nerve . The superficial peroneal nerve , on the other hand, primarily innervates muscles in the lateral compartment of the leg , which are involved in eversion of the foot .</li><li>• Option B</li><li>• Achilles tendon</li><li>• gastrocnemius</li><li>• soleus muscles</li><li>• tibial nerve</li><li>• branch</li><li>• sciatic nerve</li><li>• superficial peroneal nerve</li><li>• innervates</li><li>• lateral compartment</li><li>• leg</li><li>• eversion</li><li>• foot</li><li>• Option D . It inserts into the upper third of calcaneus: The Achilles tendon actually inserts into the posterior aspect of the calcaneus , not specifically into the upper third. It attaches near the mid-region of the calcaneus , providing the leverage necessary for plantarflexion of the foot .</li><li>• Option D</li><li>• Achilles tendon</li><li>• inserts</li><li>• posterior aspect</li><li>• calcaneus</li><li>• attaches</li><li>• mid-region</li><li>• calcaneus</li><li>• leverage</li><li>• plantarflexion</li><li>• foot</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The Achilles tendon is known to be the strongest and largest tendon in the human body . It can withstand great tensile forces , which is essential for the transmission of forces from the calf muscles to the foot , enabling activities like running , jumping , and climbing .</li><li>• The Achilles tendon is known to be the strongest and largest tendon in the human body .</li><li>• Achilles tendon</li><li>• strongest</li><li>• largest tendon</li><li>• human body</li><li>• It can withstand great tensile forces , which is essential for the transmission of forces from the calf muscles to the foot , enabling activities like running , jumping , and climbing .</li><li>• great tensile forces</li><li>• transmission</li><li>• forces</li><li>• calf muscles</li><li>• foot</li><li>• running</li><li>• jumping</li><li>• climbing</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1409</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1409</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents with aching pain and swelling in her left leg, which worsens by the end of the day and improves with leg elevation. Physical examination reveals dilated, tortuous superficial veins in her left medial thigh. Doppler ultrasound confirms venous reflux. Which vein is most likely involved in this patient's condition?", "options": [{"label": "A", "text": "Femoral Vein", "correct": false}, {"label": "B", "text": "Great Saphenous Vein", "correct": true}, {"label": "C", "text": "Popliteal Vein", "correct": false}, {"label": "D", "text": "Small Saphenous Vein", "correct": false}], "correct_answer": "B. Great Saphenous Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture48.jpg"], "explanation": "<p><strong>Ans. B) Great Saphenous Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A : The femoral vein is a deep vein , and while it can be involved in venous insufficiency , the presentation described is more typical of superficial venous insufficiency , particularly involving the great saphenous vein .</li><li>• Option A</li><li>• deep vein</li><li>• venous insufficiency</li><li>• more typical</li><li>• superficial venous insufficiency</li><li>• involving</li><li>• great saphenous vein</li><li>• Option C: The popliteal vein is also part of the deep venous system . Pathology involving the popliteal vein would likely present with symptoms of deep vein thrombosis rather than superficial varicosities .</li><li>• Option C:</li><li>• deep venous system</li><li>• popliteal vein</li><li>• symptoms</li><li>• deep vein thrombosis</li><li>• superficial varicosities</li><li>• Option D : While the small saphenous vein can be involved in varicose veins , its path along the back of the leg makes it less likely to be the vein involved in this patient's symptoms.</li><li>• Option D</li><li>• small saphenous vein</li><li>• varicose veins</li><li>• path</li><li>• back</li><li>• leg</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ This patient's symptoms and the location of the dilated veins along the medial thigh are classic for varicosities involving the great saphenous vein . This vein runs along the length of the leg and is commonly affected in chronic venous insufficiency .</li><li>➤ This patient's symptoms and the location of the dilated veins along the medial thigh are classic for varicosities involving the great saphenous vein . This vein runs along the length of the leg and is commonly affected in chronic venous insufficiency .</li><li>➤ dilated veins</li><li>➤ medial thigh</li><li>➤ classic</li><li>➤ varicosities</li><li>➤ great saphenous vein</li><li>➤ length</li><li>➤ leg</li><li>➤ affected</li><li>➤ chronic venous insufficiency</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 460.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 460.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 17-year-old, who was going to represent his college football team in an intercollege sports event, after one of his practice sessions felt a vague pain over the inner side of his midfoot just above the longitudinal arch. His orthopedician also noted redness, tenderness and swelling in the area pointed out by the patient. The below image is the X-ray of the patient’s foot. Which of the following statements is true pertaining to the arrow pointed in the above image?", "options": [{"label": "A", "text": "The patient had a Sesamoid Bone in his Medial Longitudinal Arch", "correct": false}, {"label": "B", "text": "There is Fracture of Cuboid Bone", "correct": false}, {"label": "C", "text": "The Tendon of Tibialis Posterior Muscle inserts into the Pointed Structure", "correct": true}, {"label": "D", "text": "The joint formed between the Pointed Structure &amp; Talus is a Saddle Joint", "correct": false}], "correct_answer": "C. The Tendon of Tibialis Posterior Muscle inserts into the Pointed Structure", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture-35_yZb8rGY.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The Tendon of Tibialis Posterior Muscle inserts into the Pointed Structure</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The patient had a sesamoid bone in his medial longitudinal arch: The osnaviculum is not a sesamoid bone. Sesamoid bones are small , round bones embedded in tendons , typically found in locations where a tendon passes over a joint , like the patella. The navicular bone forms part of the medial longitudinal arch of the foot and articulates with several other bones in the foot.</li><li>• Option A</li><li>• osnaviculum</li><li>• not</li><li>• Sesamoid bones</li><li>• small</li><li>• round bones</li><li>• tendons</li><li>• tendon passes</li><li>• over a joint</li><li>• navicular bone</li><li>• medial longitudinal arch</li><li>• foot</li><li>• articulates</li><li>• Option B . There is fracture of cuboid bone: The cuboid is another tarsal bone located in the foot , but it is distinct from the navicular bone. The X-ray described in the scenario would be needed to assess if there is indeed a fracture of the cuboid bone .</li><li>• Option B</li><li>• cuboid</li><li>• another tarsal bone</li><li>• foot</li><li>• needed</li><li>• assess</li><li>• indeed</li><li>• fracture</li><li>• cuboid bone</li><li>• Option D. The joint formed between the pointed structure &amp; talus is a saddle joint: The joint between the navicular bone and the talus is a plane type of synovial joint , not a saddle joint. The navicular-talus joint primarily allows for gliding movements and plays a role in the complex articulations of the foot .</li><li>• Option D.</li><li>• navicular bone</li><li>• talus</li><li>• plane type</li><li>• synovial joint</li><li>• navicular-talus joint</li><li>• allows</li><li>• gliding movements</li><li>• complex articulations</li><li>• foot</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The tendon of tibialis posterior muscle inserts into the osnaviculum structure . The tibialis posterior muscle , which plays a crucial role in supporting the arch of the foot , indeed inserts into the navicular bone , among other structures in the midfoot. This muscle is significant for maintaining foot stability and supporting the arch during activities like walking and running .</li><li>• The tendon of tibialis posterior muscle inserts into the osnaviculum structure .</li><li>• osnaviculum structure</li><li>• The tibialis posterior muscle , which plays a crucial role in supporting the arch of the foot , indeed inserts into the navicular bone , among other structures in the midfoot.</li><li>• tibialis posterior muscle</li><li>• supporting</li><li>• arch</li><li>• foot</li><li>• inserts</li><li>• navicular bone</li><li>• This muscle is significant for maintaining foot stability and supporting the arch during activities like walking and running .</li><li>• maintaining foot stability</li><li>• supporting</li><li>• arch</li><li>• activities</li><li>• walking</li><li>• running</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male had shifted into his new house with his family. He was trying to drill a hole in the wall to hang a photo frame. His four-year-old son, who was all excited and running all around the new house, accidentally pushed the stool on which his father was standing. He fell down from the stool and as he fell the drill slipped off from his hands and fell on the lateral aspect of his foot. He felt severe pain over the lateral aspect of his midfoot. Given below is the x-ray of his foot which showed fracture of cuboid bone with displaced fragments and moderate soft tissue edema. Which of the following statements is true pertaining to the given image?", "options": [{"label": "A", "text": "The Cuboid Bone has Four Articular Surfaces", "correct": false}, {"label": "B", "text": "The Tendon of Peroneus Brevis passes through a Groove on the under surface of Cuboid", "correct": false}, {"label": "C", "text": "Calcaneocuboid Joint is a Plane Synovial Joint", "correct": false}, {"label": "D", "text": "The Plantar Surface of Cuboid gives attachment to Short &amp; Long Plantar Ligaments", "correct": true}], "correct_answer": "D. The Plantar Surface of Cuboid gives attachment to Short & Long Plantar Ligaments", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture3.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture4.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture5.jpg"], "explanation": "<p><strong>Ans. D) The Plantar Surface of Cuboid gives attachment to Short &amp; Long Plantar Ligaments</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The cuboid bone has four articular surfaces: The cuboid bone typically has six articular surfaces . It articulates with the calcaneus , the lateral cuneiform , and the fourth and fifth metatarsals . Additionally, it has articular surfaces for the navicular and a part of the third metatarsal in some cases.</li><li>• Option A</li><li>• six articular surfaces</li><li>• articulates</li><li>• calcaneus</li><li>• lateral cuneiform</li><li>• fourth</li><li>• fifth metatarsals</li><li>• articular surfaces</li><li>• navicular</li><li>• third metatarsal</li><li>• Option B . The tendon of peroneus brevis passes through a groove on the undersurface of cuboid: It lies in front of the peroneus longus in a common synovial sheath . Then it passes downward and forward above the peroneal trochlea of the calcaneus underneath the superior pulley of the inferior peroneal retinaculum . Here it is enclosed in a separate synovial sheath . Finally, it passes forward and laterally to be inserted into the tubercle on the lateral side of the base of the fifth metatarsal .</li><li>• Option B</li><li>• front</li><li>• peroneus longus</li><li>• common synovial sheath</li><li>• passes downward</li><li>• forward</li><li>• above</li><li>• peroneal trochlea</li><li>• calcaneus</li><li>• superior pulley</li><li>• inferior peroneal retinaculum</li><li>• synovial sheath</li><li>• forward</li><li>• laterally</li><li>• inserted</li><li>• tubercle</li><li>• lateral side</li><li>• base</li><li>• fifth metatarsal</li><li>• Option C. Calcaneocuboid joint is a plane synovial joint: The calcaneocuboid joint , is a saddle type of synovial joint . The opposed articular surfaces of the calcaneum and cuboid are reciprocally concavo-convex .</li><li>• Option C.</li><li>• calcaneocuboid joint</li><li>• saddle type</li><li>• synovial joint</li><li>• opposed articular surfaces</li><li>• calcaneum</li><li>• cuboid</li><li>• reciprocally concavo-convex</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The plantar surface of the cuboid provides attachment points for both the short and long plantar ligaments . These ligaments play a crucial role in maintaining the arches of the foot and providing stability during weight-bearing activities .</li><li>➤ The plantar surface of the cuboid provides attachment points for both the short and long plantar ligaments . These ligaments play a crucial role in maintaining the arches of the foot and providing stability during weight-bearing activities .</li><li>➤ plantar surface</li><li>➤ cuboid</li><li>➤ attachment</li><li>➤ both</li><li>➤ short</li><li>➤ long plantar ligaments</li><li>➤ crucial role</li><li>➤ maintaining</li><li>➤ arches</li><li>➤ foot</li><li>➤ providing stability</li><li>➤ weight-bearing activities</li><li>➤ Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 437</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old male patient presented to OPD with pain in the right foot with a limp. Swelling and tenderness were found to be present on the medial aspect of his midfoot above the longitudinal arch. His past medical history revealed a trauma nine months ago which had been treated conservatively. Anteroposterior (AP) direct X-ray of the right foot and direct lateral roentgenograms of the feet and a computed tomography showed features suggestive of fracture of the pointed structure in the given image. Which of the following statements is true about the pointed structure in the given image?", "options": [{"label": "A", "text": "It Articulates with the Base of the 2 nd Metatarsal Joint to form a Hinge Synovial Joint", "correct": false}, {"label": "B", "text": "Posterior Part of its Plantar Surface receives the Insertion of Abductor Hallucis", "correct": false}, {"label": "C", "text": "Medial Surface is Non Articular and receives the Insertion of Tibialis Anterior", "correct": true}, {"label": "D", "text": "Peroneus Tertius is inserted on the Lateral Surface", "correct": false}], "correct_answer": "C. Medial Surface is Non Articular and receives the Insertion of Tibialis Anterior", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture37.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture6.jpg"], "explanation": "<p><strong>Ans. C) Medial Surface is Non Articular and receives the Insertion of Tibialis Anterior</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. It articulates with the base of the 2nd metatarsal joint to form a hinge synovial joint: The medial cuneiform does articulate with the base of the second metatarsal , but this joint is not typically classified as a hinge joint. It is more accurately described as a plane type of synovial joint , allowing for gliding movements .</li><li>• Option A.</li><li>• medial cuneiform</li><li>• articulate</li><li>• base</li><li>• second metatarsal</li><li>• more accurately</li><li>• plane type</li><li>• synovial joint</li><li>• allowing</li><li>• gliding movements</li><li>• Option B. Posterior part of its plantar surface receives the insertion of abductor hallucis: The abductor hallucis muscle inserts primarily on the medial side of the base of the proximal phalanx of the big toe , not on the medial cuneiform. The plantar surface of the medial cuneiform provides attachment for other structures, such as part of the tendon of the tibialis posterior.</li><li>• Option B.</li><li>• abductor hallucis muscle</li><li>• primarily</li><li>• medial side</li><li>• base</li><li>• proximal phalanx</li><li>• big toe</li><li>• plantar surface</li><li>• medial cuneiform</li><li>• attachment</li><li>• part</li><li>• tendon</li><li>• tibialis posterior.</li><li>• Option D . Peroneus tertius is inserted on the lateral surface: The peroneus tertius , a muscle involved in dorsiflexion and eversion of the foot , typically inserts on the base of the fifth metatarsal , not on the medial cuneiform. The dorsal surface of medial cuneiform gives attachment to dorsal cuneonavicular &amp; Cuneo metatarsal ligaments .</li><li>• Option D</li><li>• peroneus tertius</li><li>• dorsiflexion</li><li>• eversion</li><li>• foot</li><li>• inserts</li><li>• base</li><li>• fifth metatarsal</li><li>• dorsal surface</li><li>• medial cuneiform</li><li>• attachment</li><li>• dorsal cuneonavicular</li><li>• Cuneo metatarsal ligaments</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The medial surface of the medial cuneiform is non-articular and serves as the insertion point for the tibialis anterior muscle . This muscle plays a crucial role in dorsiflexion and inversion of the foot . The insertion of the tibialis anterior on the medial cuneiform is significant for foot dynamics , particularly in activities involving lifting the foot .</li><li>• The medial surface of the medial cuneiform is non-articular and serves as the insertion point for the tibialis anterior muscle .</li><li>• non-articular</li><li>• serves</li><li>• insertion</li><li>• tibialis anterior muscle</li><li>• This muscle plays a crucial role in dorsiflexion and inversion of the foot . The insertion of the tibialis anterior on the medial cuneiform is significant for foot dynamics , particularly in activities involving lifting the foot .</li><li>• crucial role</li><li>• dorsiflexion</li><li>• inversion</li><li>• foot</li><li>• insertion</li><li>• tibialis anterior</li><li>• medial cuneiform</li><li>• foot dynamics</li><li>• involving lifting</li><li>• foot</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 297</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 297</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In an anatomy review session, medical students are discussing the nerve supply to the gluteal muscles. They focus on the root values of the superior and inferior gluteal nerves and the muscles they innervate. Which of the following options correctly pairs these nerves with their respective root values and muscle supply?", "options": [{"label": "A", "text": "Superior Gluteal Nerve: L4-S1, supplies Gluteus Maximus; Inferior Gluteal Nerve: L5-S2, supplies Gluteus Medius and Minimus", "correct": false}, {"label": "B", "text": "Superior Gluteal Nerve: L4-S1, supplies Gluteus Medius and Minimus; Inferior Gluteal Nerve: L5-S2, supplies Gluteus Maximus", "correct": true}, {"label": "C", "text": "Superior Gluteal Nerve: L5-S2, supplies Gluteus Maximus; Inferior Gluteal Nerve: L4-S1, supplies Gluteus Medius and Minimus", "correct": false}, {"label": "D", "text": "Superior Gluteal Nerve: L5-S2, supplies Tensor Fasciae Latae; Inferior Gluteal Nerve: L4-S1, supplies Gluteus Maximus", "correct": false}], "correct_answer": "B. Superior Gluteal Nerve: L4-S1, supplies Gluteus Medius and Minimus; Inferior Gluteal Nerve: L5-S2, supplies Gluteus Maximus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture45.jpg"], "explanation": "<p><strong>Ans. B) Superior Gluteal Nerve: L4-S1, supplies Gluteus Medius and Minimus; Inferior Gluteal Nerve: L5-S2, supplies Gluteus Maximus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Superior gluteal nerve: L4-S1, supplies gluteus maximus; Inferior gluteal nerve: L5-S2, supplies gluteus medius and minimus: This is incorrect . The superior gluteal nerve innervates the gluteus medius and minimus , not the maximus. The inferior gluteal nerve innervates the gluteus maximus .</li><li>• Option A.</li><li>• incorrect</li><li>• gluteus medius</li><li>• minimus</li><li>• gluteus maximus</li><li>• Option C. Superior gluteal nerve: L5-S2, supplies gluteus maximus; Inferior gluteal nerve: L4-S1, supplies gluteus medius and minimus: This reverses the correct innervation and root values for the superior and inferior gluteal nerves .</li><li>• Option C.</li><li>• reverses</li><li>• correct innervation</li><li>• root values</li><li>• superior</li><li>• inferior gluteal nerves</li><li>• Option D. Superior gluteal nerve: L5-S2, supplies tensor fasciae latae; Inferior gluteal nerve: L4-S1, supplies gluteus maximus: While the superior gluteal nerve does supply the tensor fasciae latae , this option incorrectly assigns the root values and does not include the gluteus medius and minimus.</li><li>• Option D.</li><li>• superior gluteal nerve</li><li>• supply</li><li>• tensor fasciae latae</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The superior gluteal nerve , arising from L4-S1 nerve roots , supplies the gluteus medius and minimus , as well as the tensor fasciae latae . The inferior gluteal nerve , originating from L5-S2 nerve roots , innervates the gluteus maximus .</li><li>➤ The superior gluteal nerve , arising from L4-S1 nerve roots , supplies the gluteus medius and minimus , as well as the tensor fasciae latae .</li><li>➤ superior gluteal nerve</li><li>➤ L4-S1 nerve roots</li><li>➤ gluteus medius</li><li>➤ minimus</li><li>➤ tensor fasciae latae</li><li>➤ The inferior gluteal nerve , originating from L5-S2 nerve roots , innervates the gluteus maximus .</li><li>➤ inferior gluteal nerve</li><li>➤ L5-S2 nerve roots</li><li>➤ innervates</li><li>➤ gluteus maximus</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 362.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 362.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 69-year-old man presented with a 5-year history of progressive distal asymmetric leg muscle wasting, painful muscle cramps and imbalance. On examination, there was left calf atrophy, toe and foot dorsiflexion weakness and left foot eversion weakness. He exhibited mild bilateral postural tremor, minimal vibratory impairment at the ankles. His gait was ataxic with a negative finding of Romberg’s test. Results of his neurophysiologic studies&amp; MRI showed features suggestive of charcotmarie tooth (CMT) disease. Given below is the plain x-ray of the patient’s foot. Looking into his x-ray, can you find out which among the following statements is not true pertaining to this case?", "options": [{"label": "A", "text": "The Forefoot is held in Plantar-Flexion at the Transverse Tarsal Joint", "correct": false}, {"label": "B", "text": "The Cuboid lies Plantar to the Navicular", "correct": false}, {"label": "C", "text": "The Toes are also Plantarflexed at the Metatarsophalangeal Joint", "correct": true}, {"label": "D", "text": "There is an Exaggeration of Longitudinal Arch", "correct": false}], "correct_answer": "C. The Toes are also Plantarflexed at the Metatarsophalangeal Joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture38_SNgazZy.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture7.jpg"], "explanation": "<p><strong>Ans. C) The Toes are also Plantarflexed at the Metatarsophalangeal Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The forefoot is held in plantarflexion at the transverse tarsal joint: Pes cavus is characterized by an excessive elevation of the longitudinal arch of the foot . The condition often leads to plantarflexion of the forefoot at the transverse tarsal joint , which contributes to the high-arched appearance .</li><li>• Option A.</li><li>• Pes cavus</li><li>• excessive elevation</li><li>• longitudinal arch</li><li>• foot</li><li>• leads</li><li>• plantarflexion</li><li>• forefoot</li><li>• transverse tarsal joint</li><li>• contributes</li><li>• high-arched appearance</li><li>• Option B . The cuboid lies plantar to the navicular: In a normal foot, the cuboid and navicular are more or less on the same plane . However, in pes cavus, due to the exaggerated arch , the cuboid bone is displaced plantar ward ( downward ) in relation to the navicular , contributing to the arch's heightened contour .</li><li>• Option B</li><li>• cuboid</li><li>• navicular</li><li>• more</li><li>• less</li><li>• same plane</li><li>• exaggerated arch</li><li>• cuboid bone</li><li>• displaced plantar ward</li><li>• downward</li><li>• navicular</li><li>• arch's heightened contour</li><li>• Option D. There is an exaggeration of the longitudinal arch: The longitudinal arch is more pronounced than normal , leading to the characteristic high arch . This can be a result of various neuromuscular diseases , including CMT , and can contribute to various functional challenges , including balance and gait issues .</li><li>• Option D.</li><li>• longitudinal arch</li><li>• pronounced</li><li>• normal</li><li>• leading</li><li>• characteristic high arch</li><li>• neuromuscular diseases</li><li>• CMT</li><li>• functional challenges</li><li>• balance</li><li>• gait issues</li><li>• Educational objective :</li><li>• Educational objective</li><li>• In pes cavus , the toes are often held in hyperextension at the metatarsophalangeal joints, while the distal phalanges may be flexed . This results from muscle imbalances in the foot and is not characterized by plantarflexion at the metatarsophalangeal joints.</li><li>• In pes cavus , the toes are often held in hyperextension at the metatarsophalangeal joints, while the distal phalanges may be flexed . This results from muscle imbalances in the foot and is not characterized by plantarflexion at the metatarsophalangeal joints.</li><li>• pes cavus</li><li>• hyperextension</li><li>• metatarsophalangeal joints,</li><li>• distal phalanges</li><li>• flexed</li><li>• muscle imbalances</li><li>• foot</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 429</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 429</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is reviewing the branches of the lumbar plexus in preparation for a surgery rotation. Which of the following options correctly lists major branches of the lumbar plexus?", "options": [{"label": "A", "text": "Femoral Nerve, Obturator Nerve, Sciatic Nerve", "correct": false}, {"label": "B", "text": "Femoral Nerve, Genitofemoral Nerve, Ilioinguinal Nerve", "correct": true}, {"label": "C", "text": "Sciatic Nerve, Pudendal Nerve, Iliohypogastric Nerve", "correct": false}, {"label": "D", "text": "Inferior Gluteal Nerve, Superior Gluteal Nerve, Femoral Nerve", "correct": false}], "correct_answer": "B. Femoral Nerve, Genitofemoral Nerve, Ilioinguinal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture43.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-164734.jpg"], "explanation": "<p><strong>Ans. B) Femoral Nerve, Genitofemoral Nerve, Ilioinguinal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Femoral nerve, Obturator nerve, Sciatic nerve : This is partially correct . The femoral and obturator nerves are major branches of the lumbar plexus , but the sciatic nerve is a branch of the sacral plexus , not the lumbar plexus.</li><li>• Option A.</li><li>• partially correct</li><li>• femoral</li><li>• obturator nerves</li><li>• major branches</li><li>• lumbar plexus</li><li>• sciatic nerve</li><li>• sacral plexus</li><li>• Option C. Sciatic nerve, Pudendal nerve, Iliohypogastric nerve : This is incorrect . The sciatic and pudendal nerves are branches of the sacral plexus . The iliohypogastric nerve is a branch of the lumbar plexus , but the other two are not.</li><li>• Option C.</li><li>• incorrect</li><li>• sciatic</li><li>• pudendal nerves</li><li>• branches</li><li>• sacral plexus</li><li>• iliohypogastric nerve</li><li>• branch</li><li>• lumbar plexus</li><li>• Option D. Inferior gluteal nerve, Superior gluteal nerve, Femoral nerve : Incorrect , as the inferior and superior gluteal nerves are branches of the sacral plexus , not the lumbar plexus. The femoral nerve is correctly identified as a branch of the lumbar plexus .</li><li>• Option D.</li><li>• Incorrect</li><li>• inferior</li><li>• superior gluteal nerves</li><li>• sacral plexus</li><li>• femoral nerve</li><li>• branch</li><li>• lumbar plexus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The femoral nerve, genitofemoral nerve, and ilioinguinal nerve are all major branches of the lumbar plexus . The lumbar plexus is formed from the ventral rami of L1-L4 spinal nerves .</li><li>➤ The femoral nerve, genitofemoral nerve, and ilioinguinal nerve are all major branches of the lumbar plexus . The lumbar plexus is formed from the ventral rami of L1-L4 spinal nerves .</li><li>➤ all</li><li>➤ major branches</li><li>➤ lumbar plexus</li><li>➤ ventral rami</li><li>➤ L1-L4 spinal nerves</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 196.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 196.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "28-year-old male, while playing football sustained an injury to his foot. The given image is the x-ray of his foot. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "The Fracture involves the Head of Fifth Metatarsal", "correct": false}, {"label": "B", "text": "The Peroneus Longus Muscle is inserted on the Dorsal Surface of Styloid Process", "correct": false}, {"label": "C", "text": "Plantar Surface of the Base gives rise to Flexor Digitiminimi Brevis", "correct": true}, {"label": "D", "text": "Medial Surface of the Shaft gives rise to the 3 rd Dorsal Interosseous Muscle", "correct": false}], "correct_answer": "C. Plantar Surface of the Base gives rise to Flexor Digitiminimi Brevis", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture41.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Plantar Surface of the Base gives rise to Flexor Digiti Minimi Brevis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The fracture involves the head of the fifth metatarsal: This statement would be incorrect if the fracture is actually in the base of the fifth metatarsal , which is more common in athletic injuries . The head of the fifth metatarsal is located near the toe , and fractures here are less common and typically result from different mechanisms of injury compared to those of the base .</li><li>• Option A</li><li>• incorrect</li><li>• fracture</li><li>• actually</li><li>• base</li><li>• fifth metatarsal</li><li>• more common</li><li>• athletic injuries</li><li>• head</li><li>• fifth metatarsal</li><li>• toe</li><li>• fractures</li><li>• less common</li><li>• different mechanisms</li><li>• injury</li><li>• those</li><li>• base</li><li>• Option B. The peroneus longus muscle is inserted on the dorsal surface of the styloid process: This statement is incorrect . The peroneus longus muscle actually inserts on the plantar surface of the medial cuneiform and the base of the first metatarsal , not the fifth metatarsal. This muscle is important for foot eversion and support of the transverse arch of the foot .</li><li>• Option B.</li><li>• incorrect</li><li>• peroneus longus muscle</li><li>• inserts</li><li>• plantar surface</li><li>• medial cuneiform</li><li>• base</li><li>• first metatarsal</li><li>• foot eversion</li><li>• support</li><li>• transverse arch</li><li>• foot</li><li>• Option D . Medial surface of the shaft gives rise to the 3rd dorsal interosseous muscle: The dorsal interossei muscles of the foot originate from the adjacent sides of the metatarsal bones . The third dorsal interosseous muscle arises from the adjacent sides of the third and fourth metatarsal bones , not from the medial surface of the shaft of the fifth metatarsal.</li><li>• Option D</li><li>• dorsal interossei muscles</li><li>• foot</li><li>• adjacent sides</li><li>• metatarsal bones</li><li>• third dorsal interosseous muscle</li><li>• adjacent sides</li><li>• third</li><li>• fourth metatarsal bones</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The flexor digiti minimi brevis muscle , which flexes the little toe , originates from the fifth metatarsal . However, its origin is typically from the base of the fifth metatarsal on the plantar side , not the plantar surface of the head of the fifth metatarsal.</li><li>• The flexor digiti minimi brevis muscle , which flexes the little toe , originates from the fifth metatarsal .</li><li>• flexor digiti minimi brevis muscle</li><li>• flexes</li><li>• little toe</li><li>• originates</li><li>• fifth metatarsal</li><li>• However, its origin is typically from the base of the fifth metatarsal on the plantar side , not the plantar surface of the head of the fifth metatarsal.</li><li>• base</li><li>• fifth metatarsal</li><li>• plantar side</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 397</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 397</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female had chronic pain over the dorsum of her right foot after she had a fall from her two wheeler, which she tried to manage conservatively. As per the advice of the doctor, she took an X-Ray but couldn’t manage time to fix an appointment with him. The girl next door had joined a medical college recently. She took this x-ray film to her. Which of the following statements is true regarding the pointed structure in the given image?", "options": [{"label": "A", "text": "It lies in the Second Layer of Sole", "correct": false}, {"label": "B", "text": "The Tendon of the Muscle where it is located Originates from Calcaneus", "correct": false}, {"label": "C", "text": "The Tendon of that Muscle is innervated by Medial Plantar Nerve", "correct": true}, {"label": "D", "text": "The Distance between the Two Arrows is traversed by the Tendon of Flexor Digitorum Longus", "correct": false}], "correct_answer": "C. The Tendon of that Muscle is innervated by Medial Plantar Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture42.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-103507.jpg"], "explanation": "<p><strong>Ans. C) The Tendon of that Muscle is innervated by Medial Plantar Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It lies in the second layer of sole: The Flexor Hallucis Brevis lies in the third layer of the sole .</li><li>• Option A</li><li>• third layer</li><li>• sole</li><li>• Option B . The tendon of the muscle where it is located originates from calcaneus: The Flexor Hallucis Brevis has a bifurcated tendon which originates from cuboid &amp; the three cuneiforms .</li><li>• Option</li><li>• B</li><li>• Flexor Hallucis Brevis</li><li>• bifurcated tendon</li><li>• originates</li><li>• cuboid</li><li>• three cuneiforms</li><li>• Option D . The distance between the two arrows is traversed by the tendon of flexor digitorum longus: The distance between the two arrows is traversed by the tendon of flexor hallucis longus .</li><li>• Option D</li><li>• tendon</li><li>• flexor hallucis longus</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The tendon of Flexor Hallucis Brevis muscle is innervated by medial plantar nerve .</li><li>• The tendon of Flexor Hallucis Brevis muscle is innervated by medial plantar nerve .</li><li>• medial plantar nerve</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 419</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 419</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Given below is the plain x-ray of a two-month-old baby diagnosed with clubfoot. Which of the following statements is true pertaining to this case?", "options": [{"label": "A", "text": "People with Clubfoot Tend to Walk on the Medial Border of the Foot", "correct": false}, {"label": "B", "text": "Foot is Fixed in inversion at the Ankle Joint", "correct": false}, {"label": "C", "text": "The Forefoot is kept Adducted by the Adductors which are Supplied by Tibial Nerve", "correct": false}, {"label": "D", "text": "The Foot is pulled Downwards due to Tight Tendoachilles", "correct": true}], "correct_answer": "D. The Foot is pulled Downwards due to Tight Tendoachilles", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture43.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture12.jpg"], "explanation": "<p><strong>Ans. D) The Foot is pulled Downwards due to Tight Tendoachilles</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. People with clubfoot tend to walk on the medial border of the foot: Clubfoot , also known as talipes equinovarus , is characterized by a complex foot deformity that often includes outward and downward positioning of the foot . As a result, individuals with untreated clubfoot may walk on the lateral border of their foot due to the deformity's positioning .</li><li>• Option A.</li><li>• Clubfoot</li><li>• talipes equinovarus</li><li>• characterized</li><li>• complex foot deformity</li><li>• outward</li><li>• downward positioning</li><li>• foot</li><li>• untreated clubfoot</li><li>• walk</li><li>• lateral border</li><li>• foot</li><li>• deformity's positioning</li><li>• Option B. Foot is fixed in inversion at the ankle joint: One of the key characteristics of clubfoot is the inversion of the foot at the subtalar joint . The foot turns inward , and this is a significant component of the deformity that needs to be corrected through treatment .</li><li>• Option B.</li><li>• clubfoot</li><li>• inversion</li><li>• foot</li><li>• subtalar joint</li><li>• foot</li><li>• inward</li><li>• component</li><li>• deformity</li><li>• corrected</li><li>• treatment</li><li>• Option C. The forefoot is kept adducted by the adductors which are supplied by tibial nerve: While the forefoot in clubfoot is indeed adducted , it's not solely due to the action of muscles supplied by the tibial nerve. The forefoot is kept adducted by the Tibialis anterior &amp; posterior . Tibialis anterior is innervated by deep peroneal nerve &amp; tibialis posterior is innervated by tibial nerve .</li><li>• Option C.</li><li>• forefoot</li><li>• clubfoot</li><li>• adducted</li><li>• forefoot</li><li>• adducted</li><li>• Tibialis anterior</li><li>• posterior</li><li>• Tibialis anterior</li><li>• innervated</li><li>• deep peroneal nerve</li><li>• tibialis posterior</li><li>• innervated</li><li>• tibial nerve</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The Achilles tendon ( tendoachilles ) is often tight or shortened in clubfoot , contributing to the downward ( equinus ) position of the foot . This tightness is a significant factor in deformity and is a focus of treatment , which often involves stretching or lengthening the Achilles tendon to correct the position of the foot .</li><li>• The Achilles tendon ( tendoachilles ) is often tight or shortened in clubfoot , contributing to the downward ( equinus ) position of the foot .</li><li>• Achilles tendon</li><li>• tendoachilles</li><li>• tight</li><li>• shortened</li><li>• clubfoot</li><li>• downward</li><li>• equinus</li><li>• position</li><li>• foot</li><li>• This tightness is a significant factor in deformity and is a focus of treatment , which often involves stretching or lengthening the Achilles tendon to correct the position of the foot .</li><li>• tightness</li><li>• significant factor</li><li>• deformity</li><li>• focus</li><li>• treatment</li><li>• involves</li><li>• stretching</li><li>• lengthening</li><li>• Achilles tendon</li><li>• correct</li><li>• position</li><li>• foot</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 429</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 429</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 48-year-old female presented to orthopaedics OPD with complaints of foot pain. She said that there was pain over the dorsum of her left foot for the past three weeks and the pain got aggravated during walking. She had been a steadfast athlete in her school and college days. On examination, there was tenderness over the dorsal surface of 2 nd and 3 rd metatarsal bones. The given image is the x-ray of the patient’s foot. Which of the following statements is incorrect pertaining to this case?", "options": [{"label": "A", "text": "The Patient is Diagnosed with Stress Fracture involving the Metatarsal Bones", "correct": false}, {"label": "B", "text": "The Distal Part of the Metatarsal Bones are involved", "correct": false}, {"label": "C", "text": "The Secondary Centre for Ossification in the Second Metatarsal is Directed tow ards its Head", "correct": true}, {"label": "D", "text": "The Oblique Head of Adductor Hallucis arises from the Base of the Third Metatarsal", "correct": false}], "correct_answer": "C. The Secondary Centre for Ossification in the Second Metatarsal is Directed tow ards its Head", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture44.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The Secondary Centre for Ossification in the Second Metatarsal is Directed towards its Head</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The patient is diagnosed with stress fracture involving the metatarsal bones: Stress fractures in the metatarsal bones are common , especially in individuals with a history of athletic activity . These fractures often result from repetitive stress and are frequently located in the 2nd and 3rd metatarsals . The patient's history of being an athlete and the specific location of her pain and tenderness align with this diagnosis. Stress fracture involving the metatarsal bones is also called march fracture .</li><li>• Option A.</li><li>• Stress fractures</li><li>• metatarsal bones</li><li>• common</li><li>• individuals</li><li>• history</li><li>• athletic activity</li><li>• repetitive stress</li><li>• 2nd</li><li>• 3rd</li><li>• metatarsals</li><li>• athlete</li><li>• her pain</li><li>• tenderness align</li><li>• Stress fracture</li><li>• metatarsal bones</li><li>• march fracture</li><li>• Option B. The distal part of the metatarsal bones is involved: The location of stress fractures can vary, but they are often in the distal part of the metatarsal bones . The distal 1/3rd part of the metatarsal bones of 2 nd &amp; 3 rd metatarsal bones are involved.</li><li>• Option B.</li><li>• location</li><li>• stress fractures</li><li>• often</li><li>• distal part</li><li>• metatarsal bones</li><li>• distal 1/3rd</li><li>• part</li><li>• metatarsal bones</li><li>• 2 nd &amp; 3 rd</li><li>• metatarsal bones</li><li>• Option D. The oblique head of adductor hallucis arises from the base of the third metatarsal: The oblique head of the adductor hallucis muscle originates from the bases of the 2nd, 3rd , and 4th metatarsal bones . This muscle plays a role in adducting the big toe and maintaining the transverse arch of the foot .</li><li>• Option D.</li><li>• originates</li><li>• 2nd, 3rd</li><li>• 4th metatarsal bones</li><li>• adducting</li><li>• big</li><li>• toe</li><li>• maintaining</li><li>• transverse arch</li><li>• foot</li><li>• Educational objective :</li><li>• Educational objective</li><li>• The secondary center of ossification in metatarsal bones , including the second metatarsal , is typically at the base , not the head. In metatarsals, the ossification begins in the shaft during fetal development and the secondary ossification center appears at the base postnatally .</li><li>• The secondary center of ossification in metatarsal bones , including the second metatarsal , is typically at the base , not the head.</li><li>• secondary center</li><li>• ossification</li><li>• metatarsal bones</li><li>• second metatarsal</li><li>• base</li><li>• In metatarsals, the ossification begins in the shaft during fetal development and the secondary ossification center appears at the base postnatally .</li><li>• ossification begins</li><li>• shaft</li><li>• fetal development</li><li>• secondary ossification</li><li>• appears</li><li>• base postnatally</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 297, 419</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 297, 419</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is learning about the vascular examination of the lower limbs. The student is asked to identify the sites where pulsations of the major arteries of the lower limb can be palpated. Which of the following options correctly pairs the arteries with their palpation sites?", "options": [{"label": "A", "text": "Femoral Artery: Groin; Popliteal Artery: Posterior Knee; Dorsalis Pedis Artery: Dorsum of Foot", "correct": true}, {"label": "B", "text": "Femoral Artery: Mid-Thigh; Posterior Tibial Artery: Anterior Ankle; Dorsalis Pedis Artery: Lateral Malleolus", "correct": false}, {"label": "C", "text": "Femoral Artery: Inguinal Ligament; Popliteal Artery: Anterior Knee; Posterior Tibial Artery: Medial Malleolus", "correct": false}, {"label": "D", "text": "Femoral Artery: Anterior Thigh; Popliteal Artery: Lateral Knee; Dorsalis Pedis Artery: Heel", "correct": false}], "correct_answer": "A. Femoral Artery: Groin; Popliteal Artery: Posterior Knee; Dorsalis Pedis Artery: Dorsum of Foot", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture44.jpg"], "explanation": "<p><strong>Ans. A) Femoral Artery: Groin; Popliteal Artery: Posterior Knee; Dorsalis Pedis Artery: Dorsum of Foot</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Femoral artery: Mid-thigh; Posterior tibial artery: Anterior ankle; Dorsalis pedis artery: Lateral malleolus: This is incorrect . The femoral artery is palpated in the groin , not the mid-thigh. The posterior tibial artery is palpated behind the medial malleolus , not the anterior ankle, and the dorsalis pedis is on the dorsum of the foot , not the lateral malleolus.</li><li>• Option B.</li><li>• incorrect</li><li>• femoral artery</li><li>• palpated</li><li>• groin</li><li>• posterior tibial artery</li><li>• behind</li><li>• medial malleolus</li><li>• dorsalis pedis</li><li>• dorsum</li><li>• foot</li><li>• Option C. Femoral artery: Inguinal ligament; Popliteal artery: Anterior knee; Posterior tibial artery: Medial malleolus: This option incorrectly states the palpation site of the popliteal artery ; it is palpated in the posterior knee .</li><li>• Option C.</li><li>• incorrectly</li><li>• palpation site</li><li>• popliteal artery</li><li>• palpated</li><li>• posterior knee</li><li>• Option D. Femoral artery: Anterior thigh; Popliteal artery: Lateral knee; Dorsalis pedis artery: Heel: This is incorrect as none of the palpation sites match the typical locations for these arteries.</li><li>• Option D.</li><li>• incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The femoral artery is palpated in the groin , the popliteal artery in the posterior aspect of the knee , and the dorsalis pedis artery on the dorsum of the foot , lateral to the extensor hallucis longus tendon .</li><li>➤ The femoral artery is palpated in the groin , the popliteal artery in the posterior aspect of the knee , and the dorsalis pedis artery on the dorsum of the foot , lateral to the extensor hallucis longus tendon .</li><li>➤ palpated</li><li>➤ groin</li><li>➤ popliteal artery</li><li>➤ posterior aspect</li><li>➤ knee</li><li>➤ dorsalis pedis artery</li><li>➤ dorsum</li><li>➤ foot</li><li>➤ lateral</li><li>➤ extensor hallucis longus tendon</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 333, 371, 397.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 333, 371, 397.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old female presented to ortho OPD with complaints of severe pain over the ball of her right foot, which increased during walking, and she has difficulty in wearing her footwear. On examination, it was found that there was undue prominence of the medial part of the metatarsal head and abnormal plantar flexion at the PIP joint in the 2nd and 3rd toes and abnormal dorsiflexion at the MTP joints. Which of the following statements is true pertaining to this case?", "options": [{"label": "A", "text": "The Dorsal Interossei cause Plantar Flexion at MTP Joint", "correct": false}, {"label": "B", "text": "The Palmar Interossei are supplied by Medial Plantar Nerve", "correct": false}, {"label": "C", "text": "The Lumbricals cause Plantar Flexion at the PIP Joints", "correct": false}, {"label": "D", "text": "The Second, Third &amp; Fourth Lumbrical are supplied by Lateral Plantar Nerve", "correct": true}], "correct_answer": "D. The Second, Third & Fourth Lumbrical are supplied by Lateral Plantar Nerve", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/25/picture45.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) The Second, Third &amp; Fourth Lumbrical are supplied by Lateral Plantar Nerve.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The dorsal interossei cause plantar flexion at MTP joint: The dorsal interossei in the foot are responsible for abducting the toes and also aid in flexion at the metatarsophalangeal joints and extension at the proximal interphalangeal and distal interphalangeal joints . They do not cause plantar flexion at the MTP joint.</li><li>• Option A.</li><li>• dorsal interossei</li><li>• foot</li><li>• abducting</li><li>• toes</li><li>• aid</li><li>• flexion</li><li>• metatarsophalangeal joints</li><li>• extension</li><li>• proximal interphalangeal</li><li>• distal interphalangeal joints</li><li>• Option B. The palmar interossei are supplied by medial plantar nerve: In the foot , the plantar interossei are supplied by the lateral plantar nerve , not the medial plantar nerve. The plantar interossei are responsible for adducting the toes and assisting in flexion at the MTP joints and extension at the PIP and DIP joints .</li><li>• Option B.</li><li>• foot</li><li>• plantar interossei</li><li>• supplied</li><li>• lateral plantar nerve</li><li>• adducting</li><li>• toes</li><li>• assisting</li><li>• flexion</li><li>• MTP joints</li><li>• extension</li><li>• PIP</li><li>• DIP joints</li><li>• Option C. The lumbricals cause plantar flexion at the PIP joints: The lumbricals in the foot , similar to those in the hand , flex at the MTP joints and extend at the PIP and DIP joints . They do not cause plantar flexion at the PIP joints.</li><li>• Option C.</li><li>• lumbricals</li><li>• foot</li><li>• hand</li><li>• flex</li><li>• MTP joints</li><li>• extend</li><li>• PIP</li><li>• DIP joints</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• In the foot , the first lumbrical is typically innervated by the medial plantar nerve , while the second, third , and fourth lumbricals are supplied by the lateral plantar nerve . The lumbricals play a role in toe movements , particularly in flexing the MTP joints and extending the PIP and DIP joints .</li><li>• In the foot , the first lumbrical is typically innervated by the medial plantar nerve , while the second, third , and fourth lumbricals are supplied by the lateral plantar nerve .</li><li>• foot</li><li>• first lumbrical</li><li>• innervated</li><li>• medial plantar nerve</li><li>• second, third</li><li>• fourth lumbricals</li><li>• lateral plantar nerve</li><li>• The lumbricals play a role in toe movements , particularly in flexing the MTP joints and extending the PIP and DIP joints .</li><li>• toe movements</li><li>• flexing</li><li>• MTP joints</li><li>• extending</li><li>• PIP</li><li>• DIP joints</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 424</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 424</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old male sprained his ankle while playing basketball, following which he developed sharp intense pain and swelling of his ankle. He was brought to the ER in a wheelchair. On examination, there was reduced ROM over the ankle. The given image is the plain x-ray of the ankle region of the patient. Which of the following statements is not true pertaining to this case?", "options": [{"label": "A", "text": "The Patient was diagnosed with Pott’s Fracture", "correct": false}, {"label": "B", "text": "The Ankle Joint is a Modified Hinge Joint", "correct": false}, {"label": "C", "text": "During Plantarflexion the Ankle Joint is Tightly Packed", "correct": true}, {"label": "D", "text": "The Posterior Margin of Tibiofibular Mortise is deepened by the Inferior Transverse Tibiofibular Ligament", "correct": false}], "correct_answer": "C. During Plantarflexion the Ankle Joint is Tightly Packed", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/25/picture46.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture13.jpg"], "explanation": "<p><strong>Ans. C) During Plantarflexion the Ankle Joint is Tightly Packed</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The patient was diagnosed with Pott’s fracture, also known as bimalleolar fracture , is a type of ankle fracture that involves fracture in both the medial and lateral malleolus . This type of fracture is typically the result of a twisting or rotation injury to the ankle , as might happen during a bad ankle sprain , like while playing sports. The clinical features mentioned in the question, such as intense pain , swelling and reduced range of motion , align with the presentation of Pott’s fracture .</li><li>• Option A. The patient was diagnosed with Pott’s fracture,</li><li>• bimalleolar fracture</li><li>• ankle fracture</li><li>• fracture</li><li>• both</li><li>• medial</li><li>• lateral malleolus</li><li>• result</li><li>• twisting</li><li>• rotation injury</li><li>• ankle</li><li>• bad ankle sprain</li><li>• intense pain</li><li>• swelling</li><li>• reduced range</li><li>• motion</li><li>• align</li><li>• Pott’s fracture</li><li>• Option B . The ankle joint is a modified hinge joint: The ankle or talocrural joint is uniaxial modified hinge joint . A hinge joint allows movement primarily in one plane , which, for the ankle , is dorsiflexion and plantarflexion . The modification comes in because there’s also a slight degree of side-to-side movement allowed.</li><li>• Option B</li><li>• ankle</li><li>• talocrural joint</li><li>• uniaxial modified</li><li>• hinge joint</li><li>• one plane</li><li>• ankle</li><li>• dorsiflexion</li><li>• plantarflexion</li><li>• slight</li><li>• degree</li><li>• side-to-side movement</li><li>• Option D. The posterior margin of tibiofibular mortise is deepened by the inferior transverse tibiofibular ligament: The tibiofibular mortise is formed by the distal ends of the tibia and fibula , which articulate with the talus bone of the foot . The posterior margin of the tibiofibular mortise is deepened by the inferior transverse tibifibular ligament . It’s role is to provide more stability to the distal tibiofibular syndesmosis .</li><li>• Option D.</li><li>• tibiofibular mortise</li><li>• distal ends</li><li>• tibia</li><li>• fibula</li><li>• articulate</li><li>• talus bone</li><li>• foot</li><li>• posterior margin</li><li>• tibiofibular mortise</li><li>• deepened</li><li>• inferior transverse</li><li>• tibifibular ligament</li><li>• stability</li><li>• distal tibiofibular syndesmosis</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• When the ankle joint is in plantarflexion , the joint configuration is said to be in a ‘ loosely packed ’ position . In this position, tibiofibular socket encloses the narrower posterior part of the trochlear surface of talus and some joint space is available between the tibiofibular mortise and the narrow posterior part of the trochlea which is a loose packed position of the ankle joint and the joint is unstable in plantar flexion .</li><li>• When the ankle joint is in plantarflexion , the joint configuration is said to be in a ‘ loosely packed ’ position .</li><li>• ankle joint</li><li>• plantarflexion</li><li>• joint configuration</li><li>• loosely packed</li><li>• position</li><li>• In this position, tibiofibular socket encloses the narrower posterior part of the trochlear surface of talus and some joint space is available between the tibiofibular mortise and the narrow posterior part of the trochlea which is a loose packed position of the ankle joint and the joint is unstable in plantar flexion .</li><li>• tibiofibular socket</li><li>• narrower posterior part</li><li>• trochlear surface</li><li>• talus</li><li>• tibiofibular mortise</li><li>• narrow posterior part</li><li>• trochlea</li><li>• loose packed position</li><li>• ankle joint</li><li>• unstable</li><li>• plantar flexion</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 447</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 447</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Under-21 Basketball Player sprained his Right Ankle after landing on an opponent’s Foot after a Jump Shot. His Ankle went over, and it was very Painful. The Ankle Swelled very quickly and he could not bear his weight. There was no evidence of fracture of lower limb bones in x-ray. This is the patient’s first ankle injury. Which structure related to the ankle joint has been injured in this case?", "options": [{"label": "A", "text": "Anterior Talo-Fibular Ligament", "correct": true}, {"label": "B", "text": "Tibio-Calcaneal part of Deltoid Ligament", "correct": false}, {"label": "C", "text": "Capsular Ligament", "correct": false}, {"label": "D", "text": "Tibio Talar part of Deltoid Ligament", "correct": false}], "correct_answer": "A. Anterior Talo-Fibular Ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture14.jpg"], "explanation": "<p><strong>Ans. A) Anterior Talo-Fibular Ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Tibio-calcaneal part of deltoid ligament: Deltoid ligament ( medial ligament ) of the ankle joint has superficial &amp; deep parts . Superficial part includes Tibionavicular, Tibiocalcanean &amp; posterior tibiotalar part . Deep part includes the Anterior tibiotalar ligament . This ligament is part of the medial deltoid ligament complex and is not typically injured in common lateral ankle sprains. Injuries to the deltoid ligament are less common and are usually associated with severe trauma or a high-energy mechanism , often involving eversion of the foot .</li><li>• Option B.</li><li>• Deltoid ligament</li><li>• medial ligament</li><li>• ankle joint</li><li>• superficial</li><li>• deep parts</li><li>• Superficial part</li><li>• Tibionavicular,</li><li>• Tibiocalcanean</li><li>• posterior tibiotalar part</li><li>• Deep part</li><li>• Anterior tibiotalar ligament</li><li>• medial deltoid ligament complex</li><li>• Injuries</li><li>• deltoid ligament</li><li>• less common</li><li>• severe trauma</li><li>• high-energy mechanism</li><li>• involving eversion</li><li>• foot</li><li>• Option C. Capsular ligament: Capsule of the ankle joint is thin in front and behind . It attaches to the periphery of the articular surface but in the anterior part , it extends somewhat to the dorsal rough surface of the neck of the talus . While the ankle joint capsule can be involved in a sprain , it is less specific than the ATFL for the type of injury described . The capsule surrounds the entire joint , and its injury usually occurs alongside more specific ligamentous injuries .</li><li>• Option C.</li><li>• Capsule</li><li>• ankle joint</li><li>• thin</li><li>• front</li><li>• behind</li><li>• attaches</li><li>• periphery</li><li>• articular surface</li><li>• anterior part</li><li>• extends</li><li>• dorsal rough surface</li><li>• neck</li><li>• talus</li><li>• ankle joint capsule</li><li>• sprain</li><li>• less specific</li><li>• than</li><li>• ATFL</li><li>• type</li><li>• injury described</li><li>• entire joint</li><li>• alongside</li><li>• specific ligamentous injuries</li><li>• Option D. Tibio-talar part of deltoid ligament: This is another component of the medial deltoid ligament . As with the tibio-calcaneal part , it is more likely to be injured with eversion injuries , not the inversion injury described in this case.</li><li>• Option D.</li><li>• another component</li><li>• medial deltoid ligament</li><li>• tibio-calcaneal part</li><li>• injured</li><li>• eversion injuries</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Lateral ligaments of the ankle joint are Anterior &amp; Posterior talofibular ligaments , and Calcaneofibular ligament . Anterior talo-fibular ligament (ATFL) is the most commonly injured ligament in lateral ankle sprains , which typically occur when the foot is plantarflexed and inverted (as might happen when landing awkwardly on someone else's foot). The ATFL stabilizes the lateral aspect of the ankle and is particularly vulnerable in this position. Given the mechanism of injury described, this is the most likely structure to be injured .</li><li>• Lateral ligaments of the ankle joint are Anterior &amp; Posterior talofibular ligaments , and Calcaneofibular ligament .</li><li>• Anterior</li><li>• Posterior talofibular ligaments</li><li>• Calcaneofibular ligament</li><li>• Anterior talo-fibular ligament (ATFL) is the most commonly injured ligament in lateral ankle sprains , which typically occur when the foot is plantarflexed and inverted (as might happen when landing awkwardly on someone else's foot).</li><li>• injured ligament</li><li>• lateral ankle sprains</li><li>• foot</li><li>• plantarflexed</li><li>• inverted</li><li>• The ATFL stabilizes the lateral aspect of the ankle and is particularly vulnerable in this position. Given the mechanism of injury described, this is the most likely structure to be injured .</li><li>• lateral aspect</li><li>• ankle</li><li>• vulnerable</li><li>• injured</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1431</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st Edition, Pg no. 1431</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A group of medical students are learning about the femoral sheath and its contents during a clinical skills session. They are asked to identify the structures contained within the femoral sheath. Which of the following options correctly lists the contents of the femoral sheath?", "options": [{"label": "A", "text": "Femoral Artery, Femoral Vein, Femoral Nerve", "correct": false}, {"label": "B", "text": "Femoral Artery, Femoral Vein, Deep Inguinal Lymph Nodes", "correct": true}, {"label": "C", "text": "Femoral Artery, Femoral Nerve, Lymphatic Vessels", "correct": false}, {"label": "D", "text": "Femoral Vein, Femoral Nerve, Lymphatic Vessels", "correct": false}], "correct_answer": "B. Femoral Artery, Femoral Vein, Deep Inguinal Lymph Nodes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture40.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture41.jpg"], "explanation": "<p><strong>Ans. B) Femoral Artery, Femoral Vein, Deep Inguinal Lymph Nodes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Femoral artery, femoral vein, femoral nerve: This is incorrect . The femoral sheath contains the femoral artery and vein , but not the femoral nerve. The femoral nerve lies outside the sheath .</li><li>• Option A.</li><li>• incorrect</li><li>• femoral sheath</li><li>• femoral artery</li><li>• vein</li><li>• lies outside</li><li>• sheath</li><li>• Option C. Femoral artery, femoral nerve, lymphatic vessels: This is incorrect as the femoral nerve is not contained within the femoral sheath.</li><li>• Option C.</li><li>• incorrect</li><li>• Option D. Femoral vein, femoral nerve, lymphatic vessels: This option is also incorrect . While the femoral vein and lymphatic vessels are within the sheath , the femoral nerve is not.</li><li>• Option D.</li><li>• also incorrect</li><li>• femoral vein</li><li>• lymphatic vessels</li><li>• within</li><li>• sheath</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The femoral sheath, a funnel-shaped fascial tube , encloses the femoral artery , femoral vein , and deep inguinal lymph nodes (in its medial compartment , known as the femoral canal ).</li><li>➤ The femoral sheath, a funnel-shaped fascial tube , encloses the femoral artery , femoral vein , and deep inguinal lymph nodes (in its medial compartment , known as the femoral canal ).</li><li>➤ funnel-shaped fascial tube</li><li>➤ encloses</li><li>➤ femoral artery</li><li>➤ femoral vein</li><li>➤ deep inguinal lymph nodes</li><li>➤ medial compartment</li><li>➤ femoral canal</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 338.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 338.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old male, who is a passionate rugby player, after one of his regular practice sessions realized that he had pain over the side of his right knee. He decided to visit his orthopedician immediately and took x-ray. To his relief, the x-ray was normal. He was prescribed analgesics. Which of the following statements is true about the structure pointed out in the given image?", "options": [{"label": "A", "text": "Styloid Process in its Head gives attachment to Biceps Femoris", "correct": false}, {"label": "B", "text": "The Neck is related Medially to the Peroneal Vessels", "correct": false}, {"label": "C", "text": "The Tip of Lateral Malleolus lies 1 cm Below that of the Medial Malleolus", "correct": true}, {"label": "D", "text": "The Extensor Surface is Broad and intervenes between the Interosseous Border &amp; Posterior Border", "correct": false}], "correct_answer": "C. The Tip of Lateral Malleolus lies 1 cm Below that of the Medial Malleolus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/25/picture47.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The Tip of Lateral Malleolus lies 1 cm Below that of the Medial Malleolus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Styloid process in its head gives attachment to biceps femoris: A styloid process , posterolateral to the articular facet which provides attachment to the fibular collateral ligament . A sloping surface in front of the styloid process for C-shaped insertion of biceps femoris .</li><li>• Option A.</li><li>• styloid process</li><li>• , posterolateral</li><li>• articular facet</li><li>• attachment</li><li>• fibular collateral ligament</li><li>• sloping surface</li><li>• front</li><li>• styloid process</li><li>• C-shaped insertion</li><li>• biceps femoris</li><li>• Option B. The neck is related medially to the peroneal vessels: The neck of the fibula is related to the common peroneal nerve , not the peroneal vessels. The common peroneal nerve wraps around the neck of the fibula and is susceptible to injury in this area. The neck is related medially to the anterior tibial vessels .</li><li>• Option B.</li><li>• neck</li><li>• fibula</li><li>• common peroneal nerve</li><li>• wraps</li><li>• neck</li><li>• fibula</li><li>• susceptible</li><li>• injury</li><li>• neck</li><li>• medially</li><li>• anterior tibial vessels</li><li>• Option D . The extensor surface is broad and intervenes between the interosseous border &amp; posterior border: The fibula does have an interosseous border that faces medially and is part of the interosseous membrane attaching the tibia and fibula . The extensor surface is narrow and intervenes between the interosseous border &amp; anterior border .</li><li>• Option D</li><li>• interosseous border</li><li>• faces medially</li><li>• interosseous membrane</li><li>• attaching</li><li>• tibia</li><li>• fibula</li><li>• extensor surface</li><li>• narrow</li><li>• intervenes</li><li>• interosseous border</li><li>• anterior border</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Anatomically, the lateral malleolus extends further down than the medial malleolus . This difference in length is typically about 1 cm , and it is a key feature in ankle anatomy .</li><li>• Anatomically, the lateral malleolus extends further down than the medial malleolus . This difference in length is typically about 1 cm , and it is a key feature in ankle anatomy .</li><li>• extends</li><li>• medial malleolus</li><li>• difference</li><li>• length</li><li>• about 1 cm</li><li>• key feature</li><li>• ankle anatomy</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 314</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 314</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 23-year-old female, manual labourer at a construction site, accidentally stepped over a sharp-edged blade in the site, following which there was severe bleeding from her sole. She was taken to a nearby hospital, where with much difficulty, the bleeding was arrested and cut ends were sutured. Which of the following statements pertaining to the above case is not true?", "options": [{"label": "A", "text": "Blood supply to sole is from branches of posterior tibial artery", "correct": false}, {"label": "B", "text": "Lateral plantar artery is the larger terminal branch and forms the plantar arterial arch", "correct": false}, {"label": "C", "text": "Plantar arterial arch will give rise to four plantar metatarsal arteries", "correct": false}, {"label": "D", "text": "Plantar arterial arch lies between the second &amp; third layer of sole", "correct": true}], "correct_answer": "D. Plantar arterial arch lies between the second & third layer of sole", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D. Plantar arterial arch lies between the second &amp; third layer of sole</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Blood supply to sole is from branches of posterior tibial artery: The sole of the foot primarily receives its blood supply from branches of the posterior tibial artery. The posterior tibial artery, after passing posterior to the medial malleolus, enters the sole of the foot where it divides into the medial and lateral plantar arteries.</li><li>• Option A</li><li>• Option B . Lateral plantar artery is the larger terminal branch and forms the plantar arterial arch: The lateral plantar artery, a terminal branch of the posterior tibial artery, is indeed the larger of the two terminal branches. It curves medially on the sole of the foot, forming the plantar arterial arch. This arch plays a critical role in supplying blood to the plantar surface of the foot.</li><li>• Option B</li><li>• Option C . Plantar arterial arch will give rise to four plantar metatarsal arteries: The plantar arterial arch typically gives rise to four plantar metatarsal arteries. These arteries further divide into digital branches to supply the toes.</li><li>• Option C</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The plantar arterial arch lies deep to the tendons of the flexor digitorum brevis, which is in the second layer of the sole. It does not lie between the second and third layers but rather deep to the second layer.</li><li>• The plantar arterial arch lies deep to the tendons of the flexor digitorum brevis, which is in the second layer of the sole. It does not lie between the second and third layers but rather deep to the second layer.</li><li>• Ref : Textbook of Anatomy Abdomen and lower limb, 3 rd edition, Vishram Singh, Volume II, pg. 419</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and lower limb, 3 rd edition, Vishram Singh, Volume II, pg. 419</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old male, known hypertensive, diabetic and a smoker for the past 30 years, visited the surgery OPD with ulcer of the dorsum of foot close to great toe. The unit chief asked one of the first clinical students to look for dorsalis pedis artery pulsation in this patient. Which of the following statements pertaining to this case is correct?", "options": [{"label": "A", "text": "Dorsalis Pedis Artery lies beneath the Deep Fascia along the Lateral Border of Dorsum of Foot", "correct": false}, {"label": "B", "text": "Close to its Termination it is crossed by the Tendon of Extensor Hallucis Longus", "correct": false}, {"label": "C", "text": "It gives rise to the First Dorsal Metatarsal Artery before Termination", "correct": true}, {"label": "D", "text": "It lies Medial to Tendon of Extensor Hallucis Longus", "correct": false}], "correct_answer": "C. It gives rise to the First Dorsal Metatarsal Artery before Termination", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture15.jpg"], "explanation": "<p><strong>Ans. C) It gives rise to the First Dorsal Metatarsal Artery before Termination</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Dorsalis pedis artery lies beneath the deep fascia along the lateral border of dorsum of foot: The dorsalis pedis artery is a continuation of the anterior tibial artery and lies on the dorsum of the foot . It travels along the anterior surface of the ankle joint and then along the dorsum of the foot, but it is not positioned along the lateral border. It is more medial , running along the dorsal aspect of the foot slightly lateral to the extensor hallucis longus tendon .</li><li>• Option A</li><li>• dorsalis pedis artery</li><li>• continuation</li><li>• anterior tibial artery</li><li>• lies</li><li>• dorsum</li><li>• foot</li><li>• anterior surface</li><li>• ankle joint</li><li>• dorsum</li><li>• more medial</li><li>• running</li><li>• dorsal aspect</li><li>• foot slightly lateral</li><li>• extensor hallucis</li><li>• longus tendon</li><li>• Option B . Close to its termination it is crossed by the tendon of extensor hallucis longus: The dorsalis pedis artery actually runs lateral to the tendon of the extensor hallucis longus , not medial. The tendon of the extensor hallucis longus does not cross over the dorsalis pedis artery.</li><li>• Option B</li><li>• dorsalis pedis artery</li><li>• lateral</li><li>• tendon</li><li>• extensor hallucis longus</li><li>• Option D . It lies medial to tendon of extensor hallucis longus: The dorsalis pedis artery lies lateral to the tendon of extensor hallucis longus . When palpating the dorsalis pedis artery , it is typically found by palpating just lateral to the tendon of the extensor hallucis longus on the dorsum of the foot .</li><li>• Option D</li><li>• dorsalis pedis artery</li><li>• lateral</li><li>• tendon</li><li>• extensor hallucis longus</li><li>• palpating</li><li>• dorsalis pedis artery</li><li>• palpating</li><li>• lateral</li><li>• tendon</li><li>• extensor hallucis longus</li><li>• dorsum</li><li>• foot</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The dorsalis pedis artery , before it terminates , gives off several branches including the first dorsal metatarsal artery , which supplies blood to the adjacent sides of the first and second toes .</li><li>• The dorsalis pedis artery , before it terminates , gives off several branches including the first dorsal metatarsal artery , which supplies blood to the adjacent sides of the first and second toes .</li><li>• dorsalis pedis artery</li><li>• terminates</li><li>• first dorsal metatarsal artery</li><li>• supplies</li><li>• blood</li><li>• adjacent sides</li><li>• first</li><li>• second toes</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 383</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 383</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "While discussing the actions of various thigh muscles, a group of medical residents focuses on the sartorius, the longest muscle in the human body. Which of the following best describes the action of the sartorius muscle?", "options": [{"label": "A", "text": "Flexes, Abducts, and Laterally Rotates the Thigh at the Hip Joint; Extends the Knee", "correct": false}, {"label": "B", "text": "Extends, Adducts, and Medially Rotates the Thigh at the Hip Joint; Flexes the Knee", "correct": false}, {"label": "C", "text": "Flexes, Abducts, and Laterally Rotates the Thigh at the Hip Joint; Flexes the Knee", "correct": true}, {"label": "D", "text": "Extends, Abducts, and Laterally Rotates the Thigh at the Hip Joint; Extends the Knee", "correct": false}], "correct_answer": "C. Flexes, Abducts, and Laterally Rotates the Thigh at the Hip Joint; Flexes the Knee", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture38.jpg"], "explanation": "<p><strong>Ans. C) Flexes, Abducts, and Laterally Rotates the Thigh at the Hip Joint; Flexes the Knee</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Flexes, abducts, and laterally rotates the thigh at the hip joint; extends the knee: This is incorrect because the sartorius does not extend the knee; it flexes the knee .</li><li>• Option A.</li><li>• incorrect</li><li>• flexes</li><li>• knee</li><li>• Option B. Extends, adducts, and medially rotates the thigh at the hip joint; flexes the knee: This is incorrect as the sartorius muscle is involved in flexion, abduction , and lateral rotation at the hip , not extension, adduction, and medial rotation.</li><li>• Option B.</li><li>• incorrect</li><li>• sartorius muscle</li><li>• flexion, abduction</li><li>• lateral rotation</li><li>• hip</li><li>• Option D. Extends, abducts, and laterally rotates the thigh at the hip joint; extends the knee: This is incorrect as the sartorius muscle does not extend the thigh or the knee; it flexes both joints .</li><li>• Option D.</li><li>• incorrect</li><li>• flexes both joints</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The sartorius muscle crosses both the hip and knee joints and is involved in flexion , abduction , and lateral rotation of the thigh at the hip joint , as well as flexion of the knee .</li><li>➤ The sartorius muscle crosses both the hip and knee joints and is involved in flexion , abduction , and lateral rotation of the thigh at the hip joint , as well as flexion of the knee .</li><li>➤ both</li><li>➤ hip</li><li>➤ knee joints</li><li>➤ involved</li><li>➤ flexion</li><li>➤ abduction</li><li>➤ lateral rotation</li><li>➤ thigh</li><li>➤ hip joint</li><li>➤ flexion</li><li>➤ knee</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 335.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 335.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 14-year-old girl while playing with her friends, sustained a thorn prick over the little toe of her right foot. She tried to remove the thorn with her own hands but failed to do so. Few days later, she developed pain, redness &amp; swelling over the same site. Which of the following sentences is not true pertaining to the above case?", "options": [{"label": "A", "text": "The Skin over the Little Toe is innervated by Superficial Peroneal Nerve", "correct": false}, {"label": "B", "text": "The Lower Vertical Group of Superficial Linguinal Lymph Nodes are Enlarged", "correct": false}, {"label": "C", "text": "The Dorsal Digital Veins of Little Toe will Drain into Short Saphenous Vein", "correct": false}, {"label": "D", "text": "An Incision made along the Lateral Border of Sole will Injure the Lateral Plantar Nerve Branch", "correct": true}], "correct_answer": "D. An Incision made along the Lateral Border of Sole will Injure the Lateral Plantar Nerve Branch", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture16.jpg"], "explanation": "<p><strong>Ans. D) An Incision made along the Lateral Border of Sole will Injure the Lateral Plantar Artery Branch</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The skin over the little toe is innervated by superficial peroneal nerve: The skin over the little toe is primarily innervated by the sural nerve , which provides sensory innervation to the lateral aspect of the foot and the lateral side of the little toe. The superficial peroneal nerve primarily innervates the dorsum of the foot .</li><li>• Option A</li><li>• skin</li><li>• little toe</li><li>• sural nerve</li><li>• sensory innervation</li><li>• lateral aspect</li><li>• foot</li><li>• lateral side</li><li>• superficial peroneal nerve</li><li>• innervates</li><li>• dorsum</li><li>• foot</li><li>• Option B . The lower vertical group of superficial inguinal lymph nodes are enlarged: The popliteal lymph nodes are enlarged , lymphatics from the little toe will follow a short saphenous vein and drain into the popliteal group of lymph nodes .</li><li>• Option B</li><li>• popliteal lymph nodes</li><li>• enlarged</li><li>• little toe</li><li>• short saphenous vein</li><li>• drain</li><li>• popliteal group</li><li>• lymph nodes</li><li>• Option C . The dorsal digital veins of the little toe will drain into short saphenous vein: The dorsal digital veins of the little toe drain into the dorsal venous arch of the foot , which in turn drains into the great saphenous vein , not the short saphenous vein. The short saphenous vein primarily drains the lateral aspect of the leg and foot .</li><li>• Option C</li><li>• dorsal digital veins</li><li>• little toe</li><li>• dorsal venous arch</li><li>• foot</li><li>• drains</li><li>• great saphenous vein</li><li>• short saphenous vein</li><li>• drains</li><li>• lateral aspect</li><li>• leg</li><li>• foot</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The lateral plantar nerve provides sensory and motor innervation to the lateral part of the sole . An incision along the lateral border of the sole would risk injuring this nerve. However, the lateral plantar artery , responsible for blood supply to this area, would not typically be at risk in an incision made along the lateral border of the sole.</li><li>• The lateral plantar nerve provides sensory and motor innervation to the lateral part of the sole .</li><li>• sensory</li><li>• motor innervation</li><li>• lateral part</li><li>• sole</li><li>• An incision along the lateral border of the sole would risk injuring this nerve. However, the lateral plantar artery , responsible for blood supply to this area, would not typically be at risk in an incision made along the lateral border of the sole.</li><li>• lateral border</li><li>• sole</li><li>• risk injuring</li><li>• lateral plantar artery</li><li>• blood supply</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 419</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 419</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old woman presented to the clinic with left foot pain. Her numbness, tingling, and burning were mainly on the 4th, 5th toes and lateral plantar aspect of the left foot, sparing the dorsum of the foot. The patient did not have much pain on weight-bearing and preferred walking over standing. Physical examination showed no significant foot deformities or atrophy of muscles in the bilateral lower limbs with normal vascular examination. Sensory examination showed reduced sensation to light touch, temperature, and vibration on the lateral plantar aspect of the left foot. The location of maximum tenderness was on the near the medial heel of the left foot. Which of the following statements pertaining to the above case is true?", "options": [{"label": "A", "text": "The Lateral Plantar Nerve is the Larger Terminal Branch of Tibial Nerve", "correct": false}, {"label": "B", "text": "The Large Size of Lateral Plantar Nerve accounts for its Larger Cutaneous Distribution", "correct": false}, {"label": "C", "text": "It also gives Dorsal Digital Branches to Supply the Nail Bed of 4th&amp; 5th Toes", "correct": true}, {"label": "D", "text": "Deep Branch of Lateral Plantar Nerve supplies the Third Plantar &amp; Fourth Dorsal Interossei", "correct": false}], "correct_answer": "C. It also gives Dorsal Digital Branches to Supply the Nail Bed of 4th& 5th Toes", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture17.jpg"], "explanation": "<p><strong>Ans. C) It also gives Dorsal Digital Branches to Supply the Nail Bed of 4th&amp; 5thToes</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The lateral plantar nerve is the larger terminal branch of the tibial nerve: The tibial nerve divides beneath the flexor retinaculum into medial &amp; lateral nerves . Medial plantar nerve is the larger terminal branch of the tibial nerve .</li><li>• Option A</li><li>• tibial nerve</li><li>• flexor retinaculum</li><li>• medial</li><li>• lateral</li><li>• nerves</li><li>• Medial plantar nerve</li><li>• larger terminal branch</li><li>• tibial nerve</li><li>• Option B . The large size of the lateral plantar nerve accounts for its larger cutaneous distribution: Lateral plantar nerve supplies skin over lateral margin of sole and lateral one and a half digits . The lateral plantar nerve primarily innervates the lateral part of the sole and does not have a larger cutaneous distribution compared to other nerves in the foot like the medial plantar nerve.</li><li>• Option B</li><li>• Lateral plantar nerve</li><li>• skin</li><li>• lateral margin</li><li>• sole</li><li>• lateral</li><li>• half digits</li><li>• lateral plantar nerve</li><li>• innervates</li><li>• lateral part</li><li>• sole</li><li>• Option D . Deep branch of lateral plantar nerve supplies the third plantar &amp; fourth dorsal interossei: Deep branch of lateral nerve supplies adductor hallucis , 2 nd to 4 th lumbricals, dorsal &amp; plantar interossei except those of fourth interosseous space.</li><li>• Option D</li><li>• adductor hallucis</li><li>• 2 nd</li><li>• 4 th lumbricals,</li><li>• dorsal</li><li>• plantar interossei</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Dorsal branches of plantar digital nerves of lateral plantar nerve supply the nail beds .</li><li>• Dorsal branches of plantar digital nerves of lateral plantar nerve supply the nail beds .</li><li>• Dorsal</li><li>• branches</li><li>• plantar digital nerves</li><li>• supply</li><li>• nail beds</li><li>• Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 424</li><li>• Ref</li><li>• : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 424</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old man presented with complaints of progressive intermittent pain in the right foot for the past two months. The pain and burning sensation were located on the foot extending from medial malleolus along the plantar surface of the sole to toes. The patient also complained of heel pain. Prolonged standing and walking aggravated the symptoms. Which one of the following statements is not correct?", "options": [{"label": "A", "text": "The Flexor Retinaculum Forms the Medial Wall of Tarsal Tunnel", "correct": false}, {"label": "B", "text": "The Medial Malleolus lies in Front of the Tunnel", "correct": false}, {"label": "C", "text": "The Tibial Nerve lies Posterolateral to Flexor Hallucis Longus Tendon", "correct": false}, {"label": "D", "text": "The Heel Pain is due to Injury to Medial Plantar Nerve", "correct": true}], "correct_answer": "D. The Heel Pain is due to Injury to Medial Plantar Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture18.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture19.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture20.jpg"], "explanation": "<p><strong>Ans. D) The Heel Pain is due to Injury to Medial Plantar Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The flexor retinaculum forms the medial wall of the tarsal tunnel: The flexor retinaculum , also known as the laciniate ligament , is a strong fibrous band that covers the tarsal tunnel on the medial side of the ankle . It forms the roof or the superior border of the tarsal tunnel and holds the tendons , nerves , and vessels in place as they pass from the leg into the foot . Flexor retinaculum extends from the anterior border of tibia malleolus to the back of calcaneus .</li><li>• Option A</li><li>• flexor retinaculum</li><li>• laciniate ligament</li><li>• strong fibrous band</li><li>• covers</li><li>• tarsal tunnel</li><li>• medial side</li><li>• ankle</li><li>• roof</li><li>• superior border</li><li>• tarsal tunnel</li><li>• holds</li><li>• tendons</li><li>• nerves</li><li>• vessels</li><li>• pass</li><li>• leg</li><li>• foot</li><li>• Flexor retinaculum</li><li>• extends</li><li>• anterior border</li><li>• tibia malleolus</li><li>• back</li><li>• calcaneus</li><li>• Option B . The medial malleolus lies in front of the tunnel: The tarsal tunnel is located posterior to the medial malleolus . The medial malleolus is a bony prominence on the inner aspect of the ankle , forming part of the tibia , and the tarsal tunnel lies just behind it. Structures passing through flexor retinaculum include tibialis posterior tendon , flexor digitorum longus , posterior tibial artery , posterior tibial vein , tibial nerve &amp; flexor hallucis longus .</li><li>• Option B</li><li>• posterior</li><li>• medial malleolus</li><li>• bony prominence</li><li>• inner aspect</li><li>• ankle</li><li>• tibia</li><li>• tarsal tunnel</li><li>• flexor retinaculum</li><li>• tibialis posterior tendon</li><li>• flexor digitorum longus</li><li>• posterior tibial artery</li><li>• posterior tibial vein</li><li>• tibial nerve</li><li>• flexor hallucis longus</li><li>• Option C . The tibial nerve lies posterolateral to flexor hallucis longus tendon: In the tarsal tunnel , the tibial nerve is positioned posteriorly and laterally relative to the tendon of the flexor hallucis longus . The tibial nerve is one of the structures that run within the tarsal tunnel .</li><li>• Option C</li><li>• tarsal tunnel</li><li>• positioned posteriorly</li><li>• laterally</li><li>• tendon</li><li>• flexor hallucis longus</li><li>• within</li><li>• tarsal tunnel</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ While the medial plantar nerve , a branch of the tibial nerve , could contribute to heel pain , it's more common for heel pain to be associated with plantar fasciitis or other causes. The medial plantar nerve typically provides sensation to the sole of the foot and pain specifically due to its injury would more likely be localized to the areas it innervates (the medial three and a half toes and the associated sole area ), not just the heel.</li><li>➤ While the medial plantar nerve , a branch of the tibial nerve , could contribute to heel pain , it's more common for heel pain to be associated with plantar fasciitis or other causes.</li><li>➤ medial plantar nerve</li><li>➤ tibial nerve</li><li>➤ contribute</li><li>➤ heel pain</li><li>➤ heel pain</li><li>➤ plantar fasciitis</li><li>➤ The medial plantar nerve typically provides sensation to the sole of the foot and pain specifically due to its injury would more likely be localized to the areas it innervates (the medial three and a half toes and the associated sole area ), not just the heel.</li><li>➤ medial plantar nerve</li><li>➤ provides sensation</li><li>➤ sole</li><li>➤ foot</li><li>➤ pain</li><li>➤ localized</li><li>➤ areas</li><li>➤ innervates</li><li>➤ medial three</li><li>➤ half toes</li><li>➤ sole area</li><li>➤ Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li><li>➤ Ref : Textbook of Anatomy Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 405</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 80-year-old gentleman was received in the Accident and Emergency Department at 3:00 am. He was an independent gentleman with no significant comorbidities. That night after dinner, he had emptied his water bottle. Around 2 am, he woke up to empty his bladder. On the way to reach the switchboard, his foot skidded over a slippery surface and he sustained a fall. Clinical examination revealed external rotation of both legs and pain on passive movement of both hips. X-ray pelvis showed completely displaced intracapsular hip fracture on both sides. Which of the following is true about blood supply to the hip joint?", "options": [{"label": "A", "text": "Artery of Head of Femur is a Major Source of Blood Supply to the Hip Joint", "correct": false}, {"label": "B", "text": "Avascular Necrosis is more common in Extracapsular Fracture", "correct": false}, {"label": "C", "text": "Retinacular Arteries Travel Deep to the Synovial Membrane", "correct": true}, {"label": "D", "text": "Nutrient Artery to Femur originates from Obturator Artery", "correct": false}], "correct_answer": "C. Retinacular Arteries Travel Deep to the Synovial Membrane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture21.jpg"], "explanation": "<p><strong>Ans. C) Retinacular Arteries Travel Deep to the Synovial Membrane</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Artery of head of femur is a major source of blood supply to the hip joint: The artery of the head of the femur (a branch of the obturator artery) does contribute to the blood supply of the head of the femur , but it is not the major source, especially in adults. In adults , the primary blood supply to the femoral head comes from the medial and lateral circumflex femoral arteries , specifically through their retinacular branches .</li><li>• Option A.</li><li>• blood supply</li><li>• head</li><li>• femur</li><li>• adults</li><li>• primary blood</li><li>• supply</li><li>• femoral head</li><li>• medial</li><li>• lateral circumflex femoral arteries</li><li>• retinacular branches</li><li>• Option B . Avascular necrosis is more common in extracapsular fracture: Avascular necrosis ( AVN ) is more commonly associated with intracapsular fractures , not extracapsular fractures. Intracapsular fractures can disrupt the blood supply to the femoral head , leading to AVN , while extracapsular fractures typically do not affect this blood supply as severely.</li><li>• Option B</li><li>• Avascular necrosis</li><li>• AVN</li><li>• intracapsular fractures</li><li>• Intracapsular fractures</li><li>• disrupt</li><li>• blood supply</li><li>• femoral head</li><li>• AVN</li><li>• extracapsular fractures</li><li>• Option D . Nutrient artery to femur originates from obturator artery: The main nutrient artery of the femur typically originates from the profunda femoris artery , not the obturator artery. The profunda femoris artery is a major branch of the femoral artery and provides significant blood supply to the femoral shaft .</li><li>• Option D</li><li>• main nutrient artery</li><li>• femur</li><li>• profunda femoris artery</li><li>• major branch</li><li>• femoral artery</li><li>• significant blood supply</li><li>• femoral shaft</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The retinacular arteries , branches of the medial and lateral circumflex femoral arteries , travel along the neck of the femur deep to the synovial membrane and are responsible for the main blood supply to the femoral head . These arteries are susceptible to injury in intracapsular hip fractures , leading to a risk of AVN .</li><li>• The retinacular arteries , branches of the medial and lateral circumflex femoral arteries , travel along the neck of the femur deep to the synovial membrane and are responsible for the main blood supply to the femoral head .</li><li>• retinacular arteries</li><li>• branches</li><li>• medial</li><li>• lateral circumflex femoral arteries</li><li>• neck</li><li>• femur deep</li><li>• synovial membrane</li><li>• main blood supply</li><li>• femoral head</li><li>• These arteries are susceptible to injury in intracapsular hip fractures , leading to a risk of AVN .</li><li>• susceptible</li><li>• injury</li><li>• intracapsular hip fractures</li><li>• leading</li><li>• risk</li><li>• AVN</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1379</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1379</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 15-year-old boy was struck by a car while walking. He was promptly taken to the nearest hospital by emergency responders, approximately 30 minutes after the accident. On examination, the right femoral head was visibly protruding from the inner side of the thigh. However, pulsation of the ipsilateral dorsalis pedis artery was noted, and there were no signs of neurological damage. The initial X-rays indicated an anterior dislocation of the right hip. Based on this scenario, which of the following statements is false?", "options": [{"label": "A", "text": "The Sciatic Nerve lies Infero-Posterior to Hip Joint", "correct": false}, {"label": "B", "text": "The Femoral Nerve lies Anterior to Hip Joint", "correct": false}, {"label": "C", "text": "Acetabulum Covers approximately 70% of the Femoral Head during all Manoeuvres", "correct": true}, {"label": "D", "text": "Sensory Deficit over Anteromedial Aspect of Thigh and Medial Side of Leg should Raise Suspicion of Injury to Femoral Nerve", "correct": false}], "correct_answer": "C. Acetabulum Covers approximately 70% of the Femoral Head during all Manoeuvres", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/25/picture48.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture22.jpg"], "explanation": "<p><strong>Ans. C) Acetabulum Covers approximately 70% of the Femoral Head during all Manoeuvres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The sciatic nerve lies infero-posterior to the hip joint: The sciatic nerve arises from the lumbosacral plexus and descends infero-posteriorly in the thigh . It passes beneath the piriformis muscle and travels down behind the hip joint . Given its location, the sciatic nerve can potentially be injured in posterior dislocations of the hip , though this wasn't the type of dislocation described in the presented case.</li><li>• Option A.</li><li>• sciatic nerve</li><li>• lumbosacral plexus</li><li>• descends infero-posteriorly</li><li>• thigh</li><li>• piriformis muscle</li><li>• travels</li><li>• down</li><li>• hip joint</li><li>• sciatic nerve</li><li>• potentially</li><li>• posterior dislocations</li><li>• hip</li><li>• Option B. The femoral nerve lies anterior to the hip joint: The femoral nerve arises from the lumbar plexus , specifically from the dorsal divisions of the second, third , and fourth lumbar nerves . It descends through the fibers of the psoas major muscle and enters the thigh beneath the inguinal ligament , supplying the anterior thigh muscles . Given its anterior position , the femoral nerve can potentially be at risk in anterior traumatic events involving the hip , such as anterior hip dislocations .</li><li>• Option B.</li><li>• arises</li><li>• lumbar plexus</li><li>• dorsal divisions</li><li>• second, third</li><li>• fourth lumbar nerves</li><li>• descends</li><li>• fibers</li><li>• psoas major muscle</li><li>• enters</li><li>• thigh</li><li>• inguinal ligament</li><li>• supplying</li><li>• anterior thigh muscles</li><li>• anterior position</li><li>• femoral nerve</li><li>• potentially</li><li>• anterior traumatic events</li><li>• involving</li><li>• hip</li><li>• anterior hip dislocations</li><li>• Option D . Sensory deficit over the anteromedial aspect of the thigh and medial side of the leg should raise suspicion of injury to the femoral nerve: The femoral nerve provides sensory innervation to the anteromedial aspect of the thigh . If there's an injury to the femoral nerve , it can result in sensory deficits in its dermatomal distribution , which includes the anteromedial thigh . The femoral nerve does not, however, provide sensation to the medial side of the leg below the knee – that's the domain of the saphenous nerve , which is a branch of the femoral nerve .</li><li>• Option D</li><li>• femoral nerve</li><li>• sensory innervation</li><li>• anteromedial aspect</li><li>• thigh</li><li>• injury</li><li>• femoral nerve</li><li>• sensory deficits</li><li>• dermatomal distribution</li><li>• includes</li><li>• anteromedial thigh</li><li>• provide sensation</li><li>• medial side</li><li>• leg below</li><li>• knee</li><li>• domain</li><li>• saphenous nerve</li><li>• branch</li><li>• femoral nerve</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The acetabulum is the socket of the hip joint , formed by parts of three pelvic bones ( ilium , ischium , and pubis ). It holds the head of the femur to constitute the hip joint . In a healthy hip joint , the acetabulum covers approximately 40% of the femoral head during all the maneuvers . This coverage provides stability to the joint while allowing a wide range of movements .</li><li>• The acetabulum is the socket of the hip joint , formed by parts of three pelvic bones ( ilium , ischium , and pubis ). It holds the head of the femur to constitute the hip joint .</li><li>• acetabulum</li><li>• socket</li><li>• hip joint</li><li>• three pelvic bones</li><li>• ilium</li><li>• ischium</li><li>• pubis</li><li>• head</li><li>• femur</li><li>• constitute</li><li>• hip joint</li><li>• In a healthy hip joint , the acetabulum covers approximately 40% of the femoral head during all the maneuvers .</li><li>• healthy hip joint</li><li>• acetabulum</li><li>• approximately 40%</li><li>• femoral head</li><li>• all</li><li>• maneuvers</li><li>• This coverage provides stability to the joint while allowing a wide range of movements .</li><li>• stability</li><li>• joint</li><li>• allowing</li><li>• wide range</li><li>• movements</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 378</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 378</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A male child developed a right-sided limp some days after his second birthday. His parents took him to see their general practitioner (GP) as they had noticed that the child had been limping on his right side for a day. The GP then referred him to the emergency department (ED) for an urgent paediatric orthopaedic opinion. On examination, the child was afebrile with stable vital signs and appeared to have a full pain free range of movement at both hips and both knees. However, he was noted to have an antalgic gait with a limp on the right side. Plain film radiographs &amp; MRI further confirmed the diagnosis of Perthes disease. Which of the following statements is true pertaining to the pointed structure?", "options": [{"label": "A", "text": "The Head of Femur is not developed", "correct": false}, {"label": "B", "text": "It Ossifies from a Single Secondary Centre that appears around 2nd year after birth", "correct": false}, {"label": "C", "text": "The Epiphyseal Plate Between Head &amp; Neck of Femur is Horizontal upto 12 years", "correct": false}, {"label": "D", "text": "The Head of Femur is a Pressure Epiphyses", "correct": true}], "correct_answer": "D. The Head of Femur is a Pressure Epiphyses", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/25/picture49.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture23.jpg"], "explanation": "<p><strong>Ans. D) The Head of Femur is a Pressure Epiphyses</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The head of femur is not developed: In Perthes disease , the head of the femur is developed but undergoes avascular necrosis due to disrupted blood supply . This condition does not indicate an absence or lack of development of the femoral head, but rather a disruption in its normal maturation and integrity .</li><li>• Option A</li><li>• Perthes disease</li><li>• head</li><li>• femur</li><li>• undergoes avascular necrosis</li><li>• disrupted blood supply</li><li>• disruption</li><li>• normal maturation</li><li>• integrity</li><li>• Option B . It ossifies from a single secondary centre that appears around 2nd year after birth: The ossification of the femoral head begins from a single secondary center , which ossifies from a single secondary centre that appears around 6 months to one year after birth .This ossification center is crucial for the proper development of the femoral head , and its disruption can lead to conditions such as Perthes disease .</li><li>• Option B</li><li>• ossification</li><li>• femoral head</li><li>• single secondary center</li><li>• ossifies</li><li>• single secondary centre</li><li>• appears</li><li>• 6 months</li><li>• one year after birth</li><li>• ossification center</li><li>• proper development</li><li>• femoral head</li><li>• Perthes disease</li><li>• Option C . The epiphyseal plate between head &amp; neck of femur is horizontal up to 12 years: The epiphyseal plate between the head &amp; neck of the femur is horizontal initially and becomes oblique by the 8th to 12 years . The orientation of the epiphyseal plate between the head and neck of the femur changes as a child grows . The statement that it remains horizontal up to 12 years oversimplifies this developmental process.</li><li>• Option C</li><li>• epiphyseal plate</li><li>• head</li><li>• neck</li><li>• femur</li><li>• horizontal initially</li><li>• becomes oblique</li><li>• 8th</li><li>• 12 years</li><li>• orientation</li><li>• epiphyseal plate</li><li>• head</li><li>• neck</li><li>• femur</li><li>• child grows</li><li>• horizontal up</li><li>• 12 years</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The head of the femur is classified as a pressure epiphysis . Pressure epiphyses are found at the ends of long bones where they are subjected to pressure and contribute to lengthwise growth of the bone . The femoral head , as a pressure epiphysis , is important in bearing the weight of the body and enabling growth in length of the femur .</li><li>• The head of the femur is classified as a pressure epiphysis . Pressure epiphyses are found at the ends of long bones where they are subjected to pressure and contribute to lengthwise growth of the bone .</li><li>• head</li><li>• femur</li><li>• pressure epiphysis</li><li>• ends</li><li>• long bones</li><li>• subjected</li><li>• pressure</li><li>• contribute</li><li>• lengthwise growth</li><li>• bone</li><li>• The femoral head , as a pressure epiphysis , is important in bearing the weight of the body and enabling growth in length of the femur .</li><li>• femoral head</li><li>• pressure epiphysis</li><li>• bearing</li><li>• weight</li><li>• body</li><li>• enabling growth</li><li>• length</li><li>• femur</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 375</li><li>• Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 375</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An 18-year-old female while driving her Two-Wheeler accidentally collided with a Car from the Opposite side on her way to college. She failed to balance her vehicle and eventually fell down while the vehicle dropped over her left lower leg. X-ray revealed fracture of Lower Fibula and Cast was applied. Few days after this, she developed Pain and Numbness over most of the Dorsum of her Left Foot and had difficulty in turning her sole outwards. Which could be the most probable sight of Nerve Compression in this patient?", "options": [{"label": "A", "text": "Dorsum of Foot", "correct": false}, {"label": "B", "text": "Lateral Compartment of Leg", "correct": true}, {"label": "C", "text": "Anterior Compartment of Leg", "correct": false}, {"label": "D", "text": "Posterior Compartment of Leg", "correct": false}], "correct_answer": "B. Lateral Compartment of Leg", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Lateral Compartment of Leg</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Compression at the dorsum of the foot could affect the superficial peroneal nerve , which supplies sensation to most of the dorsum of the foot . However, the superficial peroneal nerve travels through the lateral compartment of the leg , and its compression is more likely to occur higher up in the leg rather than at the level of the dorsum of the foot .</li><li>• Option A</li><li>• Compression</li><li>• dorsum</li><li>• foot</li><li>• affect</li><li>• superficial peroneal nerve</li><li>• sensation</li><li>• dorsum</li><li>• foot</li><li>• superficial peroneal nerve</li><li>• lateral compartment</li><li>• leg</li><li>• higher up</li><li>• leg</li><li>• level</li><li>• dorsum</li><li>• foot</li><li>• Option C . While the anterior compartment contains muscles and nerves involved in dorsiflexion of the foot , the specific symptoms of numbness over the dorsum of the foot and difficulty in eversion point more towards the lateral compartment and peroneal nerve involvement .</li><li>• Option C</li><li>• anterior compartment</li><li>• muscles</li><li>• nerves</li><li>• dorsiflexion</li><li>• foot</li><li>• numbness</li><li>• dorsum</li><li>• foot</li><li>• difficulty</li><li>• eversion point</li><li>• towards</li><li>• lateral compartment</li><li>• peroneal nerve involvement</li><li>• Option D . The posterior compartment of the leg mainly contains muscles and nerves associated with plantarflexion of the foot . Compression in this area is less likely to cause the symptoms described, such as numbness over the dorsum of the foot and difficulty in eversion .</li><li>• Option D</li><li>• posterior compartment</li><li>• muscles</li><li>• nerves</li><li>• plantarflexion</li><li>• foot</li><li>• numbness</li><li>• dorsum</li><li>• foot</li><li>• difficulty</li><li>• eversion</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The peroneal nerve , particularly the common peroneal nerve , wraps around the neck of the fibula and then divides into superficial and deep branches . The deep peroneal nerve innervates the muscles that help in dorsiflexion and eversion of the foot . Compression or damage to these nerves in the lateral compartment , especially following a fibular fracture , could lead to the symptoms described.</li><li>• The peroneal nerve , particularly the common peroneal nerve , wraps around the neck of the fibula and then divides into superficial and deep branches .</li><li>• peroneal nerve</li><li>• common peroneal nerve</li><li>• wraps</li><li>• neck</li><li>• fibula</li><li>• superficial</li><li>• deep branches</li><li>• The deep peroneal nerve innervates the muscles that help in dorsiflexion and eversion of the foot .</li><li>• deep peroneal nerve</li><li>• dorsiflexion</li><li>• eversion</li><li>• foot</li><li>• Compression or damage to these nerves in the lateral compartment , especially following a fibular fracture , could lead to the symptoms described.</li><li>• Compression</li><li>• damage</li><li>• lateral compartment</li><li>• fibular fracture</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1415</li><li>• Ref : Gray’s Anatomy 41 st Edition, Pg no. 1415</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with a painful swelling in his right groin area. On physical examination, a bulge is noted at the mid inguinal point, which is located midway between the anterior superior iliac spine and the pubic symphysis. This finding is most suggestive of which of the following conditions?", "options": [{"label": "A", "text": "Femoral Hernia", "correct": false}, {"label": "B", "text": "Indirect Inguinal Hernia", "correct": true}, {"label": "C", "text": "Direct Inguinal Hernia", "correct": false}, {"label": "D", "text": "Spigelian Hernia", "correct": false}], "correct_answer": "B. Indirect Inguinal Hernia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture24.jpg"], "explanation": "<p><strong>Ans. B) Indirect Inguinal Hernia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Femoral Hernia: Typically appears below the inguinal ligament , more common in women . The location described in the question does not correspond to the typical site of a femoral hernia.</li><li>• Option A.</li><li>• below</li><li>• inguinal ligament</li><li>• women</li><li>• Option C. Direct Inguinal Hernia: Occurs medially to the inferior epigastric vessels and typically presents in older men . It protrudes through the posterior wall of the inguinal canal , which is not at the mid inguinal point .</li><li>• Option C.</li><li>• medially</li><li>• inferior epigastric vessels</li><li>• presents</li><li>• older men</li><li>• posterior wall</li><li>• inguinal canal</li><li>• not at</li><li>• mid inguinal point</li><li>• Option D. Spigelian Hernia: Occurs along the spigelian fascia , which is found lateral to the rectus abdominis muscles . This is not consistent with the location described in the question.</li><li>• Option D.</li><li>• spigelian fascia</li><li>• lateral</li><li>• rectus abdominis muscles</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Indirect Inguinal Hernia is the most common type of hernia in both men and women . It protrudes at the mid inguinal point , which is a landmark used to distinguish between direct and indirect inguinal hernias . This type of hernia follows the path of the inguinal canal and often protrudes into the scrotum in men .</li><li>➤ Indirect Inguinal Hernia is the most common type of hernia in both men and women . It protrudes at the mid inguinal point , which is a landmark used to distinguish between direct and indirect inguinal hernias .</li><li>➤ both men</li><li>➤ women</li><li>➤ protrudes</li><li>➤ mid inguinal point</li><li>➤ direct</li><li>➤ indirect inguinal hernias</li><li>➤ This type of hernia follows the path of the inguinal canal and often protrudes into the scrotum in men .</li><li>➤ follows</li><li>➤ path</li><li>➤ inguinal canal</li><li>➤ protrudes</li><li>➤ scrotum</li><li>➤ men</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 55</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, pg. 55</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old athlete presents with pain in the posterior aspect of his hip after a sprinting injury. On examination, the pain is localized to the ischial tuberosity. Which of the following muscles is most likely involved, given its attachment to the ischial tuberosity?", "options": [{"label": "A", "text": "Gluteus Maximus", "correct": false}, {"label": "B", "text": "Biceps Femoris", "correct": true}, {"label": "C", "text": "Adductor Magnus", "correct": false}, {"label": "D", "text": "Iliopsoas", "correct": false}], "correct_answer": "B. Biceps Femoris", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/05/screenshot-2024-02-05-162530.jpg"], "explanation": "<p><strong>Ans. B) Biceps Femoris</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Gluteus Maximus: Although it is a posterior hip muscle , the gluteus maximus primarily attaches to the gluteal tuberosity of the femur and the iliotibial tract , not the ischial tuberosity.</li><li>• Option A.</li><li>• posterior hip muscle</li><li>• attaches</li><li>• gluteal tuberosity</li><li>• femur</li><li>• iliotibial tract</li><li>• Option C. Adductor Magnus: It has an attachment to the ischial tuberosity , but it is primarily involved in adduction of the thigh and is less likely to be involved in sprinting injuries that present with pain at the ischial tuberosity.</li><li>• Option C.</li><li>• attachment</li><li>• ischial tuberosity</li><li>• adduction</li><li>• thigh</li><li>• Option D. Iliopsoas: This muscle primarily originates from the lumbar vertebrae and the iliac fossa and inserts on the lesser trochanter of the femur . It is not attached to the ischial tuberosity and thus is not likely involved in this case.</li><li>• Option D.</li><li>• originates</li><li>• lumbar vertebrae</li><li>• iliac fossa</li><li>• inserts</li><li>• lesser trochanter</li><li>• femur</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 367</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 367</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a surgical anatomy class, medical students are asked about the boundaries of the femoral triangle, an important region for vascular access and hernia repairs. Which of the following correctly identifies the boundaries of the Femoral Triangle?", "options": [{"label": "A", "text": "Superior: Inguinal Ligament; Lateral: Sartorius Muscle; Medial: Adductor Longus Muscle", "correct": true}, {"label": "B", "text": "Superior: Inguinal Ligament; Lateral: Adductor Longus Muscle; Medial: Sartorius Muscle", "correct": false}, {"label": "C", "text": "Superior: Sartorius Muscle; Lateral: Inguinal Ligament; Medial: Adductor Longus Muscle", "correct": false}, {"label": "D", "text": "Superior: Adductor Longus Muscle; Lateral: Sartorius Muscle; Medial: Inguinal Ligament", "correct": false}], "correct_answer": "A. Superior: Inguinal Ligament; Lateral: Sartorius Muscle; Medial: Adductor Longus Muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture39.jpg"], "explanation": "<p><strong>Ans. A) Superior: Inguinal Ligament; Lateral: Sartorius Muscle; Medial: Adductor Longus Muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Superior: Inguinal ligament; Lateral: Adductor longus muscle; Medial: Sartorius muscle: This is incorrect because it reverses the lateral and medial boundaries .</li><li>• Option B.</li><li>• incorrect</li><li>• reverses</li><li>• lateral</li><li>• medial boundaries</li><li>• Option C. Superior: Sartorius muscle; Lateral: Inguinal ligament; Medial: Adductor longus muscle: This is incorrect as it incorrectly identifies the superior boundary and misplaces the inguinal ligament and sartorius muscle.</li><li>• Option C.</li><li>• incorrect</li><li>• Option D. Superior: Adductor longus muscle; Lateral: Sartorius muscle; Medial: Inguinal ligament: This option incorrectly identifies all the boundaries of the femoral triangle.</li><li>• Option D.</li><li>• incorrectly</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The femoral triangle is an important anatomical landmark located in the upper part of the medial thigh . Its boundaries are superiorly by the inguinal ligament , laterally by the sartorius muscle , and medially by the adductor longus muscle .</li><li>➤ The femoral triangle is an important anatomical landmark located in the upper part of the medial thigh .</li><li>➤ upper part</li><li>➤ medial thigh</li><li>➤ Its boundaries are superiorly by the inguinal ligament , laterally by the sartorius muscle , and medially by the adductor longus muscle .</li><li>➤ superiorly</li><li>➤ inguinal ligament</li><li>➤ laterally</li><li>➤ sartorius muscle</li><li>➤ medially</li><li>➤ adductor longus muscle</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 337.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 337.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male presents with a palpable mass in his groin during a routine physical examination. To determine the nature of the mass, it is essential to understand the anatomical landmarks in the groin area. Which structure is located at the mid inguinal point, a landmark situated midway between the anterior superior iliac spine and the pubic symphysis?", "options": [{"label": "A", "text": "Deep Inguinal Ring", "correct": false}, {"label": "B", "text": "Superficial Inguinal Ring", "correct": false}, {"label": "C", "text": "Femoral Artery", "correct": true}, {"label": "D", "text": "Inferior Epigastric Artery", "correct": false}], "correct_answer": "C. Femoral Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture26.jpg"], "explanation": "<p><strong>Ans. C) Femoral Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The deep inguinal ring is an opening in the transversalis fascia . It is located superior to the midpoint of the inguinal ligament but not at the mid inguinal point.</li><li>• Option A.</li><li>• opening</li><li>• transversalis fascia</li><li>• superior</li><li>• midpoint</li><li>• inguinal ligament</li><li>• Option B. Superficial Inguinal Ring is an opening in the external oblique aponeurosis . While it is near the mid inguinal point , it is not precisely located at this point.</li><li>• Option B.</li><li>• opening</li><li>• external oblique aponeurosis</li><li>• near</li><li>• mid inguinal point</li><li>• Option D. Inferior Epigastric Artery arises from the external iliac artery and travels superiorly on the posterior surface of the rectus abdominis . It is not located at the mid inguinal point.</li><li>• Option D.</li><li>• external iliac artery</li><li>• travels superiorly</li><li>• posterior surface</li><li>• rectus abdominis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Femoral Artery : The femoral artery passes directly underneath the mid inguinal point . This is a crucial landmark for procedures such as femoral artery catheterization .</li><li>➤ Femoral Artery : The femoral artery passes directly underneath the mid inguinal point . This is a crucial landmark for procedures such as femoral artery catheterization .</li><li>➤ Femoral Artery</li><li>➤ femoral artery</li><li>➤ directly</li><li>➤ mid inguinal point</li><li>➤ crucial landmark</li><li>➤ femoral artery catheterization</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 338.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 338.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents with sciatic nerve pain. Understanding the anatomy of the pelvis, specifically the structures passing through the greater and lesser sciatic notches, is crucial for diagnosing conditions affecting this nerve. Which of the following sets of structures correctly passes through the greater and lesser sciatic notches?", "options": [{"label": "A", "text": "Greater Sciatic Notch: Sciatic Nerve, Pudendal Nerve; Lesser Sciatic Notch: Superior Gluteal Artery", "correct": false}, {"label": "B", "text": "Greater Sciatic Notch: Sciatic Nerve, Superior Gluteal Artery; Lesser Sciatic Notch: Pudendal Nerve, Internal Pudendal Artery", "correct": false}, {"label": "C", "text": "Greater Sciatic Notch: Piriformis Muscle, Sciatic Nerve; Lesser Sciatic Notch: Tendon of Obturator Internus, Pudendal Nerve", "correct": true}, {"label": "D", "text": "Greater Sciatic Notch: Inferior Gluteal Artery, Nerve to Quadratus Femoris; Lesser Sciatic Notch: Sciatic Nerve, Nerve to Obturator Internus", "correct": false}], "correct_answer": "C. Greater Sciatic Notch: Piriformis Muscle, Sciatic Nerve; Lesser Sciatic Notch: Tendon of Obturator Internus, Pudendal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture27.jpg"], "explanation": "<p><strong>Ans. C) Greater Sciatic Notch: Piriformis Muscle, Sciatic Nerve; Lesser Sciatic Notch: Tendon of Obturator Internus, Pudendal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Greater sciatic notch: Sciatic nerve, Pudendal nerve; Lesser sciatic notch: Superior gluteal artery: This is incorrect as the pudendal nerve and internal pudendal vessels pass through the lesser sciatic notch after exiting the greater sciatic notch .</li><li>• Option A.</li><li>• incorrect</li><li>• pudendal nerve</li><li>• internal pudendal vessels</li><li>• lesser sciatic notch</li><li>• exiting</li><li>• greater sciatic</li><li>• notch</li><li>• Option B. Greater sciatic notch: Sciatic nerve, Superior gluteal artery; Lesser sciatic notch: Pudendal nerve, Internal pudendal artery: The superior gluteal artery passes through the greater sciatic notch , but the pudendal nerve and internal pudendal artery pass through both notches .</li><li>• Option B.</li><li>• superior gluteal artery</li><li>• greater sciatic notch</li><li>• pudendal nerve</li><li>• internal pudendal artery</li><li>• both notches</li><li>• Option D. Greater sciatic notch: Inferior gluteal artery, Nerve to quadratus femoris; Lesser sciatic notch: Sciatic nerve, Nerve to obturator internus: This is incorrect as the sciatic nerve passes through the greater sciatic notch , not the lesser.</li><li>• Option D.</li><li>• incorrect</li><li>• sciatic nerve</li><li>• greater sciatic notch</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The greater sciatic notch allows passage of the piriformis muscle and the sciatic nerve among other structures. The lesser sciatic notch allows passage of the tendon of the obturator internus and structures such as the pudendal nerve .</li><li>➤ The greater sciatic notch allows passage of the piriformis muscle and the sciatic nerve among other structures. The lesser sciatic notch allows passage of the tendon of the obturator internus and structures such as the pudendal nerve .</li><li>➤ passage</li><li>➤ piriformis muscle</li><li>➤ sciatic nerve</li><li>➤ lesser sciatic notch</li><li>➤ passage</li><li>➤ tendon</li><li>➤ obturator internus</li><li>➤ structures</li><li>➤ pudendal nerve</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 356.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 356.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During an orthopedic rotation, a medical resident is asked to assess a patient with abnormal gait. The attending physician emphasizes the importance of understanding the angles associated with the femur for accurate diagnosis. The resident is asked to differentiate between the angle of the neck of the femur and the angle of femoral torsion. Which of the following best describes these angles?", "options": [{"label": "A", "text": "Angle of the Neck of Femur: 120-135 Degrees, Frontal Plane; Angle of Femoral Torsion: 10-15 Degrees, Transverse Plane", "correct": true}, {"label": "B", "text": "Angle of the Neck of Femur: 125-150 Degrees, Transverse Plane; Angle of Femoral Torsion: 20-25 Degrees, Sagittal Plane", "correct": false}, {"label": "C", "text": "Angle of the Neck of Femur: 110-140 Degrees, Sagittal Plane; Angle of Femoral Torsion: 30-40 Degrees, Frontal Plane", "correct": false}, {"label": "D", "text": "Angle of the Neck of Femur: 130-140 Degrees, Transverse Plane; Angle of Femoral Torsion: 10-20 Degrees, Transverse Plane", "correct": false}], "correct_answer": "A. Angle of the Neck of Femur: 120-135 Degrees, Frontal Plane; Angle of Femoral Torsion: 10-15 Degrees, Transverse Plane", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture28.jpg"], "explanation": "<p><strong>Ans. A)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Angle of the neck of femur: 125-150 degrees, transverse plane; Angle of femoral torsion: 20-25 degrees, sagittal plane : This is incorrect as it misrepresents the planes and normal ranges of the angles.</li><li>• Option B.</li><li>• incorrect</li><li>• Option C. Angle of the neck of femur: 110-140 degrees, sagittal plane; Angle of femoral torsion: 30-40 degrees, frontal plane : Again, this option inaccurately describes the planes and the normal range values.</li><li>• Option C.</li><li>• inaccurately</li><li>• Option D. Angle of the neck of femur: 130-140 degrees, transverse plane; Angle of femoral torsion: 10-20 degrees, transverse plane : This option incorrectly describes the planes of measurement.</li><li>• Option D.</li><li>• incorrectly</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The angle of the neck of the femur, also known as the angle of inclination , is typically between 120-135 degrees in adults and is measured in the frontal plane . The angle of femoral torsion , also known as femoral anteversion , is about 10-15 degrees and is measured in the transverse plane .</li><li>➤ The angle of the neck of the femur, also known as the angle of inclination , is typically between 120-135 degrees in adults and is measured in the frontal plane .</li><li>➤ angle of inclination</li><li>➤ between 120-135 degrees</li><li>➤ adults</li><li>➤ frontal plane</li><li>➤ The angle of femoral torsion , also known as femoral anteversion , is about 10-15 degrees and is measured in the transverse plane .</li><li>➤ angle</li><li>➤ femoral torsion</li><li>➤ femoral anteversion</li><li>➤ about 10-15 degrees</li><li>➤ measured</li><li>➤ transverse plane</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 305.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 305.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a neuroanatomy lecture, a medical instructor asks the students about the root values of the femoral and obturator nerves. The students are required to correctly identify the spinal nerve roots that contribute to these nerves. Which of the following options accurately represents the root values for the femoral and obturator nerves?", "options": [{"label": "A", "text": "Femoral Nerve: L2-L4; Obturator Nerve: L4-L5", "correct": false}, {"label": "B", "text": "Femoral Nerve: L3-L5; Obturator Nerve: L2-L4", "correct": false}, {"label": "C", "text": "Femoral Nerve: L2-L4; Obturator Nerve: L2-L4", "correct": true}, {"label": "D", "text": "Femoral Nerve: L1-L3; Obturator Nerve: L3-L5", "correct": false}], "correct_answer": "C. Femoral Nerve: L2-L4; Obturator Nerve: L2-L4", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture42.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-163631.jpg"], "explanation": "<p><strong>Ans. C) Femoral Nerve: L2-L4; Obturator Nerve: L2-L4</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Femoral nerve: L2-L4; Obturator nerve: L4-L5: This option is incorrect because it incorrectly assigns the root values for the obturator nerve. The obturator nerve arises from L2-L4 .</li><li>• Option A.</li><li>• incorrect</li><li>• obturator nerve</li><li>• L2-L4</li><li>• Option B. Femoral nerve: L3-L5; Obturator nerve: L2-L4: This option is incorrect as the femoral nerve arises from L2-L4 , not L3-L5.</li><li>• Option B.</li><li>• incorrect</li><li>• femoral nerve</li><li>• L2-L4</li><li>• Option D. Femoral nerve: L1-L3; Obturator nerve: L3-L5: This is incorrect as it misrepresents the root values for both the femoral and obturator nerves .</li><li>• Option D.</li><li>• incorrect</li><li>• misrepresents</li><li>• root values</li><li>• both</li><li>• femoral</li><li>• obturator nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Both the femoral and obturator nerves originate from the L2-L4 spinal nerve roots . The femoral nerve is a major nerve of the lumbar plexus , and the obturator nerve is a branch of the lumbar plexus .</li><li>➤ Both the femoral and obturator nerves originate from the L2-L4 spinal nerve roots . The femoral nerve is a major nerve of the lumbar plexus , and the obturator nerve is a branch of the lumbar plexus .</li><li>➤ femoral</li><li>➤ obturator nerves</li><li>➤ L2-L4 spinal nerve roots</li><li>➤ femoral nerve</li><li>➤ major nerve</li><li>➤ lumbar plexus</li><li>➤ obturator nerve</li><li>➤ branch</li><li>➤ lumbar plexus</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 196.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 196.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a clinical anatomy class, medical students are discussing the vascular supply of the lower limb bones. One student asks about the nutrient artery of the tibia. Which of the following statements best describes the characteristics and source of the nutrient artery of the tibia?", "options": [{"label": "A", "text": "Originates from the Anterior Tibial Artery and Enters the Tibia on its Anterior Surface", "correct": false}, {"label": "B", "text": "Originates from the Posterior Tibial Artery and Enters the Tibia on its Posterior Surface", "correct": false}, {"label": "C", "text": "Originates from the Fibular Artery and Enters the Tibia on its Lateral Surface", "correct": false}, {"label": "D", "text": "Originates from the Popliteal Artery and Enters the Tibia on its Posterior Surface", "correct": true}], "correct_answer": "D. Originates from the Popliteal Artery and Enters the Tibia on its Posterior Surface", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture29.jpg"], "explanation": "<p><strong>Ans. D) Originates from the Popliteal Artery and Enters the Tibia on its Posterior Surface</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Originates from the anterior tibial artery and enters the tibia on its anterior surface: The anterior tibial artery primarily supplies the anterior compartment of the leg , but it is not the source of the nutrient artery to the tibia.</li><li>• Option A.</li><li>• anterior tibial artery</li><li>• supplies</li><li>• anterior compartment</li><li>• leg</li><li>• Option B. Originates from the posterior tibial artery and enters the tibia on its posterior surface: While the posterior tibial artery is a major vessel of the lower leg , it does not give off the nutrient artery to the tibia.</li><li>• Option B.</li><li>• posterior tibial artery</li><li>• major vessel</li><li>• lower leg</li><li>• Option C. Originates from the fibular artery and enters the tibia on its lateral surface: The fibular artery supplies the lateral compartment of the leg and the fibula , not the tibia.</li><li>• Option C.</li><li>• fibular artery supplies</li><li>• lateral compartment</li><li>• leg</li><li>• fibula</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The nutrient artery of the tibia usually arises from the popliteal artery and enters the bone on its posterior surface . It is crucial for the blood supply to the shaft of the tibia .</li><li>➤ The nutrient artery of the tibia usually arises from the popliteal artery and enters the bone on its posterior surface . It is crucial for the blood supply to the shaft of the tibia .</li><li>➤ nutrient artery</li><li>➤ tibia</li><li>➤ arises</li><li>➤ popliteal artery</li><li>➤ enters</li><li>➤ bone</li><li>➤ posterior surface</li><li>➤ crucial</li><li>➤ blood supply</li><li>➤ shaft</li><li>➤ tibia</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 313.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 313.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A third-year medical student is studying the anatomy of the hip joint for an upcoming exam. Which of the following ligaments is correctly paired with its primary function in stabilizing the hip joint?", "options": [{"label": "A", "text": "Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint", "correct": true}, {"label": "B", "text": "Ischiofemoral Ligament: Prevents Excessive Medial Rotation of the Hip Joint", "correct": false}, {"label": "C", "text": "Pubofemoral Ligament: Limits Abduction and External Rotation of the Hip Joint", "correct": false}, {"label": "D", "text": "Ligamentum Teres: Primary Stabilizer of the Hip Joint in all Movements", "correct": false}], "correct_answer": "A. Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture30.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture31.jpg"], "explanation": "<p><strong>Ans. A) Iliofemoral Ligament: Prevents Hyperextension of the Hip Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Ischiofemoral ligament is located posteriorly and primarily limits excessive internal rotation and extension of the hip joint , not medial rotation.</li><li>• Option B.</li><li>• posteriorly</li><li>• limits excessive internal rotation</li><li>• extension</li><li>• hip joint</li><li>• Option C. Pubofemoral ligament extends from the pubic portion of the acetabular rim to the neck of the femur . It restricts excessive abduction and external rotation of the hip joint , making this statement partially correct. However, its primary role is in limiting excessive abduction .</li><li>• Option C.</li><li>• pubic portion</li><li>• acetabular</li><li>• neck</li><li>• femur</li><li>• restricts excessive abduction</li><li>• external rotation</li><li>• hip joint</li><li>• primary role</li><li>• limiting excessive abduction</li><li>• Option D. Ligamentum teres is relatively weak and does not play a significant role in stabilizing the hip joint. Its primary role is to carry a small artery to the head of the femur , rather than act as a stabilizer.</li><li>• Option D.</li><li>• relatively weak</li><li>• small artery</li><li>• head</li><li>• femur</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Iliofemoral ligament : This is the strongest ligament in the body and prevents hyperextension of the hip joint. It is located anteriorly and is often referred to as the Y-ligament of Bigelow .</li><li>➤ Iliofemoral ligament : This is the strongest ligament in the body and prevents hyperextension of the hip joint. It is located anteriorly and is often referred to as the Y-ligament of Bigelow .</li><li>➤ Iliofemoral ligament</li><li>➤ strongest ligament</li><li>➤ body</li><li>➤ hyperextension</li><li>➤ anteriorly</li><li>➤ Y-ligament</li><li>➤ Bigelow</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 378.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 378.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical resident is evaluating a patient with hip joint dysfunction and needs to understand the various muscle groups involved in hip movements. Which of the following correctly pairs a muscle group with its primary action on the hip joint?", "options": [{"label": "A", "text": "Iliopsoas: Primary Extensor of the Hip", "correct": false}, {"label": "B", "text": "Gluteus Maximus: Primary Flexor of the Hip", "correct": false}, {"label": "C", "text": "Gluteus Medius: Primary Adductor of the Hip", "correct": false}, {"label": "D", "text": "Obturator Internus: Primary External Rotator of the Hip", "correct": true}], "correct_answer": "D. Obturator Internus: Primary External Rotator of the Hip", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-143406.jpg"], "explanation": "<p><strong>Ans. D) Obturator Internus: Primary External Rotator of the Hip</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Explanation:</li><li>• Explanation:</li><li>• Option A. Iliopsoas: Primary extensor of the hip : This is incorrect . The iliopsoas, consisting of the iliacus and psoas major muscles, is a major flexor of the hip , not an extensor.</li><li>• Option A.</li><li>• incorrect</li><li>• major flexor</li><li>• hip</li><li>• Option B. Gluteus maximus: Primary flexor of the hip : This is incorrect . The gluteus maximus is one of the primary extensors of the hip, especially during activities like climbing stairs or standing from a sitting position .</li><li>• Option B.</li><li>• incorrect</li><li>• primary extensors</li><li>• climbing stairs</li><li>• standing</li><li>• sitting position</li><li>• Option C. Gluteus medius: Primary adductor of the hip : This is incorrect . The gluteus medius is a primary abductor of the hip, not an adductor. It is crucial for stabilizing the pelvis during walking .</li><li>• Option C.</li><li>• incorrect</li><li>• primary abductor</li><li>• stabilizing</li><li>• pelvis</li><li>• walking</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The obturator internus, along with other muscles in the deep gluteal region , acts as a primary external rotator of the hip joint .</li><li>➤ The obturator internus, along with other muscles in the deep gluteal region , acts as a primary external rotator of the hip joint .</li><li>➤ deep gluteal region</li><li>➤ primary external rotator</li><li>➤ hip joint</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 383.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 383.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical resident is discussing knee joint mechanics with her attending physician. They focus on the process of locking (terminal knee extension) and unlocking (initiating knee flexion), which is crucial for efficient gait. Which muscle is primarily responsible for the locking and unlocking mechanism of the knee joint?", "options": [{"label": "A", "text": "Quadriceps Femoris", "correct": false}, {"label": "B", "text": "Biceps Femoris", "correct": false}, {"label": "C", "text": "Popliteus", "correct": true}, {"label": "D", "text": "Gastrocnemius", "correct": false}], "correct_answer": "C. Popliteus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-143915.jpg"], "explanation": "<p><strong>Ans. C) Popliteus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Quadriceps Femoris muscle group is responsible for knee extension but not specifically for the locking and unlocking mechanism. It plays a significant role in maintaining knee extension but does not initiate knee flexion.</li><li>• Option A.</li><li>• knee extension</li><li>• maintaining knee extension</li><li>• Option B. Biceps Femoris part of the hamstring muscles , biceps femoris is involved in knee flexion and hip extension . However, it does not play a primary role in the locking and unlocking mechanism of the knee.</li><li>• Option B.</li><li>• hamstring muscles</li><li>• knee flexion</li><li>• hip extension</li><li>• Option D. While Gastrocnemius crosses the knee joint and contributes to knee flexion , gastrocnemius is not primarily responsible for the locking and unlocking mechanism of the knee.</li><li>• Option D.</li><li>• crosses</li><li>• knee joint</li><li>• knee flexion</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The popliteus muscle is key in initiating knee flexion from a fully extended position ( unlocking ). It laterally rotates the femur on the tibia when the foot is fixed or medially rotates the tibia on the femur when the foot can move , unlocking the knee .</li><li>➤ The popliteus muscle is key in initiating knee flexion from a fully extended position ( unlocking ).</li><li>➤ initiating knee flexion</li><li>➤ fully extended position</li><li>➤ unlocking</li><li>➤ It laterally rotates the femur on the tibia when the foot is fixed or medially rotates the tibia on the femur when the foot can move , unlocking the knee .</li><li>➤ rotates</li><li>➤ femur</li><li>➤ tibia</li><li>➤ foot</li><li>➤ fixed</li><li>➤ medially rotates</li><li>➤ tibia</li><li>➤ femur</li><li>➤ move</li><li>➤ unlocking</li><li>➤ knee</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 447.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 447.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "In a clinical anatomy lecture, a medical instructor is discussing the movements of the foot. She asks the students to identify the joint responsible for inversion and eversion movements of the foot. Which joint allows these specific movements?", "options": [{"label": "A", "text": "Ankle (Talocrural) Joint", "correct": false}, {"label": "B", "text": "Subtalar (Talocalcaneal) Joint", "correct": true}, {"label": "C", "text": "Midtarsal (Chopart's) Joint", "correct": false}, {"label": "D", "text": "Metatarsophalangeal Joint", "correct": false}], "correct_answer": "B. Subtalar (Talocalcaneal) Joint", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/picture32.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/02/03/screenshot-2024-02-03-145037.jpg"], "explanation": "<p><strong>Ans. B) Subtalar (Talocalcaneal) Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Ankle (Talocrural) Joint primarily allows dorsiflexion and plantarflexion of the foot. It does not significantly contribute to inversion or eversion movements.</li><li>• Option A.</li><li>• allows dorsiflexion</li><li>• plantarflexion</li><li>• Option C. Midtarsal (Chopart's) Joint complex contributes to inversion and eversion , but the primary site of these movements is the subtalar joint . The midtarsal joint assists in these movements but is not the primary joint responsible.</li><li>• Option C.</li><li>• inversion</li><li>• eversion</li><li>• subtalar joint</li><li>• Option D. Metatarsophalangeal Joint primarily allow flexion and extension of the toes. They do not play a significant role in inversion or eversion of the foot.</li><li>• Option D.</li><li>• allow flexion</li><li>• extension</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The subtalar joint, located below the talocrural (ankle) joint , is responsible for inversion and eversion movements of the foot . These movements are essential for adapting to uneven terrain and are involved in activities that require lateral movement.</li><li>➤ The subtalar joint, located below the talocrural (ankle) joint , is responsible for inversion and eversion movements of the foot .</li><li>➤ below</li><li>➤ talocrural (ankle) joint</li><li>➤ inversion</li><li>➤ eversion movements</li><li>➤ foot</li><li>➤ These movements are essential for adapting to uneven terrain and are involved in activities that require lateral movement.</li><li>➤ adapting</li><li>➤ uneven terrain</li><li>➤ require lateral movement.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 455.</li><li>➤ Ref : Textbook of Anatomy, Abdomen and Lower Limb, 3 rd Edition, Vishram Singh, Volume II, Pg. 455.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 82 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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On examination, her blood pressure is 100/70 mm Hg, and a systolic murmur is heard along the left sternal border. An echocardiogram reveals severe aortic stenosis. Right coronary artery origin part was affected. Where does the right coronary artery originate from?", "options": [{"label": "A", "text": "Posterior Aortic Sinus", "correct": false}, {"label": "B", "text": "Coronary Sinus", "correct": false}, {"label": "C", "text": "Left aortic Sinus", "correct": false}, {"label": "D", "text": "Anterior Aortic Sinus", "correct": true}], "correct_answer": "D. Anterior Aortic Sinus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture1.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture2.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture3.jpg"], "explanation": "<p><strong>Ans. D) Anterior Aortic Sinus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Posterior Aortic Sinus is located just above the aortic valve . The right coronary artery does not arise from this sinus. Instead, it's typically the non-coronary sinus or occasionally the left coronary artery that is associated with the posterior aortic sinus .</li><li>• Option A.</li><li>• above</li><li>• aortic valve</li><li>• typically</li><li>• non-coronary sinus</li><li>• left coronary artery</li><li>• posterior aortic sinus</li><li>• Option B. Coronary Sinus is on the posterior aspect of the heart . The right coronary artery is not connected to the coronary sinus as it is an artery, not a vein.</li><li>• Option B.</li><li>• posterior aspect</li><li>• heart</li><li>• Option C. Left Aortic Sinus, also known as the left posterior aortic sinus . This sinus is typically the origin of the left coronary artery . The left coronary artery branches into the left anterior descending artery and the circumflex artery , supplying blood to the left side of the heart .</li><li>• Option C.</li><li>• left posterior aortic sinus</li><li>• origin</li><li>• left coronary artery</li><li>• left anterior descending artery</li><li>• circumflex artery</li><li>• left side</li><li>• heart</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Aortic Sinus, also known as the right anterior aortic sinus , is the correct origin of the right coronary artery . The right coronary artery arises from this sinus and travels down the right side of the heart, supplying blood to the right atrium, right ventricle, part of the left ventricle , the sinoatrial node and the atrioventricular node .</li><li>➤ Anterior Aortic Sinus, also known as the right anterior aortic sinus , is the correct origin of the right coronary artery .</li><li>➤ right anterior aortic sinus</li><li>➤ right coronary artery</li><li>➤ The right coronary artery arises from this sinus and travels down the right side of the heart, supplying blood to the right atrium, right ventricle, part of the left ventricle , the sinoatrial node and the atrioventricular node .</li><li>➤ travels down</li><li>➤ right side</li><li>➤ right atrium, right ventricle,</li><li>➤ left ventricle</li><li>➤ sinoatrial node</li><li>➤ atrioventricular node</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 38-year-old male patient presents with a 6-month history of progressive dyspnea on exertion and occasional chest pain. Physical examination reveals elevated jugular venous pressure and a diastolic murmur heard at the left sternal border. An echocardiogram confirms the diagnosis of severe aortic regurgitation. During surgery to repair the aortic valve, the surgeon encounters the left superior intercostal vein. Which vessel is most likely to receive the blood drained by the left superior intercostal vein in this patient?", "options": [{"label": "A", "text": "Hemiazygos Vein", "correct": false}, {"label": "B", "text": "Brachiocephalic Vein", "correct": true}, {"label": "C", "text": "Azygos Vein", "correct": false}, {"label": "D", "text": "Internal Thoracic Vein", "correct": false}], "correct_answer": "B. Brachiocephalic Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture4.jpg"], "explanation": "<p><strong>Ans. B) Brachiocephalic Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Hemiazygos Vein is a vein of the thoracic which drains the posterior walls of the thorax and abdomen . It typically receives the lower three or four intercostal veins on the left side , among other veins. However, it does not usually receive the left superior intercostal vein.</li><li>• Option A.</li><li>• thoracic</li><li>• posterior walls</li><li>• thorax</li><li>• abdomen</li><li>• receives</li><li>• lower three</li><li>• four intercostal veins</li><li>• left side</li><li>• Option C. Azygos Vein is the vein running along the right side of the vertebral column . It typically receives the right superior intercostal vein and other right-sided posterior intercostal veins . It's responsible for draining most of the thoracic wall and upper lumbar region , but it does not typically receive the left superior intercostal vein.</li><li>• Option C.</li><li>• right side</li><li>• vertebral column</li><li>• receives</li><li>• right superior intercostal vein</li><li>• right-sided posterior intercostal veins</li><li>• draining</li><li>• thoracic wall</li><li>• upper lumbar region</li><li>• Option D. The internal thoracic vein (also known as the internal mammary vein ) runs along the inside of the anterior thoracic wall and drains areas such as the breasts and the anterior thoracic wall . However, it is not the typical drainage point for the left superior intercostal vein.</li><li>• Option D.</li><li>• internal mammary vein</li><li>• anterior thoracic wall</li><li>• breasts</li><li>• anterior thoracic wall</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The left superior intercostal vein typically drains into the left brachiocephalic vein. The left brachiocephalic vein is formed by the union of the left internal jugular and left subclavian veins and is crucial in draining blood from the head, neck , and upper limb on the left side . It's important in the venous return from the upper part of the left thoracic wall and the left upper limb .</li><li>➤ The left superior intercostal vein typically drains into the left brachiocephalic vein.</li><li>➤ The left brachiocephalic vein is formed by the union of the left internal jugular and left subclavian veins and is crucial in draining blood from the head, neck , and upper limb on the left side .</li><li>➤ union</li><li>➤ left internal jugular</li><li>➤ left subclavian veins</li><li>➤ head, neck</li><li>➤ upper limb</li><li>➤ left side</li><li>➤ It's important in the venous return from the upper part of the left thoracic wall and the left upper limb .</li><li>➤ venous return</li><li>➤ upper part</li><li>➤ left thoracic wall</li><li>➤ left upper limb</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statement is correct regarding Tendon of Todaro?", "options": [{"label": "A", "text": "Raised Interatrial Septal Ridge", "correct": false}, {"label": "B", "text": "Connects IVC and Right Atrium", "correct": true}, {"label": "C", "text": "Connects Left Atrium and Right Atrium", "correct": false}, {"label": "D", "text": "Situated in Smooth Wall of Right Atrium", "correct": false}], "correct_answer": "B. Connects IVC and Right Atrium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture5.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-102428.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture6.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture7.jpg"], "explanation": "<p><strong>Ans. B) Connects IVC and Right Atrium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. A raised ridge in the interatrial septum area is typically referred to as the limbus fossa ovalis , not the Tendon of Todaro. The fossa ovalis is a remnant of the fetal foramen ovale , a hole in the interatrial septum that allows blood to bypass the lungs in a fetus .</li><li>• Option A.</li><li>• limbus fossa ovalis</li><li>• remnant</li><li>• fetal foramen ovale</li><li>• interatrial septum</li><li>• blood</li><li>• bypass</li><li>• lungs</li><li>• fetus</li><li>• Option C. The Tendon of Todaro does not connect the left atrium to the right atrium. It is not involved in directly connecting the atria.</li><li>• Option C.</li><li>• does not connect</li><li>• Option D. The Tendon of Todaro is not located in the smooth wall of the right atrium. The right atrium has two parts - a smooth-walled part and a rough-walled part . The Tendon of Todaro , however, is a distinct structure running within the heart's fibrous skeleton and is not a part of the atrial wall itself.</li><li>• Option D.</li><li>• smooth-walled part</li><li>• rough-walled part</li><li>• The Tendon of Todaro</li><li>• distinct structure</li><li>• within</li><li>• heart's fibrous skeleton</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Tendon of Todaro connects IVC and Right Atrium :</li><li>➤ Tendon of Todaro connects IVC and Right Atrium</li><li>➤ Tendon of Todaro is a raised subendocardial ridge that extends from the central fibrous body to the left horn of the Inferior vena cava . It is an important landmark in electrophysiology , as it forms the posterior border of the triangle of Koch , a critical area for atrioventricular node location .</li><li>➤ Tendon of Todaro is a raised subendocardial ridge that extends from the central fibrous body to the left horn of the Inferior vena cava .</li><li>➤ raised subendocardial ridge</li><li>➤ central fibrous body</li><li>➤ left horn</li><li>➤ Inferior vena cava</li><li>➤ It is an important landmark in electrophysiology , as it forms the posterior border of the triangle of Koch , a critical area for atrioventricular node location .</li><li>➤ important landmark</li><li>➤ electrophysiology</li><li>➤ posterior border</li><li>➤ triangle of Koch</li><li>➤ atrioventricular node location</li><li>➤ Boundaries of Triangle of Koch:</li><li>➤ Boundaries of Triangle of Koch:</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male patient presents to the emergency department with sudden-onset chest pain radiating to his left arm and associated diaphoresis. An electrocardiogram (ECG) shows ST-segment elevation in leads V1 to V6. Which area of the heart is most likely affected by the occlusion of the Left Anterior Descending (LAD) artery in this patient?", "options": [{"label": "A", "text": "Posterior Part of Inter-ventricular Septum", "correct": false}, {"label": "B", "text": "Anterior Wall of Left Ventricle", "correct": true}, {"label": "C", "text": "Lateral Part of Heart", "correct": false}, {"label": "D", "text": "Inferior Surface of Right Ventricle", "correct": false}], "correct_answer": "B. Anterior Wall of Left Ventricle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture8.jpg"], "explanation": "<p><strong>Ans. B) Anterior Wall of Left Ventricle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Posterior interventricular artery arising from right coronary artery supplies posteroinferior 1/3rd interventricular septum .</li><li>• Option A.</li><li>• posteroinferior 1/3rd interventricular septum</li><li>• Option C. Left coronary artery supplies the left atrium , left ventricle , part of right ventricle ( sternocostal surface close to anterior interventricular groove ).</li><li>• Option C.</li><li>• left atrium</li><li>• left ventricle</li><li>• right ventricle</li><li>• sternocostal surface</li><li>• anterior interventricular groove</li><li>• Option D. Right coronary artery supplies the right atrium , right ventricle and diaphragmatic surface of the left ventricle close to the posterior interventricular groove .</li><li>• Option D.</li><li>• right atrium</li><li>• right ventricle</li><li>• diaphragmatic surface</li><li>• left ventricle</li><li>• posterior interventricular groove</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Anterior Wall of Left Ventricle :</li><li>• Anterior Wall of Left Ventricle</li><li>• The LAD artery primarily supplies the anterior wall of the left ventricle , the anterior portion of the septum , and the apex of the heart . Occlusion of the LAD artery can lead to a myocardial infarction in these areas, often referred to as an \"anterior wall myocardial infarction.\" This can be a serious condition due to the large area of the heart muscle that the LAD supplies .</li><li>• The LAD artery primarily supplies the anterior wall of the left ventricle , the anterior portion of the septum , and the apex of the heart .</li><li>• anterior wall</li><li>• left ventricle</li><li>• anterior portion</li><li>• septum</li><li>• apex of the heart</li><li>• Occlusion of the LAD artery can lead to a myocardial infarction in these areas, often referred to as an \"anterior wall myocardial infarction.\"</li><li>• myocardial infarction</li><li>• \"anterior wall myocardial infarction.\"</li><li>• This can be a serious condition due to the large area of the heart muscle that the LAD supplies .</li><li>• large area</li><li>• heart muscle</li><li>• LAD supplies</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "What causes the appearance of the torus aorticus in the heart?", "options": [{"label": "A", "text": "Atrium Bulging into Aorta", "correct": false}, {"label": "B", "text": "Aortic Sinus Bulging into Left Atrium", "correct": false}, {"label": "C", "text": "Aortic Sinus Bulging into Right Atrium", "correct": true}, {"label": "D", "text": "Aortic Wall Tear", "correct": false}], "correct_answer": "C. Aortic Sinus Bulging into Right Atrium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture10.jpg"], "explanation": "<p><strong>Ans. C) Aortic Sinus Bulging into Right Atrium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Normally, there is no structural feature in which an atrium bulges into the aorta. The atria and the aorta are separate chambers with distinct functions .</li><li>• Option A.</li><li>• atria</li><li>• aorta</li><li>• separate chambers</li><li>• distinct functions</li><li>• Option B. Aortic Sinus Bulging into Left Atrium are the dilations at the root of the aorta , just above the aortic valve . While these sinuses are close to the left atrium, they do not bulge into it. The structure of the heart prevents such an occurrence under normal conditions, and such a bulging would likely indicate a pathological condition.</li><li>• Option B.</li><li>• dilations</li><li>• root</li><li>• aorta</li><li>• above</li><li>• aortic valve</li><li>• Option D. Aortic Wall Tear, also known as an aortic dissection , where the inner layer of the aorta tears , causing blood to flow between the layers of the wall of the aorta . This condition does not lead to the formation of the torus aorticus.</li><li>• Option D.</li><li>• aortic dissection</li><li>• inner layer</li><li>• aorta tears</li><li>• layers</li><li>• wall of the aorta</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aortic Sinus Bulging into Right Atrium:</li><li>➤ Aortic Sinus Bulging into Right Atrium:</li><li>➤ The torus aorticus is caused by the bulging of the right posterior aortic sinus into the right atrium . The aortic sinus, one of the three aortic sinuses, is located near the right atrium . The bulging of this sinus into the right atrium can create a noticeable impression , known as the torus aorticus , on the wall of the right atrium .</li><li>➤ The torus aorticus is caused by the bulging of the right posterior aortic sinus into the right atrium .</li><li>➤ bulging</li><li>➤ right posterior aortic sinus</li><li>➤ right atrium</li><li>➤ The aortic sinus, one of the three aortic sinuses, is located near the right atrium . The bulging of this sinus into the right atrium can create a noticeable impression , known as the torus aorticus , on the wall of the right atrium .</li><li>➤ right atrium</li><li>➤ noticeable impression</li><li>➤ torus aorticus</li><li>➤ wall</li><li>➤ right atrium</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male patient with a history of coronary artery disease presents with worsening chest pain radiating to the left arm and jaw. An electrocardiogram (ECG) shows ST-segment elevation in the anterior leads. The patient is taken to the catheterization lab for urgent coronary angiography. During the procedure, the cardiologist is concerned about the anatomical relationships surrounding the heart. Which of the following structures is most likely to be found anterior to the transverse pericardial sinus in this patient?", "options": [{"label": "A", "text": "Aorta", "correct": true}, {"label": "B", "text": "Pulmonary Trunk", "correct": false}, {"label": "C", "text": "SVC", "correct": false}, {"label": "D", "text": "Left Atrium", "correct": false}], "correct_answer": "A. Aorta", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture12.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-104532.jpg"], "explanation": "<p><strong>Ans. A) Aorta</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Pulmonary Trunk, located anterior to the transverse pericardial sinus , alongside the ascending aorta . However, the aorta is a more accurate answer because it is more centrally placed and prominent in that position.</li><li>• Option B.</li><li>• anterior</li><li>• transverse pericardial sinus</li><li>• ascending aorta</li><li>• Option C. Superior Vena Cava is not located anterior to the transverse pericardial sinus. It is positioned more superiorly and slightly to the right , draining into the right atrium from above.</li><li>• Option C.</li><li>• positioned more superiorly</li><li>• right</li><li>• right atrium</li><li>• Option D. Left Atrium is situated posteriorly in the heart and thus is not anterior to the transverse pericardial sinus. In fact, the transverse pericardial sinus lies between the aorta and pulmonary trunk anteriorly and the left atrium posteriorly .</li><li>• Option D.</li><li>• posteriorly</li><li>• heart</li><li>• transverse pericardial sinus</li><li>• aorta</li><li>• pulmonary trunk anteriorly</li><li>• left atrium posteriorly</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Aorta , particularly the ascending aorta , lies anterior to the transverse pericardial sinus . The transverse pericardial sinus is situated behind the ascending aorta and the pulmonary trunk . Surgeons often pass a finger through this sinus during cardiac surgery to isolate these vessels.</li><li>• Aorta , particularly the ascending aorta , lies anterior to the transverse pericardial sinus .</li><li>• ascending aorta</li><li>• anterior</li><li>• transverse pericardial sinus</li><li>• The transverse pericardial sinus is situated behind the ascending aorta and the pulmonary trunk .</li><li>• behind</li><li>• ascending aorta</li><li>• pulmonary trunk</li><li>• Surgeons often pass a finger through this sinus during cardiac surgery to isolate these vessels.</li><li>• sinus</li><li>• cardiac surgery</li><li>• isolate</li><li>• Transverse Sinus :</li><li>• Transverse Sinus</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 257</li><li>• Ref</li><li>• : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 257</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old female presents with hypertension and diminished pulses in her lower extremities. On physical examination, you notice a significant difference in blood pressure between her upper and lower extremities. An echocardiogram confirms the diagnosis of post-ductal coarctation of the aorta. In post ductal coarctation of aorta, which of the following arteries are not involved in collaterals?", "options": [{"label": "A", "text": "Axillary Artery", "correct": false}, {"label": "B", "text": "Posterior Intercostals Artery", "correct": false}, {"label": "C", "text": "Suprascapular Artery", "correct": false}, {"label": "D", "text": "Vertebral Artery", "correct": true}], "correct_answer": "D. Vertebral Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture15.jpg"], "explanation": "<p><strong>Ans. D) Vertebral Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Axillary Artery can be involved in collateral formation in post-ductal coarctation of the aorta . It can provide an alternate route for blood flow around the coarctation through branches that connect with branches of the internal thoracic or intercostal arteries .</li><li>• Option A.</li><li>• collateral formation</li><li>• post-ductal coarctation</li><li>• aorta</li><li>• alternate route</li><li>• blood flow</li><li>• coarctation</li><li>• branches</li><li>• branches</li><li>• internal thoracic</li><li>• intercostal arteries</li><li>• Option B. The posterior intercostal arteries are commonly involved in the development of collateral circulation in coarctation of the aorta . These arteries can enlarge and form connections with branches of the subclavian artery , bypassing the narrowed segment of the aorta and supplying blood to the lower part of the body.</li><li>• Option B.</li><li>• commonly</li><li>• development</li><li>• collateral circulation</li><li>• coarctation</li><li>• aorta</li><li>• enlarge</li><li>• connections</li><li>• branches</li><li>• subclavian artery</li><li>• narrowed segment</li><li>• aorta</li><li>• supplying blood</li><li>• lower part</li><li>• Option C. Suprascapular Artery, a branch of the subclavian artery , can also participate in collateral circulation . It can form connections with other arteries in the shoulder and upper back area to help bypass the coarctation .</li><li>• Option C.</li><li>• branch</li><li>• subclavian artery</li><li>• participate</li><li>• collateral circulation</li><li>• connections</li><li>• shoulder</li><li>• upper back area</li><li>• bypass</li><li>• coarctation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vertebral Artery , which primarily supplies blood to the posterior part of the brain , is not typically involved in collateral circulation in coarctation of the aorta. Their primary function and pathway do not lend themselves to forming effective collateral routes for bypassing aortic coarctation . Postductal coarctation collateral channels: Anterior Intercostal Artery (Internal Thoracic Artery) V/S Posterior Intercostal Artery (Costocervical Trunk, Descending Aorta) Superior Epigastric Artery (Internal Thoracic Artery) V/S Inferior Epigastric Artery (External Iliac Artery) Superior Intercostal Artery (from Costocervical Trunk) V/S 3 rd Posterior Intercostal Artery Suprascapular Artery (Dorsal Scapular Artery) V/S Subscapular Artery, Circumflex Scapular Artery + (Axillary Artery)</li><li>➤ Vertebral Artery , which primarily supplies blood to the posterior part of the brain , is not typically involved in collateral circulation in coarctation of the aorta.</li><li>➤ posterior part</li><li>➤ brain</li><li>➤ Their primary function and pathway do not lend themselves to forming effective collateral routes for bypassing aortic coarctation .</li><li>➤ effective collateral routes</li><li>➤ bypassing aortic coarctation</li><li>➤ Postductal coarctation collateral channels: Anterior Intercostal Artery (Internal Thoracic Artery) V/S Posterior Intercostal Artery (Costocervical Trunk, Descending Aorta) Superior Epigastric Artery (Internal Thoracic Artery) V/S Inferior Epigastric Artery (External Iliac Artery) Superior Intercostal Artery (from Costocervical Trunk) V/S 3 rd Posterior Intercostal Artery Suprascapular Artery (Dorsal Scapular Artery) V/S Subscapular Artery, Circumflex Scapular Artery + (Axillary Artery)</li><li>➤ Postductal coarctation collateral channels:</li><li>➤ Anterior Intercostal Artery (Internal Thoracic Artery) V/S Posterior Intercostal Artery (Costocervical Trunk, Descending Aorta) Superior Epigastric Artery (Internal Thoracic Artery) V/S Inferior Epigastric Artery (External Iliac Artery) Superior Intercostal Artery (from Costocervical Trunk) V/S 3 rd Posterior Intercostal Artery Suprascapular Artery (Dorsal Scapular Artery) V/S Subscapular Artery, Circumflex Scapular Artery + (Axillary Artery)</li><li>➤ Anterior Intercostal Artery (Internal Thoracic Artery) V/S Posterior Intercostal Artery (Costocervical Trunk, Descending Aorta)</li><li>➤ Superior Epigastric Artery (Internal Thoracic Artery) V/S Inferior Epigastric Artery (External Iliac Artery)</li><li>➤ Superior Intercostal Artery (from Costocervical Trunk) V/S 3 rd Posterior Intercostal Artery</li><li>➤ Suprascapular Artery (Dorsal Scapular Artery) V/S Subscapular Artery, Circumflex Scapular Artery + (Axillary Artery)</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 283</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 283</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the emergency room with severe chest pain following a motor vehicle accident. On examination, the pain is exacerbated by breathing and coughing. The physician suspects a pleural injury and explains to the medical student about the nerve supply to different parts of the pleura. Which of the following nerves is primarily responsible for innervating the parietal pleura?", "options": [{"label": "A", "text": "Vagus Nerve", "correct": false}, {"label": "B", "text": "Phrenic Nerve", "correct": false}, {"label": "C", "text": "Intercostal Nerves", "correct": true}, {"label": "D", "text": "Sympathetic Trunk", "correct": false}], "correct_answer": "C. Intercostal Nerves", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture16.jpg"], "explanation": "<p><strong>Ans. C) Intercostal Nerves</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Vagus nerve primarily innervates the visceral pleura and the lungs but is not involved in innervating the parietal pleura.</li><li>• Option A.</li><li>• visceral pleura</li><li>• lungs</li><li>• Option B. The Phrenic nerve provides sensory innervation to the mediastinal and central diaphragmatic parts of the parietal pleura , but it is not the primary nerve responsible for the costal part, which is often involved in traumatic injuries .</li><li>• Option B.</li><li>• sensory innervation</li><li>• mediastinal</li><li>• central diaphragmatic parts</li><li>• parietal pleura</li><li>• traumatic injuries</li><li>• Option D. The Sympathetic trunk is involved in autonomic innervation but does not provide direct sensory innervation to the parietal pleura in the context of pain sensation.</li><li>• Option D.</li><li>• autonomic innervation</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Intercostal nerves provide sensory innervation to the costal pleura and are responsible for the pain sensation in pleural injuries . Identify that the intercostal nerves are primarily responsible for innervating the costal part of the parietal pleura , conveying pain sensation in cases of pleural injuries .</li><li>➤ The Intercostal nerves provide sensory innervation to the costal pleura and are responsible for the pain sensation in pleural injuries .</li><li>➤ sensory innervation</li><li>➤ costal pleura</li><li>➤ pain sensation</li><li>➤ pleural injuries</li><li>➤ Identify that the intercostal nerves are primarily responsible for innervating the costal part of the parietal pleura , conveying pain sensation in cases of pleural injuries .</li><li>➤ intercostal nerves</li><li>➤ innervating</li><li>➤ costal part</li><li>➤ parietal pleura</li><li>➤ conveying pain sensation</li><li>➤ pleural injuries</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 229.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 229.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents with recurrent episodes of palpitations and dizziness. An echocardiogram reveals an enlarged right atrium and evidence of a right-to-left shunt. During the cardiac catheterization procedure, the cardiologist observes a valve-like structure within the right atrium. Which of the following structures guards the opening of the coronary sinus and may be contributing to the patient's symptoms?", "options": [{"label": "A", "text": "Crista Terminalis", "correct": false}, {"label": "B", "text": "Thebesian Valve", "correct": true}, {"label": "C", "text": "Mitral Valve", "correct": false}, {"label": "D", "text": "Eustachian Valve", "correct": false}], "correct_answer": "B. Thebesian Valve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture17.jpg"], "explanation": "<p><strong>Ans. B) Thebesian Valve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Crista terminalis is a smooth muscle ridge which extends from the upper part of the atrial septum to the right horn of the IVC valve .</li><li>• Option A.</li><li>• smooth muscle ridge</li><li>• upper part</li><li>• atrial septum</li><li>• right horn</li><li>• IVC valve</li><li>• Option C. Mitral valve guards the left atrioventricular orifice .</li><li>• Option C. Mitral valve</li><li>• left atrioventricular orifice</li><li>• Option D. The Eustachian valve guards the opening of IVC .</li><li>• Option D.</li><li>• Eustachian valve</li><li>• opening of IVC</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Coronary sinus opening is situated in the lower part of interatrial septum and opening is guarded by thebesian valve .</li><li>➤ lower part</li><li>➤ interatrial septum</li><li>➤ thebesian valve</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 263</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old male patient presents to the emergency department with crushing chest pain radiating to the left arm and neck. An electrocardiogram (ECG) reveals ST-segment elevation in the anterior leads, and a diagnosis of acute anterior myocardial infarction (MI) is made. The patient is taken to the catheterization lab for coronary angiography. In patients with acute anterior MI, which structure does the anterior cardiac vein primarily drain into?", "options": [{"label": "A", "text": "Right Atrium", "correct": true}, {"label": "B", "text": "Great Cardiac Vein", "correct": false}, {"label": "C", "text": "Coronary Sinus", "correct": false}, {"label": "D", "text": "Marginal Vein", "correct": false}], "correct_answer": "A. Right Atrium", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture18.jpg"], "explanation": "<p><strong>Ans. A) Right Atrium</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Great cardiac vein opens into the coronary sinus .</li><li>• Option B.</li><li>• Great cardiac vein</li><li>• coronary sinus</li><li>• Option C. Coronary sinus receives about 60% venous blood and is 2 to 3 cm long .</li><li>• Option C. Coronary sinus</li><li>• about 60% venous blood</li><li>• 2 to 3 cm long</li><li>• Option D. Venae cordis minimi open into different chambers of the heart through foramina minimarum .</li><li>• Option D. Venae cordis minimi</li><li>• different chambers</li><li>• foramina minimarum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior cardiac veins, sometimes called the right marginal vein , open in the atrium proper through foramina venarum .</li><li>➤ right marginal vein</li><li>➤ atrium</li><li>➤ foramina venarum</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 267</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 267</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old male patient presents to the cardiology clinic with complaints of chest pain and shortness of breath, particularly during physical activity. An exercise stress test reveals significant ST-segment depression on ECG, indicating myocardial ischemia. The cardiologist decides to perform coronary angiography. In patients with symptoms of myocardial ischemia, which of the following locations is most likely to be drained by the middle cardiac vein?", "options": [{"label": "A", "text": "Anterior Inter-Ventricular Sulcus", "correct": false}, {"label": "B", "text": "Posterior Inter-Ventricular Sulcus", "correct": true}, {"label": "C", "text": "Anterior Atrio-Ventricular (AV) Groove", "correct": false}, {"label": "D", "text": "Posterior Atrio-Ventricular (AV) Groove", "correct": false}], "correct_answer": "B. Posterior Inter-Ventricular Sulcus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture19.jpg"], "explanation": "<p><strong>Ans.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterior interventricular sulcus lodges Left anterior descending artery and great cardiac vein .</li><li>• Option A.</li><li>• Left anterior descending artery</li><li>• great cardiac vein</li><li>• Option C. Right coronary lodges in the right part of the anterior atrioventricular groove .</li><li>• Option C.</li><li>• right part</li><li>• anterior atrioventricular groove</li><li>• Option D. Coronary sinus lodges in the left part of the posterior atrioventricular groove .</li><li>• Option D.</li><li>• left part</li><li>• posterior atrioventricular groove</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior interventricular sulcus lodges posterior interventricular artery and middle cardiac vein .</li><li>➤ posterior interventricular artery</li><li>➤ middle cardiac vein</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 270</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 270</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents with shortness of breath and cough. On physical examination, decreased breath sounds are noted in the right lower lung field. A chest X-ray reveals a well-defined, air-filled space in the right lung, adjacent to the diaphragm. Which of the following best describes the structure involved in this condition?", "options": [{"label": "A", "text": "Mediastinum", "correct": false}, {"label": "B", "text": "Costophrenic Angle", "correct": false}, {"label": "C", "text": "Pulmonary Hilum", "correct": false}, {"label": "D", "text": "Pulmonary Recess", "correct": true}], "correct_answer": "D. Pulmonary Recess", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture21.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture22.jpg"], "explanation": "<p><strong>Ans. D) Pulmonary Recess.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. The mediastinum is the central compartment of the thoracic cavity , containing the heart , major blood vessels , and other structures. It is not typically associated with air-filled spaces like those seen in this case.</li><li>• Option A.</li><li>• central compartment</li><li>• thoracic cavity</li><li>• heart</li><li>• major blood vessels</li><li>• Option B. The costophrenic angle is the sharp angle formed by the junction of the diaphragm and the ribcage on a chest X-ray . It is not an air-filled space but rather a bony junction.</li><li>• Option B.</li><li>• sharp angle</li><li>• junction</li><li>• diaphragm</li><li>• ribcage</li><li>• chest X-ray</li><li>• Option C. The pulmonary hilum, also known as the pulmonary root , is the area where the pulmonary arteries , veins , and bronchi enter and exit the lungs . It is not an air-filled space and is located near the middle of the lung, not adjacent to the diaphragm.</li><li>• Option C.</li><li>• pulmonary root</li><li>• pulmonary arteries</li><li>• veins</li><li>• bronchi enter</li><li>• exit the lungs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pulmonary recesses are air-filled spaces that can be found at the periphery of the lungs , often adjacent to the diaphragm . They are most commonly associated with pleural effusions or pneumothorax . In this case, the description is consistent with a pulmonary recess , as seen on a chest X-ray.</li><li>➤ Pulmonary recesses are air-filled spaces that can be found at the periphery of the lungs , often adjacent to the diaphragm .</li><li>➤ air-filled spaces</li><li>➤ periphery</li><li>➤ lungs</li><li>➤ adjacent</li><li>➤ diaphragm</li><li>➤ They are most commonly associated with pleural effusions or pneumothorax . In this case, the description is consistent with a pulmonary recess , as seen on a chest X-ray.</li><li>➤ pleural effusions</li><li>➤ pneumothorax</li><li>➤ pulmonary recess</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 229.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 229.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 3-week-old male infant is brought to the pediatric clinic by his parents due to persistent respiratory distress and feeding difficulties since birth. The baby appears to have labored breathing, and the parents report that he frequently vomits after feeds. On physical examination, the infant is tachypneic with retractions and decreased breath sounds on the left side. A chest X-ray shows abdominal contents in the left thoracic cavity, confirming the diagnosis of a diaphragmatic hernia. Which of the following structure passes through the marked opening in the given image?", "options": [{"label": "A", "text": "IVC", "correct": false}, {"label": "B", "text": "Oesophagus", "correct": true}, {"label": "C", "text": "Aorta", "correct": false}, {"label": "D", "text": "Greater Splanchnic Nerve", "correct": false}], "correct_answer": "B. Oesophagus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture23.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-120230.jpg"], "explanation": "<p><strong>Ans. B) Oesophagus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. IVC opening is located opposite the T8 vertebra .</li><li>• Option A.</li><li>• opposite</li><li>• T8 vertebra</li><li>• Option C. Aortic opening lies opposite T10 .</li><li>• Option C.</li><li>• opposite T10</li><li>• Option D. Greater and lesser splanchnic nerves pierce each crus .</li><li>• Option D. Greater</li><li>• lesser splanchnic nerves</li><li>• crus</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Oesophageal branches of left gastric vessels , anterior and posterior vagal trunks pass through esophageal opening .</li><li>• left gastric vessels</li><li>• anterior</li><li>• posterior vagal trunks</li><li>• esophageal opening</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Venous drainage of the heart removes deoxygenated blood, preventing myocardial congestion and maintaining cardiac function, while also serving as a diagnostic tool in cardiology. Which of the following veins does not open into the pointed structure?", "options": [{"label": "A", "text": "Venae Cordis Minimi", "correct": true}, {"label": "B", "text": "Oblique Vein of Left Atrium", "correct": false}, {"label": "C", "text": "Small Cardiac Vein", "correct": false}, {"label": "D", "text": "Great Cardiac Vein", "correct": false}], "correct_answer": "A. Venae Cordis Minimi", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-03.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture25.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-120846.jpg"], "explanation": "<p><strong>Ans. A) Venae Cordis Minimi</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Oblique Vein of Left Atrium runs on the posterior surface of the left atrium and is a remnant of the left superior vena cava . The oblique vein of the left atrium drains into the coronary sinus , contributing to its blood flow .</li><li>• Option B.</li><li>• posterior surface</li><li>• left atrium</li><li>• remnant</li><li>• left superior vena cava</li><li>• oblique vein</li><li>• left atrium</li><li>• coronary sinus</li><li>• blood flow</li><li>• Option C. Small Cardiac Vein runs along the right margin of the heart and drains the right atrium and ventricle and typically drains into the coronary sinus , contributing to the venous drainage of the heart.</li><li>• Option C.</li><li>• right margin</li><li>• heart</li><li>• drains</li><li>• right atrium</li><li>• ventricle</li><li>• coronary sinus</li><li>• venous drainage</li><li>• Option D. Great Cardiac Vein begins at the heart's apex and runs alongside the anterior interventricular artery . It drains into the coronary sinus , forming one of its major tributaries.</li><li>• Option D.</li><li>• heart's apex</li><li>• anterior interventricular artery</li><li>• drains</li><li>• coronary sinus</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Venae Cordis Minimi, also known as Thebesian veins , these are small veins that drain directly into all four chambers of the heart , mostly the right atrium and right ventricle. They do not typically drain into the coronary sinus. Instead, they open directly into the heart chambers , particularly the atria . Venae cordis minimi opens into different chambers of heart through foramina minimarum.</li><li>• Venae Cordis Minimi, also known as Thebesian veins , these are small veins that drain directly into all four chambers of the heart , mostly the right atrium and right ventricle. They do not typically drain into the coronary sinus.</li><li>• Venae Cordis Minimi,</li><li>• Thebesian veins</li><li>• small veins</li><li>• all four chambers of the heart</li><li>• mostly</li><li>• right atrium</li><li>• right</li><li>• ventricle.</li><li>• Instead, they open directly into the heart chambers , particularly the atria .</li><li>• directly into</li><li>• heart chambers</li><li>• atria</li><li>• Venae cordis minimi opens into different chambers of heart through foramina minimarum.</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 261</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 261</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following septum is supplied by the marked structure in the given image?", "options": [{"label": "A", "text": "Anterosuperior 1/3rd Interventricular Septum", "correct": false}, {"label": "B", "text": "Posteroinferior 1/3rd Interventricular Septum", "correct": false}, {"label": "C", "text": "Anterosuperior of 2/3rd Interatrial Septum", "correct": false}, {"label": "D", "text": "Anterosuperior 2/3rd Interventricular Septum", "correct": true}], "correct_answer": "D. Anterosuperior 2/3rd Interventricular Septum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-04.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture26.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-121226.jpg"], "explanation": "<p><strong>Ans. D) Anterosuperior 2 / 3rd Interventricular Septum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The LAD artery supplies the anterosuperior 2/3rd of the interventricular septum . The LAD runs down the anterior interventricular groove and supplies the bulk of the interventricular septum .</li><li>• Option A.</li><li>• LAD artery</li><li>• anterosuperior 2/3rd of the interventricular septum</li><li>• anterior interventricular groove</li><li>• bulk</li><li>• interventricular septum</li><li>• Option B. Posteroinferior 1/3rd Interventricular Septum is generally supplied by the posterior descending artery , which arises from the right coronary artery in a right-dominant circulation or from the left circumflex artery in a left-dominant circulation . The LAD does not supply this area of the septum.</li><li>• Option B.</li><li>• posterior descending artery</li><li>• right coronary artery</li><li>• right-dominant circulation</li><li>• left circumflex artery</li><li>• left-dominant circulation</li><li>• Option C. The LAD artery does not supply the interatrial septum.</li><li>• Option C.</li><li>• does not</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The LAD artery supplies the anterosuperior 2/3rds of the interventricular septum. This artery descends along the anterior interventricular groove and provides blood to the majority of the interventricular septum , including both the anterior wall of the left ventricle and the anterior portion of the septum .</li><li>• The LAD artery supplies the anterosuperior 2/3rds of the interventricular septum.</li><li>• LAD artery</li><li>• anterosuperior 2/3rds</li><li>• interventricular septum.</li><li>• This artery descends along the anterior interventricular groove and provides blood to the majority of the interventricular septum , including both the anterior wall of the left ventricle and the anterior portion of the septum .</li><li>• descends</li><li>• anterior interventricular groove</li><li>• majority</li><li>• interventricular septum</li><li>• both</li><li>• anterior wall</li><li>• left ventricle</li><li>• anterior portion</li><li>• septum</li><li>• Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li><li>• Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following option is the remnant of marked structure in the given image?", "options": [{"label": "A", "text": "Septum Primum", "correct": false}, {"label": "B", "text": "Septum Secundum", "correct": true}, {"label": "C", "text": "Left Venous Valve", "correct": false}, {"label": "D", "text": "Right Venous Valve", "correct": false}], "correct_answer": "B. Septum Secundum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-05.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture27.jpg"], "explanation": "<p><strong>Ans. B) Septum Secundum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. In fetal life , the septum primum is a thin , crescent-shaped piece of tissue that initially grows towards the endocardial cushions , contributing to the division between the atria . However, the septum primum itself does not form the remnant of the limbus fossa ovalis. Rather, it contributes to the structure of the fossa ovalis during fetal development .</li><li>• Option A.</li><li>• fetal life</li><li>• thin</li><li>• crescent-shaped piece</li><li>• endocardial cushions</li><li>• division</li><li>• atria</li><li>• contributes</li><li>• structure</li><li>• fossa ovalis</li><li>• fetal development</li><li>• Option C. Left Venous Valve, also known as the valve of the coronary sinus , is a different structure . It guards the opening of the coronary sinus into the right atrium . It is not related to the fossa ovalis or its limbus.</li><li>• Option C.</li><li>• valve of the coronary sinus</li><li>• structure</li><li>• guards</li><li>• opening</li><li>• coronary sinus</li><li>• right atrium</li><li>• Option D. Right Venous Valve, also known as the Eustachian valve , is located at the junction of the inferior vena cava and the right atrium . Like the left venous valve, it is not related to the fossa ovalis or its limbus.</li><li>• Option D.</li><li>• Eustachian valve</li><li>• junction</li><li>• inferior vena cava</li><li>• right atrium</li><li>• Educational objective :</li><li>• Educational objective</li><li>• Septum Secundum: It is a thicker and more muscular structure that develops to the right of the septum primum in the fetal heart . The upper part of the septum secundum forms the limbus of the fossa ovalis , a prominent rim surrounding the fossa ovalis in the right atrium of the adult heart . This rim is the remnant of the septum secundum .</li><li>• Septum Secundum: It is a thicker and more muscular structure that develops to the right of the septum primum in the fetal heart .</li><li>• Septum Secundum:</li><li>• thicker</li><li>• more muscular structure</li><li>• right</li><li>• septum primum</li><li>• fetal heart</li><li>• The upper part of the septum secundum forms the limbus of the fossa ovalis , a prominent rim surrounding the fossa ovalis in the right atrium of the adult heart . This rim is the remnant of the septum secundum .</li><li>• limbus</li><li>• fossa ovalis</li><li>• rim</li><li>• fossa ovalis</li><li>• right atrium</li><li>• adult heart</li><li>• remnant</li><li>• septum secundum</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 260</li><li>• Ref</li><li>• : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 260</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "The marked structure in image is a vital component of the autonomic nervous system, regulating cardiac function by influencing heart rate and contraction strength. Dysfunction of this can lead to arrhythmias and other cardiac issues, requiring careful assessment and management in cardiology practice. Which of the following doesn’t contribute to the given plexus?", "options": [{"label": "A", "text": "Cardiac branch from superior cervical ganglion of left sympathetic trunk", "correct": true}, {"label": "B", "text": "Cardiac branch from middle cervical ganglion of right sympathetic trunk", "correct": false}, {"label": "C", "text": "Cardiac branch of right recurrent laryngeal nerve", "correct": false}, {"label": "D", "text": "Lower cervical cardiac branch of right vagus", "correct": false}], "correct_answer": "A. Cardiac branch from superior cervical ganglion of left sympathetic trunk", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-06.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-122215_4gav44l.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture28_vSQpPr1.jpg"], "explanation": "<p><strong>Ans. A) Cardiac branch from superior cervical ganglion of left sympathetic trunk</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Similar to the superior cervical ganglion , the middle cervical ganglion of the sympathetic trunk also contributes to the cardiac plexus . These branches from the middle cervical ganglion bring sympathetic innervation to the heart.</li><li>• Option B.</li><li>• superior cervical ganglion</li><li>• middle cervical ganglion</li><li>• sympathetic trunk</li><li>• cardiac plexus</li><li>• middle cervical ganglion</li><li>• sympathetic innervation</li><li>• Option C. The recurrent laryngeal nerves , branches of the vagus nerves , are primarily involved in innervating the larynx . While the vagus nerve contributes parasympathetic fibers to the cardiac plexus , the recurrent laryngeal nerves directly contribute to the deep cardiac plexus .</li><li>• Option C.</li><li>• recurrent laryngeal nerves</li><li>• vagus nerves</li><li>• innervating</li><li>• larynx</li><li>• vagus nerve</li><li>• parasympathetic fibers</li><li>• cardiac plexus</li><li>• directly contribute</li><li>• deep cardiac plexus</li><li>• Option D. The lower cervical cardiac branches of the vagus nerves contribute to the parasympathetic innervation of the heart, influencing heart rate and other functions.</li><li>• Option D.</li><li>• parasympathetic innervation</li><li>• heart rate</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• All the cardiac branches derived from three cervical and upper 4 or 5 thoracic ganglia of the sympathetic chains except the superior cervical cardiac branch of left cervical sympathetic . All the cardiac branches of vagus and recurrent laryngeal nerves except the inferior cervical cardiac branch of the left vagus nerve .</li><li>• All the cardiac branches derived from three cervical and upper 4 or 5 thoracic ganglia of the sympathetic chains except the superior cervical cardiac branch of left cervical sympathetic .</li><li>• All the cardiac branches</li><li>• three cervical</li><li>• upper 4</li><li>• 5 thoracic ganglia</li><li>• sympathetic chains</li><li>• except</li><li>• superior cervical cardiac branch</li><li>• left cervical sympathetic</li><li>• All the cardiac branches of vagus and recurrent laryngeal nerves except the inferior cervical cardiac branch of the left vagus nerve .</li><li>• All the cardiac branches</li><li>• vagus</li><li>• recurrent laryngeal nerves</li><li>• except</li><li>• inferior cervical cardiac branch</li><li>• left vagus nerve</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 257</li><li>• Ref</li><li>• : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 257</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old girl realized that she felt very exhausted and tired after a short walk. She also experienced leg cramps and shortness of breath. On examination, radiofemoral delay was noted and BP in the upper limb was 110/80 mmHg and in the lower limb was 90/60 mmHg. Chest x-ray showed notching of ribs. Echocardiography showed narrowing of the archof the aorta beyond attachment of ligamentum arteriosum. All the statements pertaining to the above condition are correct except?", "options": [{"label": "A", "text": "The girl was diagnosed to have coarctation of aorta", "correct": false}, {"label": "B", "text": "Notching of ribs is due to dilatation and tortuosity of posterior intercostal arteries", "correct": false}, {"label": "C", "text": "The ligamentum arteriosum extends from pulmonary trunk to the descending aorta distal to the origin of left subclavian artery", "correct": true}, {"label": "D", "text": "There is reversal of blood flow in posterior intercostal arteries", "correct": false}], "correct_answer": "C. The ligamentum arteriosum extends from pulmonary trunk to the descending aorta distal to the origin of left subclavian artery", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The ligamentum arteriosum extends from pulmonary trunk to the descending aorta distal to the origin of left subclavian artery.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. In postductal coarctation of aorta , descending aorta receives blood from enlarged and tortuous posterior intercostal arteries of 3 rd to 9 th spaces .</li><li>• Option A.</li><li>• postductal coarctation of aorta</li><li>• descending aorta</li><li>• blood</li><li>• enlarged</li><li>• tortuous posterior intercostal arteries</li><li>• 3 rd to 9 th spaces</li><li>• Option B. These arteries in turn receive blood from the anastomoses with anterior intercostal arteries from the internal thoracic artery and its musculophrenic branch .</li><li>• Option B.</li><li>• receive blood</li><li>• anastomoses</li><li>• anterior intercostal arteries</li><li>• internal thoracic artery</li><li>• musculophrenic branch</li><li>• Option D. Posterior intercostal arteries of upper two spaces arise from superior intercostal arteries and rest of the spaces directly from descending aorta .</li><li>• Option D. Posterior intercostal arteries</li><li>• upper two spaces</li><li>• superior intercostal arteries</li><li>• descending aorta</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Ligamentum arteriosum extends from the proximal part of the left pulmonary artery to the aorta distal to the origin of the left subclavian artery .</li><li>• proximal part</li><li>• left pulmonary artery</li><li>• aorta distal</li><li>• origin</li><li>• left subclavian artery</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1024</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1024</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A cashier in a bank who prefers to eat deep fried foods and ice cream daily before bed, on his way home suddenly felt an uneasiness in the left side of his chest. He managed to drive to a nearby hospital. The physician advised him to take a coronary angiogram. Which of the following is true about arterial supply to the heart?", "options": [{"label": "A", "text": "The SA Node is supplied by Left Coronary Artery", "correct": false}, {"label": "B", "text": "Coronary predominance is based on origin of Anterior Interventricular Branch", "correct": false}, {"label": "C", "text": "The Interventricular Septum is supplied only by Right Coronary Artery", "correct": false}, {"label": "D", "text": "The trunk of Left Coronary Artery is very short", "correct": true}], "correct_answer": "D. The trunk of Left Coronary Artery is very short", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture29.jpg"], "explanation": "<p><strong>Ans. D) The trunk of left coronary artery is very short</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The SA node and AV node are supplied by branches of the right coronary artery .</li><li>• Option A.</li><li>• SA node</li><li>• AV node</li><li>• right coronary artery</li><li>• Option B. Coronary predominance is based on the origin of the posterior interventricular branch .</li><li>• Option B.</li><li>• origin</li><li>• posterior interventricular branch</li><li>• Option C. Anterior 2/3rd of the interventricular septum is supplied by the left coronary artery and the posterior 1/3rd by right coronary artery .</li><li>• Option C.</li><li>• Anterior 2/3rd</li><li>• interventricular septum</li><li>• left coronary artery</li><li>• posterior 1/3rd</li><li>• right coronary artery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The trunk of the left coronary artery is very short it soon bifurcates into the anterior interventricular branch and left circumflex artery .</li><li>• The trunk of the left coronary artery is very short it soon bifurcates into the anterior interventricular branch and left circumflex artery .</li><li>• trunk</li><li>• left coronary artery</li><li>• very short</li><li>• bifurcates</li><li>• anterior interventricular branch</li><li>• left circumflex artery</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 995</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 995</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 56-year-old man who was suffering from back pain for the past two years was admitted. Posteroanterior chest X-ray showed left hilar enlargement. Computerised thorax tomography (CTT) images were taken and a saccular thoracic aortic aneurysm, 7 cm in diameter was found. An endovascular stent graft was successfully implanted in the patient. Which of the following statements is correct?", "options": [{"label": "A", "text": "Arch of Aorta is situated in the Inferior Mediastinum", "correct": false}, {"label": "B", "text": "Arch of Aorta is crossed by Left Brachiocephalic Vein", "correct": false}, {"label": "C", "text": "Arch of Aorta is connected to Right Pulmonary Artery by Ligamentum Arteriosum", "correct": false}, {"label": "D", "text": "Dilatation of Aortic Arch can compress Left Recurrent Laryngeal Nerve", "correct": true}], "correct_answer": "D. Dilatation of Aortic Arch can compress Left Recurrent Laryngeal Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture30.jpg"], "explanation": "<p><strong>Ans. D) Dilatation of Aortic Arch can compress Left Recurrent Laryngeal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Left recurrent laryngeal nerve hooks the arch of aorta as shown in image below:</li><li>• Left recurrent laryngeal nerve hooks the arch of aorta as shown in image below:</li><li>• Left recurrent laryngeal</li><li>• hooks</li><li>• arch of aorta</li><li>• Option A. Arch of aorta is a content of superior mediastinum .</li><li>• Option A.</li><li>• superior mediastinum</li><li>• Option B. It is crossed by the left superior intercostal vein .</li><li>• Option B.</li><li>• left superior intercostal vein</li><li>• Option C. Ligamentum arteriosum connects the left pulmonary artery to the arch of aorta distal to the origin of the left subclavian artery .</li><li>• Option C.</li><li>• left pulmonary artery</li><li>• arch of aorta</li><li>• distal</li><li>• origin</li><li>• left subclavian artery</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Arch of aorta is posteriorly related to: Deep cardiac plexus Trachea, oesophagus Thoracic duct Left recurrent laryngeal nerve</li><li>• Arch of aorta is posteriorly related to: Deep cardiac plexus Trachea, oesophagus Thoracic duct Left recurrent laryngeal nerve</li><li>• Arch of aorta</li><li>• posteriorly</li><li>• Deep cardiac plexus Trachea, oesophagus Thoracic duct Left recurrent laryngeal nerve</li><li>• Deep cardiac plexus</li><li>• Trachea, oesophagus</li><li>• Thoracic duct</li><li>• Left recurrent laryngeal nerve</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1024</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st edition, pg no. 1024</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old man felt heaviness in his chest while digging in his garden. He had similar episodes like this in the past few months. He found that the discomfort disappeared with rest after about 5 minutes. He visited the emergency department because this time, the chest discomfort had occurred with much less exertion. Which of the following statements concerning this case is incorrect?", "options": [{"label": "A", "text": "The diagnosis is a classic case of angina pectoris", "correct": false}, {"label": "B", "text": "The afferent pain fibers enter the spinal cord via the posterior roots of the upper four thoracic spinal nerves", "correct": false}, {"label": "C", "text": "Superficial cardiac plexus is contributed by cardiac branch from inferior cervical ganglion of left sympathetic trunk and left vagus nerve", "correct": true}, {"label": "D", "text": "Deep cardiac plexus is situated in front of bifurcation of trachea", "correct": false}], "correct_answer": "C. Superficial cardiac plexus is contributed by cardiac branch from inferior cervical ganglion of left sympathetic trunk and left vagus nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-125210.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture28_Vu9PmPn.jpg"], "explanation": "<p><strong>Ans. C) Superficial cardiac plexus is contributed by cardiac branch from Inferior Cervical Ganglion of Left Sympathetic Trunk and Left Vagus Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The diagnosis is a classic case of angina pectoris, often happens with exertion or stress and goes away with rest or medication . The man's symptoms - chest heaviness that appears with exertion and resolves with rest - are classic signs of angina pectoris .</li><li>• Option A</li><li>• angina pectoris,</li><li>• exertion</li><li>• stress</li><li>• rest or medication</li><li>• chest heaviness</li><li>• exertion</li><li>• resolves with rest</li><li>• classic signs</li><li>• angina pectoris</li><li>• Option B. In angina pectoris, the pain is typically referred to the upper body , including the chest, arms, shoulders, neck, jaw , or back . The sensory information from the heart is carried through sympathetic nerves , which enter the spinal cord through the upper thoracic and lower cervical segments (T1-T4/C7-C8) .</li><li>• Option B.</li><li>• upper body</li><li>• chest, arms, shoulders, neck, jaw</li><li>• back</li><li>• sympathetic nerves</li><li>• spinal cord</li><li>• upper thoracic</li><li>• lower cervical segments (T1-T4/C7-C8)</li><li>• Option D. Deep cardiac plexus is situated in front of bifurcation of trachea: The deep cardiac plexus is located near the bifurcation of the trachea and above the bifurcation of the pulmonary artery. It receives contributions from the cervical cardiac nerves and branches of the thoracic cardiac nerves, playing a crucial role in heart innervation.</li><li>• Option D.</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Superficial cardiac plexus is contributed by cardiac branch from inferior cervical ganglion of left sympathetic trunk and left vagus nerve : The superficial cardiac plexus is located below the arch of the aorta. It is formed by the cardiac branches of the left vagus nerve and the left sympathetic trunk, particularly from the inferior cervical ganglion. This plexus plays a role in the autonomic regulation of heart functions.</li><li>• Superficial cardiac plexus is contributed by cardiac branch from inferior cervical ganglion of left sympathetic trunk and left vagus nerve : The superficial cardiac plexus is located below the arch of the aorta.</li><li>• Superficial cardiac plexus is contributed by cardiac branch from inferior cervical ganglion of left sympathetic trunk and left vagus nerve</li><li>• It is formed by the cardiac branches of the left vagus nerve and the left sympathetic trunk, particularly from the inferior cervical ganglion. This plexus plays a role in the autonomic regulation of heart functions.</li><li>• Ref: Gray’s Anatomy 41 st edition, pg no. 997</li><li>• Ref: Gray’s Anatomy 41 st edition, pg no. 997</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 57-year-old male lorry driver presented to his local emergency department with a 20-minute episode of diaphoresis and chest pain. The chest pain was central, radiating to the left arm and crushing in nature. The pain settled promptly following 300 mg aspirin orally and 800 mcg glyceryl trinitrate (GTN) spray sublingually administered by paramedics in the community. On examination, he appeared comfortable and was able to complete sentences fully. There were no heart murmurs present on cardiac auscultation. Blood pressure was 180/105 mmHg, heart rate was 83 bpm and regular, oxygen saturation was 97%. He was taken to the catheterization lab where the left anterior descending coronary artery (LAD) was shown to be completely occluded. Which of the following statements is incorrect about LAD?", "options": [{"label": "A", "text": "The left anterior descending artery lies in the anterior interventricular sulcus", "correct": false}, {"label": "B", "text": "It is accompanied by great cardiac vein", "correct": false}, {"label": "C", "text": "It supplies anterior 2/3 of interventricular septum", "correct": false}, {"label": "D", "text": "It anastomoses with the posterior interventricular branch at the apex of the heart", "correct": true}], "correct_answer": "D. It anastomoses with the posterior interventricular branch at the apex of the heart", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) It anastomoses with the posterior interventricular branch at the apex of the heart</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The LAD runs down the anterior interventricular sulcus , supplying the sternocostal surface of the heart and the anterior part of the interventricular septum .</li><li>• Option A.</li><li>• LAD</li><li>• down</li><li>• anterior interventricular sulcus</li><li>• sternocostal surface</li><li>• anterior part</li><li>• interventricular septum</li><li>• Option B . The LAD is accompanied by the great cardiac vein .</li><li>• Option B</li><li>• great cardiac vein</li><li>• Option C. The LAD provides blood to the anterior 2/3 of the interventricular septum , which includes the bundle branches of the heart's electrical conduction system .</li><li>• Option C.</li><li>• anterior 2/3</li><li>• interventricular septum</li><li>• bundle branches</li><li>• electrical conduction system</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Left anterior descending branch anastomose with the posterior interventricular branch of the right coronary artery at the junction of anterior one third and posterior two third of posterior interventricular groove . While the LAD does extend to the apex of the heart , the main anastomosis at the apex is between the terminal branches of the LAD and the posterior descending artery . The PDA is often a branch of the right coronary artery (in right-dominant circulation ) or a branch of the circumflex artery (in left-dominant circulation ).</li><li>• Left anterior descending branch anastomose with the posterior interventricular branch of the right coronary artery at the junction of anterior one third and posterior two third of posterior interventricular groove .</li><li>• posterior interventricular branch</li><li>• right coronary artery</li><li>• anterior one third</li><li>• posterior two third</li><li>• posterior interventricular groove</li><li>• While the LAD does extend to the apex of the heart , the main anastomosis at the apex is between the terminal branches of the LAD and the posterior descending artery .</li><li>• apex of the heart</li><li>• main anastomosis</li><li>• apex</li><li>• between</li><li>• terminal branches</li><li>• LAD</li><li>• posterior descending artery</li><li>• The PDA is often a branch of the right coronary artery (in right-dominant circulation ) or a branch of the circumflex artery (in left-dominant circulation ).</li><li>• branch</li><li>• right coronary artery</li><li>• right-dominant circulation</li><li>• branch</li><li>• circumflex artery</li><li>• left-dominant circulation</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1016</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 1016</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 62-year-old man was brought to the casualty due to sudden onset of severe chest pain. On examination, his respiratory rate and pulse were rapid. On auscultation, the heart sounds were faintly audible. X-ray chest showed a globular enlarged shadow suggestive of fluid around the heart. Which of the following is not true?", "options": [{"label": "A", "text": "The fibrous pericardium is supplied by phrenic nerve", "correct": false}, {"label": "B", "text": "Cardiac dullness is located to the left of the sternal margin from 4 th to 6 th costal cartilages.", "correct": false}, {"label": "C", "text": "In costoxiphoid approach, the needle is inserted through the left 6 th intercostal space", "correct": true}, {"label": "D", "text": "In CABG, the ascending aorta and pulmonary trunk are ligated in transverse pericardial sinus", "correct": false}], "correct_answer": "C. In costoxiphoid approach, the needle is inserted through the left 6 th intercostal space", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture31.jpg"], "explanation": "<p><strong>Ans. C) In costoxiphoid approach, the needle is inserted through the left 6thintercostal space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A. The phrenic nerve , which originates from the cervical spinal segments (C3-C5) , innervates the fibrous pericardium . It provides sensory innervation , which is why pericarditis can cause referred pain to the shoulder or neck .</li><li>• Option A.</li><li>• phrenic nerve</li><li>• originates</li><li>• cervical spinal segments (C3-C5)</li><li>• fibrous pericardium</li><li>• sensory innervation</li><li>• referred pain</li><li>• shoulder</li><li>• neck</li><li>• Option B. Cardiac dullness is typically located to the left of the sternal margin , extending from the 4th to the 6th costal cartilages .</li><li>• Option B.</li><li>• Cardiac dullness</li><li>• left</li><li>• sternal margin</li><li>• 4th</li><li>• 6th costal cartilages</li><li>• Option D. During CABG , the ascending aorta and pulmonary trunk are not ligated in the transverse pericardial sinus. Instead, this sinus is used as a pathway to pass instruments or grafts around these vessels . Ligation of these major vessels would be detrimental and is not a part of standard CABG procedure.</li><li>• Option D.</li><li>• CABG</li><li>• ascending aorta</li><li>• pulmonary trunk</li><li>• pathway</li><li>• pass instruments</li><li>• grafts</li><li>• vessels</li><li>• Ligation</li><li>• major vessels</li><li>• detrimental</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The costoxiphoid approach is one of the methods used for pericardiocentesis . The needle is typically inserted just below the xiphoid process at the costoxiphoid angle , not through the left 6th intercostal space. The incorrect location can increase the risk of injuring the heart or other structures.</li><li>➤ The costoxiphoid approach is one of the methods used for pericardiocentesis .</li><li>➤ costoxiphoid approach</li><li>➤ pericardiocentesis</li><li>➤ The needle is typically inserted just below the xiphoid process at the costoxiphoid angle , not through the left 6th intercostal space.</li><li>➤ needle</li><li>➤ inserted</li><li>➤ below</li><li>➤ xiphoid process</li><li>➤ costoxiphoid angle</li><li>➤ The incorrect location can increase the risk of injuring the heart or other structures.</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 997</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st edition, pg no. 997</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structures passes through the aortic opening of the diaphragm?", "options": [{"label": "A", "text": "Thoracic Duct", "correct": true}, {"label": "B", "text": "Right Phrenic Nerve", "correct": false}, {"label": "C", "text": "IVC", "correct": false}, {"label": "D", "text": "Least Splanchnic Nerve", "correct": false}], "correct_answer": "A. Thoracic Duct", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture32.jpg"], "explanation": "<p><strong>Ans. A) Thoracic Duct</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Right phrenic nerve branches pass through IVC opening , left phrenic nerve pierces left cupola .</li><li>• Option B.</li><li>• IVC opening</li><li>• left phrenic nerve</li><li>• left cupola</li><li>• Option C . IVC opening lies opposite the T8 vertebral level in the central tendon .</li><li>• Option C</li><li>• T8 vertebral level</li><li>• central tendon</li><li>• Option D. Least splanchnic nerve passes behind the medial arcuate ligament .</li><li>• Option D.</li><li>• behind</li><li>• medial arcuate ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Aortic opening lies opposite the T12 vertebra . It transmits aorta , thoracic duct , and sometimes azygos vein .</li><li>➤ Aortic opening</li><li>➤ opposite</li><li>➤ T12 vertebra</li><li>➤ transmits</li><li>➤ aorta</li><li>➤ thoracic duct</li><li>➤ azygos vein</li><li>➤ Ref: Textbook of Anatomy, Abdomen and lower limb, 3 rd edition, Vishram Singh, pg. 179</li><li>➤ Ref: Textbook of Anatomy, Abdomen and lower limb, 3 rd edition, Vishram Singh, pg. 179</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Pleural tapping, also known as thoracentesis, is a medical procedure used to remove excess fluid or air from the pleural space surrounding the lungs. It is a valuable diagnostic and therapeutic tool in managing conditions such as pleural effusion, pneumothorax, and certain lung infections, helping to relieve symptoms and improve respiratory function. Which of the following structure is not pierced during pleural tapping?", "options": [{"label": "A", "text": "Internal Intercostal", "correct": false}, {"label": "B", "text": "External Intercostal", "correct": false}, {"label": "C", "text": "Costal Pleura", "correct": false}, {"label": "D", "text": "Pulmonary Pleura", "correct": true}], "correct_answer": "D. Pulmonary Pleura", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture33.jpg"], "explanation": "<p><strong>Ans. D) Pulmonary Pleura</strong></p>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient presented with a persistent cough and wheezing. Upon examination and imaging, a localized consolidation was identified in the right lung, corresponding to the bronchopulmonary segment. Suspected diagnosis is pneumonia. Further evaluation and treatment plan discussed with the patient. Which are the segments of the upper lobe in the right lung?", "options": [{"label": "A", "text": "Anterior, Posterior, Medial", "correct": false}, {"label": "B", "text": "Apical, Anterior, Posterior", "correct": true}, {"label": "C", "text": "Lateral, Medial, Superior", "correct": false}, {"label": "D", "text": "Basal, Lateral, Medial", "correct": false}], "correct_answer": "B. Apical, Anterior, Posterior", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture34.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-132905.jpg"], "explanation": "<p><strong>Ans. B) Apical, Anterior, Posterior</strong></p>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The bronchopulmonary segments are functional and anatomical subdivisions of the lungs, each served by its own bronchus and arterial supply . Both the right and left lungs are divided into these segments, which are important for surgical planning and understanding lung disease patterns. Each segment is an independent unit and can be surgically removed if necessary, without significantly affecting the adjacent segments. The bronchopulmonary segments are named based on their position and the bronchial and arterial structures that supply them.</li><li>➤ The bronchopulmonary segments are functional and anatomical subdivisions of the lungs, each served by its own bronchus and arterial supply . Both the right and left lungs are divided into these segments, which are important for surgical planning and understanding lung disease patterns.</li><li>➤ functional</li><li>➤ anatomical subdivisions</li><li>➤ own bronchus</li><li>➤ arterial supply</li><li>➤ right</li><li>➤ left lungs</li><li>➤ surgical planning</li><li>➤ lung disease</li><li>➤ Each segment is an independent unit and can be surgically removed if necessary, without significantly affecting the adjacent segments.</li><li>➤ independent unit</li><li>➤ surgically removed</li><li>➤ The bronchopulmonary segments are named based on their position and the bronchial and arterial structures that supply them.</li><li>➤ Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 240</li><li>➤ Ref: Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 240</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Patient's chest X-ray revealed an abnormal shadow in the pulmonary hilum region, prompting concern for potential mediastinal lymphadenopathy. Clinical examination and additional imaging recommended to assess for underlying causes such as infection or malignancy. Patient advised to follow up with a pulmonologist for further evaluation and management. Which is the most inferior structure in the right hilum in lung?", "options": [{"label": "A", "text": "Bronchus", "correct": false}, {"label": "B", "text": "Inferior Pulmonary Vein", "correct": true}, {"label": "C", "text": "Pulmonary Artery", "correct": false}, {"label": "D", "text": "Inferior Bronchial Vein", "correct": false}], "correct_answer": "B. Inferior Pulmonary Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture35.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-133524.jpg"], "explanation": "<p><strong>Ans. B) Inferior Pulmonary Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The right main bronchus enters the right lung at the hilum . In the typical arrangement, it is positioned posteriorly and slightly superiorly within the hilum .</li><li>• Option A.</li><li>• right main bronchus</li><li>• right lung</li><li>• hilum</li><li>• positioned posteriorly</li><li>• slightly superiorly</li><li>• hilum</li><li>• Option C. In the right lung, the right pulmonary artery is located anteriorly and slightly superiorly at the hilum, just above the right main bronchus .</li><li>• Option C.</li><li>• right pulmonary artery</li><li>• anteriorly</li><li>• slightly superiorly</li><li>• right main bronchus</li><li>• Option D. Inferior Bronchial Vein are relatively small compared to the other structures in the hilum and do not occupy a consistent or prominent position like the pulmonary veins or arteries.</li><li>• Option D.</li><li>• small</li><li>• hilum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inferior Pulmonary Vein is typically the most inferior structure in the hilum of the lung . It drains from the lower lobes of the lung and returns it to the left atrium of the heart .</li><li>➤ Inferior Pulmonary Vein</li><li>➤ most inferior structure</li><li>➤ hilum</li><li>➤ lung</li><li>➤ drains</li><li>➤ lower lobes</li><li>➤ lung</li><li>➤ returns it</li><li>➤ left atrium</li><li>➤ heart</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 235</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 235</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents with recurrent episodes of hemoptysis and chest pain. A tributary of the azygous vein is most likely involved in this patient's symptoms? It is also the last tributary of azygous vein? Identify it from following options:", "options": [{"label": "A", "text": "Right Superior Intercostal Vein", "correct": false}, {"label": "B", "text": "Hemi Azygos Vein", "correct": false}, {"label": "C", "text": "Right Bronchial Vein", "correct": true}, {"label": "D", "text": "Left Gastric Vein", "correct": false}], "correct_answer": "C. Right Bronchial Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture36.jpg"], "explanation": "<p><strong>Ans. C) Right Bronchial Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Right superior intercostal vein is formed by the union of upper 3 posterior intercostal veins drain into the arch of the azygos vein , the rest of the intercostal veins end separately in the azygos vein .</li><li>• Option A.</li><li>• union</li><li>• upper 3 posterior intercostal veins</li><li>• arch of the azygos vein</li><li>• rest</li><li>• intercostal veins</li><li>• end</li><li>• azygos vein</li><li>• Option B. The Hemiazygos vein joins the azygos vein opposite the 7th thoracic vertebra . Azygos vein opposite 7 th thoracic vertebra .</li><li>• Option B.</li><li>• azygos vein opposite</li><li>• 7th thoracic vertebra</li><li>• opposite 7 th thoracic vertebra</li><li>• Option C. Esophageal, pericardial and mediastinal veins also open into the azygos vein . Left gastric vein into portal vein .</li><li>• Option C.</li><li>• Esophageal, pericardial</li><li>• mediastinal veins</li><li>• azygos vein</li><li>• Left gastric vein</li><li>• portal vein</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The right bronchial vein is the last tributary of azygos veins just before it opens into superior vena cava .</li><li>➤ right bronchial vein</li><li>➤ last tributary</li><li>➤ azygos veins</li><li>➤ superior vena cava</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following structure lies in posterior relation with hilum of the lung?", "options": [{"label": "A", "text": "Vagus Nerve", "correct": true}, {"label": "B", "text": "Phrenic Nerve", "correct": false}, {"label": "C", "text": "Pulmonary Ligament", "correct": false}, {"label": "D", "text": "Pericardiophrenic Arteries", "correct": false}], "correct_answer": "A. Vagus Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture38.jpg"], "explanation": "<p><strong>Ans. A) Vagus Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option B. Phrenic nerve lies anterior to the hilum .</li><li>• Option B.</li><li>• anterior</li><li>• hilum</li><li>• Option C. Pulmonary ligament extends from sides of the oesophagus to the mediastinal surface below the inferior pulmonary vein .</li><li>• Option C.</li><li>• oesophagus</li><li>• mediastinal surface</li><li>• below</li><li>• inferior pulmonary vein</li><li>• Option D. Peri-cardiacophrenic arteries are branches of the internal thoracic artery .</li><li>• Option D.</li><li>• branches</li><li>• internal thoracic artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Vagus runs posterior to the hilum .</li><li>➤ Vagus runs posterior to the hilum .</li><li>➤ posterior</li><li>➤ hilum</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 233</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 233</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient presents with dysphagia and a sensation of food getting stuck in the throat. On examination, the clinician measures the distance from the patient's central incisor to the cricopharyngeal constrictor and finds it to be:", "options": [{"label": "A", "text": "15 cm", "correct": true}, {"label": "B", "text": "22.5 cm", "correct": false}, {"label": "C", "text": "27.5 cm", "correct": false}, {"label": "D", "text": "40 cm", "correct": false}], "correct_answer": "A. 15 cm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-142249.jpg"], "explanation": "<p><strong>Ans. A) 15 cm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . At 22.5 cm, this distance from incisor, esophageal constriction due to arch of aorta is located.</li><li>• Option B</li><li>• incisor, esophageal constriction</li><li>• arch of aorta</li><li>• Option C. At 25.5 cm, this distance from incisor, esophageal constriction due to left bronchus is located.</li><li>• Option C.</li><li>• incisor, esophageal constriction</li><li>• left bronchus</li><li>• Option D. At 40 cm, this distance from incisor, esophageal constriction due to diaphragm is located.</li><li>• Option D.</li><li>• incisor, esophageal constriction</li><li>• diaphragm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male with a history of smoking presents to the clinic with complaints of persistent cough and occasional hemoptysis. A chest X-ray reveals a mass in the lung. Physical examination indicates decreased breath sounds in the lower regions of one lung. Given his history and clinical findings, where is the mass most likely located?", "options": [{"label": "A", "text": "Upper Lobe of the Right Lung", "correct": false}, {"label": "B", "text": "Lower Lobe of the Right Lung", "correct": true}, {"label": "C", "text": "Upper Lobe of the Left Lung", "correct": false}, {"label": "D", "text": "Lower Lobe of the Left Lung", "correct": false}], "correct_answer": "B. Lower Lobe of the Right Lung", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/screenshot-2024-01-01-160846_NaGqIrR.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture40.jpg"], "explanation": "<p><strong>Ans. B) Lower Lobe of the Right Lung.</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The right lung has three lobes ( upper, middle, and lower ). While the upper lobe is a common site for lung masses , especially in smokers , the specific symptom of decreased breath sounds in the lower regions points more towards a mass in the lower lobe .</li><li>• Option A.</li><li>• right lung</li><li>• three lobes</li><li>• upper, middle, and lower</li><li>• upper lobe</li><li>• common site</li><li>• lung masses</li><li>• smokers</li><li>• decreased breath sounds</li><li>• lower regions</li><li>• mass</li><li>• lower lobe</li><li>• Option C. The left lung consists of only two lobes ( upper and lower ). While lung masses can certainly occur in the left lung , the patient's symptoms of decreased breath sounds in the lower regions are less indicative of a mass in the upper lobe .</li><li>• Option C.</li><li>• left lung</li><li>• only two lobes</li><li>• upper and lower</li><li>• left lung</li><li>• decreased breath sounds</li><li>• lower regions</li><li>• less indicative</li><li>• mass</li><li>• upper lobe</li><li>• Option D. While a mass in the lower lobe of the left lung could present with similar symptoms, the right lung's anatomy makes it more susceptible to such conditions, especially in the context of a smoking history .</li><li>• Option D.</li><li>• lower lobe</li><li>• left lung</li><li>• right lung's anatomy</li><li>• more susceptible</li><li>• smoking history</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anatomical differences between the right and left lungs can influence the presentation and likelihood of lung pathologies, with the right lung being more prone to certain conditions due to its larger size and more vertical bronchus.</li><li>➤ Ref : BD Chaurasia’s Human Anatomy, 8 th Edition, Volume 1, Page no- 265, 267</li><li>➤ Ref : BD Chaurasia’s Human Anatomy, 8 th Edition, Volume 1, Page no- 265, 267</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Following are the branches of marked structure, except?", "options": [{"label": "A", "text": "Anterior Intercostal Artery", "correct": false}, {"label": "B", "text": "Posterior Intercostal Artery", "correct": true}, {"label": "C", "text": "Musculophrenic Artery", "correct": false}, {"label": "D", "text": "Superior Epigastric Artery", "correct": false}], "correct_answer": "B. Posterior Intercostal Artery", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-08.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture41.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture42.jpg"], "explanation": "<p><strong>Ans. B) Posterior intercostal artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anterior intercostal arteries are two in number in each space . They are absent in the lower two spaces.</li><li>• Option A.</li><li>• two in number</li><li>• each space</li><li>• absent</li><li>• Option C. Internal thoracic artery terminates into superior epigastric and musculophrenic arteries in 6 th intercostal space .</li><li>• Option C.</li><li>• terminates</li><li>• superior epigastric</li><li>• musculophrenic arteries</li><li>• 6 th intercostal space</li><li>• Option D. 7 th to 9 th spaces anterior intercostal arteries arise from musculophrenic arteries .</li><li>• Option D.</li><li>• anterior intercostal arteries</li><li>• musculophrenic arteries</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Posterior intercostal artery of the upper two spaces arises from the superior intercostal artery and the rest of the spaces arise from descending aorta.</li><li>➤ Posterior intercostal artery of the upper two spaces arises from the superior intercostal artery and the rest of the spaces arise from descending aorta.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 214</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 214</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is not supplied by the marked structure?", "options": [{"label": "A", "text": "Diaphragm", "correct": false}, {"label": "B", "text": "Mediastinal Pleura", "correct": false}, {"label": "C", "text": "Costal Pleura", "correct": true}, {"label": "D", "text": "Medial part of Diaphragmatic Pleura", "correct": false}], "correct_answer": "C. Costal Pleura", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/thorax-20230425t095738z-001-09.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) Costal pleura</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The phrenic nerve is the primary nerve supply for the diaphragm, providing both motor and sensory innervation . \"C3, C4, and C5 keep the diaphragm alive\" is a mnemonic often used to remember the spinal roots of the phrenic nerve .</li><li>• Option A</li><li>• primary nerve supply</li><li>• both motor</li><li>• sensory innervation</li><li>• \"C3, C4, and C5 keep the diaphragm alive\"</li><li>• spinal roots</li><li>• phrenic nerve</li><li>• Option B . The phrenic nerve provides sensory innervation to the mediastinal pleura .</li><li>• Option B</li><li>• sensory innervation</li><li>• mediastinal pleura</li><li>• Option D. The phrenic nerve provides sensory innervation to the central or medial part of the diaphragmatic pleura . However, the peripheral part of the diaphragmatic receives sensory innervation from the lower six intercostal nerves .</li><li>• Option D.</li><li>• sensory innervation</li><li>• central</li><li>• medial part</li><li>• diaphragmatic pleura</li><li>• receives sensory innervation</li><li>• lower six intercostal nerves</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Costal pleura : This part is not primarily supplied by the phrenic nerve for sensation. Instead, it receives sensory innervation from the intercostal nerves .</li><li>➤ Costal pleura : This part is not primarily supplied by the phrenic nerve for sensation. Instead, it receives sensory innervation from the intercostal nerves .</li><li>➤ Costal pleura</li><li>➤ receives sensory innervation</li><li>➤ intercostal nerves</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 225</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 225</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male indulged in a quarrel with his friend who refused to accept his views regarding their business loss. In a moment of temper, he plunged a knife at his friend, striking his anterior neck over the left clavicle. The friend collapsed on the floor, bleeding profusely from the wound. On examination in the emergency department of the hospital, the following conditions were found except?", "options": [{"label": "A", "text": "A cut was seen about 3 cm wide over the left clavicle", "correct": false}, {"label": "B", "text": "Auscultation revealed diminished breath sounds over the left hemithorax", "correct": false}, {"label": "C", "text": "The left upper limb was lying stationary on the table, and active movement of the small muscles of the left hand was absent", "correct": false}, {"label": "D", "text": "The patient was insensitive to pin prick along the lateral side of the left arm, forearm, and hand", "correct": true}], "correct_answer": "D. The patient was insensitive to pin prick along the lateral side of the left arm, forearm, and hand", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The patient was insensitive to pin prick along the lateral side of the left arm, forearm, and hand</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• Option A. A cut is possible over the left clavicle in case of injury by knife over the clavicle .</li><li>• Option A.</li><li>• left clavicle</li><li>• injury</li><li>• knife</li><li>• clavicle</li><li>• Option B. Left pneumothorax with left-sided diminished breath sounds and a deflection of the trachea to the left as a result of injury to the apex of the left lung.</li><li>• Option B.</li><li>• left-sided diminished breath sounds</li><li>• deflection</li><li>• trachea</li><li>• left</li><li>• apex</li><li>• Option C. Loss of movement of the small muscles of the left hand especially those supplied by the ulnar nerve .</li><li>• Option C.</li><li>• Loss of movement</li><li>• small muscles</li><li>• left hand</li><li>• ulnar nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ The knife had struck the lower trunk of brachial plexus which involves C8 &amp; T1 dermatome &amp; ulnar nerve . Loss of skin sensation is due to this C8 and T1 dermatomes damage on the medial side of the left forearm and hand ( ulnar nerve ).</li><li>➤ lower trunk</li><li>➤ brachial plexus</li><li>➤ C8 &amp; T1</li><li>➤ dermatome &amp; ulnar nerve</li><li>➤ Loss of skin sensation</li><li>➤ C8</li><li>➤ T1 dermatomes</li><li>➤ medial side</li><li>➤ left forearm</li><li>➤ hand</li><li>➤ ulnar nerve</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 956</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st edition, pg no. 956</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old man was admitted to the hospital with a diagnosis of left-sided pleurisy with pneumonia. Pleurocentesis was planned. The resident inserted the needle close to the lower border of the eighth rib in the anterior axillary line. The next morning, he was surprised to hear that the patient had complained of altered skin sensation extending from the point where the needle was inserted downward and forward to the midline of the abdominal wall above the umbilicus. The altered skin sensation in this patient after the needle thoracostomy could be explained by which of the following?", "options": [{"label": "A", "text": "The needle had penetrated too deeply and pierced the lung.", "correct": false}, {"label": "B", "text": "The needle was inserted too close to the lower border of the eighth rib and damaged the eighth intercostal nerve", "correct": true}, {"label": "C", "text": "The needle was inserted too low down in the intercostal space", "correct": false}, {"label": "D", "text": "The needle had penetrated the eighth rib", "correct": false}], "correct_answer": "B. The needle was inserted too close to the lower border of the eighth rib and damaged the eighth intercostal nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture43.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture44.jpg"], "explanation": "<p><strong>Ans. B) The needle was inserted too close to the lower border of the eighth rib and damaged the eighth intercostal nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The needle had penetrated too deeply and pierced the lung ; In this condition more complication involving the lung symptoms will be seen.</li><li>• Option A.</li><li>• too deeply</li><li>• pierced the lung</li><li>• more complication</li><li>• lung symptoms</li><li>• Option C. The needle was inserted too low down in the intercostal space; In question given that the resident inserted the needle close to the lower border of the eighth rib in the anterior axillary line. Hence this option is not the answer.</li><li>• Option C.</li><li>• Option D. The needle had penetrated the eighth rib; Again this option could not be the answer as in question already told that the resident inserted the needle close to the lower border of the eighth rib in the anterior axillary line.</li><li>• Option D.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Aspiration of any fluid from the pleural cavity is called Paracentesis Thoracis . It is usually done in the eighth intercostal space in the mid axillary line . The needle is passed through the lower part of the space to avoid injury to the principal neurovascular bundle , i.e. Vein, Artery and Nerve (VAN).</li><li>➤ Aspiration of any fluid from the pleural cavity is called Paracentesis Thoracis . It is usually done in the eighth intercostal space in the mid axillary line .</li><li>➤ Aspiration</li><li>➤ pleural cavity</li><li>➤ Paracentesis Thoracis</li><li>➤ eighth intercostal space</li><li>➤ mid axillary</li><li>➤ line</li><li>➤ The needle is passed through the lower part of the space to avoid injury to the principal neurovascular bundle , i.e. Vein, Artery and Nerve (VAN).</li><li>➤ lower part</li><li>➤ space</li><li>➤ avoid injury</li><li>➤ principal neurovascular bundle</li><li>➤ Vein, Artery and Nerve (VAN).</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 943, BD Chaurasia’s Human Anatomy, 8 th Edition, Volume 1, Page no- 261</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st edition, pg no. 943, BD Chaurasia’s Human Anatomy, 8 th Edition, Volume 1, Page no- 261</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 72-year-old male, chronic smoker, visited his physician with complaints of persistent cough, weight loss and for the past few days, there was blood in his sputum. He also noticed an absence of sweating on the right side of his face. On examination, partial ptosis and constriction of pupil were noted in the right eye. PA view of chest X-ray showed a lesion in the apex of the right lung. All the following structures form posterior relation to the apex of the lung except?", "options": [{"label": "A", "text": "Middle Trunk of Brachial Plexus", "correct": true}, {"label": "B", "text": "Highest Intercostal Vein", "correct": false}, {"label": "C", "text": "Sympathetic Chain", "correct": false}, {"label": "D", "text": "Ventral Ramus of T1", "correct": false}], "correct_answer": "A. Middle Trunk of Brachial Plexus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture45.jpg"], "explanation": "<p><strong>Ans. A) Middle Trunk of Brachial Plexus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Highest Intercostal Vein is located near the apex of the lung . This vein has a close relationship to the apex of the lung .</li><li>• Option B.</li><li>• near</li><li>• apex</li><li>• lung</li><li>• close relationship</li><li>• apex</li><li>• lung</li><li>• Option C. In the thoracic region, Sympathetic Chain is located posterior to the pleura and the lungs . The sympathetic chain is indeed posterior to the apex of the lung and can be implicated in Pancoast tumor , leading to symptoms like Horner’s syndrome (as seen in this patient).</li><li>• Option C.</li><li>• posterior</li><li>• pleura</li><li>• lungs</li><li>• posterior</li><li>• apex</li><li>• lung</li><li>• Pancoast tumor</li><li>• Horner’s syndrome</li><li>• Option D. While Ventral Ramus of T1 contributes to the formation of the lower part of the brachial plexus , it is in a direct posterior relation to the apex of the lung and neck of first rib .</li><li>• Option D.</li><li>• formation</li><li>• lower part</li><li>• brachial plexus</li><li>• direct posterior</li><li>• apex</li><li>• lung</li><li>• neck</li><li>• first rib</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The middle trunk of the brachial plexus is formed from the C7 nerve root , which is positioned lower than the apex of the lung . Therefore, it does not form a posterior relation to the apex of the lung. Structures that intervene between them from medial to lateral are, Sympathetic chain , first posterior intercostal vein , superior intercostal artery , ventral ramus of T1</li><li>➤ The middle trunk of the brachial plexus is formed from the C7 nerve root , which is positioned lower than the apex of the lung . Therefore, it does not form a posterior relation to the apex of the lung.</li><li>➤ C7 nerve root</li><li>➤ positioned</li><li>➤ lower</li><li>➤ apex</li><li>➤ lung</li><li>➤ Structures that intervene between them from medial to lateral are, Sympathetic chain , first posterior intercostal vein , superior intercostal artery , ventral ramus of T1</li><li>➤ intervene</li><li>➤ medial to lateral</li><li>➤ Sympathetic chain</li><li>➤ first posterior intercostal vein</li><li>➤ superior intercostal artery</li><li>➤ ventral ramus of T1</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 956</li><li>➤ Ref</li><li>➤ : Gray’s Anatomy 41 st edition, pg no. 956</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man suddenly experiences a severe pain in the left side of his chest, is breathless, and goes into a state of shock. He was a known case of emphysema lung. On examination of this case, the following findings will be present except?", "options": [{"label": "A", "text": "The Trachea is displaced to the Right in the Supra-sternal Notch", "correct": false}, {"label": "B", "text": "The Right Lung is collapsed", "correct": true}, {"label": "C", "text": "The Elastic Recoil of the Lung Tissue caused the Lung to Collapse", "correct": false}, {"label": "D", "text": "The Apex Beat of the Heart can be felt in the Fifth Left Intercostal Space just Lateral to the Sternum", "correct": false}], "correct_answer": "B. The Right Lung is collapsed", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) The Right Lung is collapsed</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Tracheal deviation can occur in cases of pneumothorax . If the left lung collapses , the pressure changes can cause the trachea to shift towards the opposite side , which would be the right in this case. This deviation is a sign of tension pneumothorax</li><li>• Option A.</li><li>• pneumothorax</li><li>• left lung collapses</li><li>• pressure changes</li><li>• trachea</li><li>• towards</li><li>• opposite side</li><li>• right</li><li>• deviation</li><li>• sign</li><li>• tension pneumothorax</li><li>• Option C. In emphysema , the elastic recoil of the lung tissue is compromised . This makes the lungs more susceptible to collapse . A sudden increase in pleural pressure or a rupture in the lung tissue can lead to pneumothorax , where the lung collapses due to its natural tendency to recoil .</li><li>• Option C.</li><li>• emphysema</li><li>• elastic recoil</li><li>• compromised</li><li>• lungs</li><li>• more susceptible</li><li>• collapse</li><li>• sudden increase</li><li>• pleural pressure</li><li>• rupture</li><li>• lung tissue</li><li>• pneumothorax</li><li>• lung collapses</li><li>• natural tendency</li><li>• recoil</li><li>• Option D. The normal position of the apex beat of the heart is in the fifth left intercostal space , just medial to the midclavicular line . However, in cases of pneumothorax , especially if severe, there might be a shift in the mediastinal structures including the heart , which could slightly alter the position of the apex beat .</li><li>• Option D.</li><li>• fifth left intercostal space</li><li>• medial</li><li>• midclavicular line</li><li>• pneumothorax</li><li>• shift</li><li>• mediastinal structures</li><li>• heart</li><li>• slightly</li><li>• position</li><li>• apex beat</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Lung collapse , medically termed pneumothorax , refers to the condition where air enters the space between the lung and chest wall , leading to the collapse of part or all of a lung . This can result from trauma , certain medical procedures, or spontaneously, particularly in people with underlying lung diseases . Symptoms typically include sudden chest pain and shortness of breath . Diagnosis is often confirmed through a chest X-ray or CT scan . Treatment varies based on severity and may involve simple observation , needle aspiration , or chest tube insertion to re-expand the lung . Quick medical intervention is crucial to prevent complications and restore normal lung function .</li><li>• Lung collapse , medically termed pneumothorax , refers to the condition where air enters the space between the lung and chest wall , leading to the collapse of part or all of a lung .</li><li>• Lung collapse</li><li>• pneumothorax</li><li>• air enters</li><li>• space</li><li>• lung</li><li>• chest wall</li><li>• collapse of part</li><li>• all of a lung</li><li>• This can result from trauma , certain medical procedures, or spontaneously, particularly in people with underlying lung diseases .</li><li>• trauma</li><li>• underlying lung diseases</li><li>• Symptoms typically include sudden chest pain and shortness of breath . Diagnosis is often confirmed through a chest X-ray or CT scan .</li><li>• sudden chest pain</li><li>• shortness of breath</li><li>• chest X-ray</li><li>• CT scan</li><li>• Treatment varies based on severity and may involve simple observation , needle aspiration , or chest tube insertion to re-expand the lung . Quick medical intervention is crucial to prevent complications and restore normal lung function .</li><li>• severity</li><li>• simple observation</li><li>• needle aspiration</li><li>• chest tube insertion</li><li>• re-expand</li><li>• lung</li><li>• prevent complications</li><li>• restore normal lung function</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 956</li><li>• Ref</li><li>• : Gray’s Anatomy 41 st edition, pg no. 956</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "From which vessel do the upper two posterior intercostal arteries originate?", "options": [{"label": "A", "text": "Aorta", "correct": false}, {"label": "B", "text": "Superior Intercostal Artery", "correct": true}, {"label": "C", "text": "Internal Mammary Artery", "correct": false}, {"label": "D", "text": "Bronchial Artery", "correct": false}], "correct_answer": "B. Superior Intercostal Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture41_VS2zJvJ.jpg"], "explanation": "<p><strong>Ans. B) Superior Intercostal Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Aorta gives 3 rd to 11 th posterior ICA not upper 2.</li><li>• Option A.</li><li>• 3 rd to 11 th posterior ICA</li><li>• Option C. Internal mammary artery is branch of subclavian artery . It has no relation with Posterior ICA.</li><li>• Option C.</li><li>• Internal mammary artery</li><li>• subclavian artery</li><li>• Option D. There is usually one bronchial artery on the right , which arises from the third posterior intercostal artery or from the upper left bronchial artery . The left bronchial arteries usually number two and arise from the descending thoracic aorta inferior to the origin of the third posterior intercostal artery .</li><li>• Option D.</li><li>• one bronchial artery</li><li>• right</li><li>• third posterior intercostal artery</li><li>• upper left bronchial artery</li><li>• left bronchial arteries</li><li>• number two</li><li>• descending thoracic aorta inferior</li><li>• origin</li><li>• third posterior intercostal artery</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In the upper two spaces, posterior intercostal arteries arise from superior intercostal arteries .</li><li>➤ posterior intercostal arteries</li><li>➤ superior intercostal arteries</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 215</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 215</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old woman presents to the clinic with numbness and a tingling sensation in the medial aspect of her upper arm and axilla. She reports no history of trauma or surgery in the area. Physical examination reveals a loss of sensation in the corresponding region without any motor deficits. This sensory loss pattern is most likely associated with a branch of which of the following nerves?", "options": [{"label": "A", "text": "First Intercostal Nerve", "correct": false}, {"label": "B", "text": "Second Intercostal Nerve", "correct": true}, {"label": "C", "text": "Third Intercostal Nerve", "correct": false}, {"label": "D", "text": "Upper Trunk of Brachial Plexus", "correct": false}], "correct_answer": "B. Second Intercostal Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Second Intercostal Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. First intercostal nerve- It gives sensory innervation along medial border of forearm .</li><li>• Option A.</li><li>• sensory innervation</li><li>• medial border</li><li>• forearm</li><li>• Option C. Third intercostal nerve- It gives sensory innervation above the nipple</li><li>• Option C.</li><li>• sensory innervation</li><li>• nipple</li><li>• Option D. Upper trunk of brachial plexus- It is formed by C5 &amp; C6 Roots</li><li>• Option D.</li><li>• C5</li><li>• C6 Roots</li><li>• Above all are not related to sensory nerve supply along medial aspect of upper arm and axilla as mentioned in question hence these are not the answer.</li><li>• not related</li><li>• sensory nerve supply</li><li>• medial aspect</li><li>• upper arm</li><li>• axilla</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Intercostobrachial nerve is the undivided lateral cutaneous branch of ventral ramus of T2 .</li><li>• Intercostobrachial nerve</li><li>• undivided lateral cutaneous branch</li><li>• ventral ramus of T2</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 211</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following is a synchondrosis joint?", "options": [{"label": "A", "text": "A, D", "correct": false}, {"label": "B", "text": "B, C", "correct": false}, {"label": "C", "text": "C, D", "correct": true}, {"label": "D", "text": "D, B", "correct": false}], "correct_answer": "C. C, D", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/26/untitled-20.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture46.jpg"], "explanation": "<p><strong>Ans. C) C, D</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Acromioclavicular joint is a plane synovial joint .</li><li>• Option A.</li><li>• Acromioclavicular joint</li><li>• plane synovial joint</li><li>• Option B. Manubriosternal joint , Xiphisternal joint is secondary cartilaginous/symphyseal joint .</li><li>• Option B.</li><li>• Manubriosternal joint</li><li>• Xiphisternal joint</li><li>• secondary cartilaginous/symphyseal joint</li><li>• Option D. 2 nd to 6 th chondrosternal joints are plane synovial joints .</li><li>• Option D.</li><li>• 2 nd to 6 th</li><li>• chondrosternal joints</li><li>• plane synovial joints</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ First chondrosternal joint, D- Costochondral joint are primary cartilaginous joints/synchondrosis</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 197</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 197</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 46-year-old man suffered from burning pain on the right side of his chest. The physician noted that there were several watery blebs on the skin in the painful area. On examination, the patient indicated that the pain passed forward over the right seventh intercostal space from the posterior axillary line forward as far as the midline over the sternum. Which of the following statements are correct?", "options": [{"label": "A", "text": "Patient was Stung by some Insect", "correct": false}, {"label": "B", "text": "Pain may precede or follow Skin Eruptions", "correct": false}, {"label": "C", "text": "There is no associated Muscle Weakness", "correct": false}, {"label": "D", "text": "It is due to Herpes Zoster infection of Spinal Ganglia", "correct": true}], "correct_answer": "D. It is due to Herpes Zoster infection of Spinal Ganglia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture47.jpg"], "explanation": "<p><strong>Ans. D) It is due to Herpes Zoster infection of Spinal Ganglia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Patient was stung by some insect- in this case dermatome involvement not seen . Hence it is not the answer.</li><li>• Option A.</li><li>• not seen</li><li>• Option B. Pain may precede or follow skin eruptions- it is not seen in case of herpes infection usually. Hence it is not the answer.</li><li>• Option B.</li><li>• not seen</li><li>• Option C. There is no associated muscle weakness- There is no relation of muscle weakness with herpes infection. Hence it is also not the answer.</li><li>• Option C.</li><li>• no relation</li><li>• Educational objective :</li><li>• Educational objective</li><li>• “ Painful vesicular eruption along the dermatome ” is classical presentation of herpes infection .</li><li>• Painful vesicular eruption along the dermatome</li><li>• herpes infection</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 944</li><li>• Ref : Gray’s Anatomy 41 st edition, pg no. 944</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 52-year-old male presents to the emergency department with crushing substernal chest pain and diaphoresis. ECG findings reveal ST-segment elevation in the anteroseptal leads (V1-V4). Which of the following coronary arteries is most likely occluded in this patient?", "options": [{"label": "A", "text": "Left Anterior Descending Artery (LAD)", "correct": true}, {"label": "B", "text": "Left Circumflex Artery (LCx)", "correct": false}, {"label": "C", "text": "Right Coronary Artery (RCA)", "correct": false}, {"label": "D", "text": "Posterior Descending Artery (PDA)", "correct": false}], "correct_answer": "A. Left Anterior Descending Artery (LAD)", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture48.jpg"], "explanation": "<p><strong>Ans. A) Left Anterior Descending Artery (LAD)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Left Circumflex artery (LCx) , primarily supplies the lateral and posterior wall of the left ventricle and may cause lateral MI when occluded .</li><li>• Option B.</li><li>• Left Circumflex artery (LCx)</li><li>• lateral</li><li>• posterior wall</li><li>• left ventricle</li><li>• lateral MI</li><li>• occluded</li><li>• Option C. The Right Coronary Artery (RCA) , typically supplies the right atrium , right ventricle , and inferior wall of the left ventricle . RCA occlusion can lead to an inferior MI or posterior MI , but it is less likely to cause anteroseptal ST-segment elevation.</li><li>• Option C.</li><li>• Right Coronary Artery (RCA)</li><li>• supplies</li><li>• right atrium</li><li>• right ventricle</li><li>• inferior wall</li><li>• left ventricle</li><li>• lead</li><li>• inferior MI</li><li>• posterior MI</li><li>• Option D. The Posterior Descending Artery (PDA) is a branch of the RCA and primarily supplies the posterior septum and inferior wall . It is not the primary artery involved in anteroseptal MI.</li><li>• Option D.</li><li>• Posterior Descending Artery (PDA)</li><li>• branch</li><li>• RCA</li><li>• supplies</li><li>• posterior septum</li><li>• inferior wall</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Left Anterior Descending Artery (LADA), often colloquially referred to as the \" widowmaker ,\" is the most common artery involved in myocardial infarctions (MI). LADA supplies a large portion of the left ventricle , the heart's main pumping chamber . Occlusion of this artery, typically due to atherosclerotic plaque rupture and thrombus formation , can lead to a significant myocardial infarction with extensive damage to the left ventricular myocardium .</li><li>➤ Left Anterior Descending Artery (LADA), often colloquially referred to as the \" widowmaker ,\" is the most common artery involved in myocardial infarctions (MI).</li><li>➤ widowmaker</li><li>➤ most common artery</li><li>➤ myocardial infarctions</li><li>➤ LADA supplies a large portion of the left ventricle , the heart's main pumping chamber . Occlusion of this artery, typically due to atherosclerotic plaque rupture and thrombus formation , can lead to a significant myocardial infarction with extensive damage to the left ventricular myocardium .</li><li>➤ large portion</li><li>➤ left ventricle</li><li>➤ pumping chamber</li><li>➤ due</li><li>➤ atherosclerotic plaque rupture</li><li>➤ thrombus formation</li><li>➤ significant myocardial infarction</li><li>➤ extensive damage</li><li>➤ left ventricular myocardium</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 265</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 55-year-old male presents to the emergency department with sudden onset severe chest pain radiating to the back. His blood pressure is 170/95 mmHg in the right arm and 145/90 mmHg in the left arm. He has a history of hypertension and smoking. A CT angiogram of the chest is ordered. Which of the following branches of the aorta is most likely to be involved in the pathology suggested by this clinical scenario?", "options": [{"label": "A", "text": "Brachiocephalic Trunk", "correct": false}, {"label": "B", "text": "Left common Carotid Artery", "correct": false}, {"label": "C", "text": "Left subclavian Artery", "correct": false}, {"label": "D", "text": "Descending Thoracic Aorta", "correct": true}], "correct_answer": "D. Descending Thoracic Aorta", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture49.jpg"], "explanation": "<p><strong>Ans. D) Descending Thoracic Aorta</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Brachiocephalic trunk involvement is less likely, as dissections involving this branch typically present with symptoms related to cerebral or upper extremity ischemia, which are not described in this scenario.</li><li>• Option A.</li><li>• Option B. The Left common carotid artery, when involved, may present with symptoms of cerebral ischemia, which are not mentioned in this patient's presentation.</li><li>• Option B.</li><li>• Option C. Left subclavian artery involvement might present with symptoms related to ischemia of the left upper extremity , which is not indicated in this scenario.</li><li>• Option C.</li><li>• Left subclavian artery</li><li>• ischemia</li><li>• left upper extremity</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Descending thoracic aort involvement is most consistent with the patient's presentation , particularly the radiating back pain and differential blood pressure readings , which can occur due to involvement of the intercostal arteries and differential involvement of the aortic branches . Recognize that aortic dissection often involves the descending thoracic aorta , especially in patients presenting with sudden onset severe chest pain radiating to the back and differential blood pressure between the arms .</li><li>➤ Descending thoracic aort involvement is most consistent with the patient's presentation , particularly the radiating back pain and differential blood pressure readings , which can occur due to involvement of the intercostal arteries and differential involvement of the aortic branches .</li><li>➤ Descending thoracic aort</li><li>➤ most consistent</li><li>➤ patient's presentation</li><li>➤ radiating back pain</li><li>➤ differential blood pressure</li><li>➤ readings</li><li>➤ involvement</li><li>➤ intercostal arteries</li><li>➤ differential involvement</li><li>➤ aortic branches</li><li>➤ Recognize that aortic dissection often involves the descending thoracic aorta , especially in patients presenting with sudden onset severe chest pain radiating to the back and differential blood pressure between the arms .</li><li>➤ aortic dissection</li><li>➤ involves</li><li>➤ descending thoracic aorta</li><li>➤ sudden onset severe chest pain</li><li>➤ back</li><li>➤ differential blood pressure</li><li>➤ arms</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 285.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 285.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man undergoes a bronchoscopy for evaluation of a persistent cough. The bronchoscope is advanced to the level of the tracheal bifurcation. At this anatomical landmark, the bronchoscope shows two openings. Which of the following structures is most likely to be visualized first as the bronchoscope is advanced past the tracheal bifurcation?", "options": [{"label": "A", "text": "Left Main Bronchus", "correct": false}, {"label": "B", "text": "Right Main Bronchus", "correct": true}, {"label": "C", "text": "Esophagus", "correct": false}, {"label": "D", "text": "Carina", "correct": false}], "correct_answer": "B. Right Main Bronchus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture50.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture51.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture52.jpg"], "explanation": "<p><strong>Ans. B) Right Main Bronchus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Left main bronchus is narrower, longer , and more horizontal compared to the right , making it less likely to be entered first during bronchoscopy .</li><li>• Option A.</li><li>• narrower, longer</li><li>• more horizontal</li><li>• right</li><li>• entered first</li><li>• bronchoscopy</li><li>• Option C. The Esophagus is a posterior structure and would not be visualized in a bronchoscopy , which is a procedure for examining the airways.</li><li>• Option C.</li><li>• posterior structure</li><li>• bronchoscopy</li><li>• Option D. The Carina is the ridge at the tracheal bifurcation but is not a passage into which the bronchoscope would advance; it is the landmark just before the bifurcation into the main bronchi .</li><li>• Option D.</li><li>• ridge</li><li>• tracheal bifurcation</li><li>• landmark</li><li>• before</li><li>• bifurcation</li><li>• main bronchi</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Right main bronchus's anatomy makes it the most likely to be visualized first when advancing the bronchoscope past the tracheal bifurcation . Understand that the right main bronchus , due to its anatomical configuration ( wider, shorter, and more vertical ), is more likely to be entered first in procedures such as bronchoscopy when advancing past the tracheal bifurcation.</li><li>➤ The Right main bronchus's anatomy makes it the most likely to be visualized first when advancing the bronchoscope past the tracheal bifurcation .</li><li>➤ bronchus's anatomy</li><li>➤ visualized first</li><li>➤ advancing</li><li>➤ bronchoscope past</li><li>➤ tracheal bifurcation</li><li>➤ Understand that the right main bronchus , due to its anatomical configuration ( wider, shorter, and more vertical ), is more likely to be entered first in procedures such as bronchoscopy when advancing past the tracheal bifurcation.</li><li>➤ right main bronchus</li><li>➤ anatomical configuration</li><li>➤ wider, shorter,</li><li>➤ more vertical</li><li>➤ entered first</li><li>➤ procedures</li><li>➤ bronchoscopy</li><li>➤ past the tracheal bifurcation.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old woman is brought to the emergency department after being involved in a motor vehicle accident. She is hemodynamically stable but complains of chest pain. A chest x-ray is ordered to evaluate for potential rib fractures. The physician palpates a bony landmark to identify the second rib before counting the ribs on the x-ray. Which of the following landmarks corresponds to the attachment of the second rib?", "options": [{"label": "A", "text": "Xiphoid Process", "correct": false}, {"label": "B", "text": "Sternal Angle of Louis", "correct": true}, {"label": "C", "text": "Costal Margin", "correct": false}, {"label": "D", "text": "Inferior Border of the Scapula", "correct": false}], "correct_answer": "B. Sternal Angle of Louis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture53.jpg"], "explanation": "<p><strong>Ans. B) Sternal Angle of Louis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Xiphoid process is the inferior , cartilaginous portion of the sternum and does not correspond to the attachment of the second rib.</li><li>• Option A.</li><li>• inferior</li><li>• cartilaginous portion</li><li>• sternum</li><li>• Option C. The Costal margin is the lower border of the rib cage formed by the costal cartilages of the seventh to tenth ribs and is not related to the second rib.</li><li>• Option C.</li><li>• lower border</li><li>• rib</li><li>• cage</li><li>• costal cartilages</li><li>• seventh to tenth ribs</li><li>• Option D. The Inferior border of the scapula , when the arms are at the sides , is typically at the level of the seventh or eighth rib and not the second rib.</li><li>• Option D.</li><li>• Inferior border</li><li>• scapula</li><li>• arms</li><li>• sides</li><li>• level</li><li>• seventh</li><li>• eighth rib</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Sternal angle of Louis corresponds to the level of the second rib's attachment to the sternum and is the correct answer . Identify the sternal angle of Louis as the anatomical landmark that corresponds to the attachment of the second rib to the sternum , which is useful for orientation during chest examinations and interpreting chest x-rays .</li><li>➤ The Sternal angle of Louis corresponds to the level of the second rib's attachment to the sternum and is the correct answer .</li><li>➤ Sternal angle of Louis</li><li>➤ level</li><li>➤ second rib's attachment</li><li>➤ sternum</li><li>➤ correct answer</li><li>➤ Identify the sternal angle of Louis as the anatomical landmark that corresponds to the attachment of the second rib to the sternum , which is useful for orientation during chest examinations and interpreting chest x-rays .</li><li>➤ sternal angle of Louis</li><li>➤ anatomical landmark</li><li>➤ attachment</li><li>➤ second rib</li><li>➤ sternum</li><li>➤ orientation</li><li>➤ chest examinations</li><li>➤ interpreting chest x-rays</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 293.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "During a clinical anatomy class, medical students are reviewing the attachments of the ribs to the sternum. One student asks about the anatomical landmarks related to the first rib. Which of the following structures is most closely associated with the attachment of the first rib?", "options": [{"label": "A", "text": "Manubrium of the Sternum", "correct": true}, {"label": "B", "text": "Body of the Sternum", "correct": false}, {"label": "C", "text": "Xiphoid Process", "correct": false}, {"label": "D", "text": "Sternal Angle of Louis", "correct": false}], "correct_answer": "A. Manubrium of the Sternum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture54.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture55.jpg"], "explanation": "<p><strong>Ans. A) Manubrium of the Sternum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Body of the sternum is the longest part of the sternum and articulates with the ribs from the second to the seventh rib , but not the first rib.</li><li>• Option B.</li><li>• Body</li><li>• sternum</li><li>• longest part</li><li>• sternum</li><li>• articulates</li><li>• ribs</li><li>• second</li><li>• seventh rib</li><li>• Option C. The Xiphoid process is the smallest and most inferior part of the sternum and does not articulate directly with any ribs.</li><li>• Option C.</li><li>• Xiphoid process</li><li>• smallest</li><li>• most inferior part</li><li>• sternum</li><li>• Option D. The Sternal angle of Louis is the joint formed by the articulation of the manubrium and the body of the sternum and corresponds to the second rib's attachment , not the first.</li><li>• Option D.</li><li>• Sternal angle of Louis</li><li>• joint</li><li>• articulation</li><li>• manubrium</li><li>• body</li><li>• sternum</li><li>• second rib's attachment</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Manubrium of the sternum is the correct answer. It is the upper part of the sternum and articulates with the first rib and the clavicle . Recognize that the first rib attaches to the manubrium of the sternum , distinguishing it from the other ribs which attach to the body of the sternum or not at all (in the case of the xiphoid process ).</li><li>➤ The Manubrium of the sternum is the correct answer. It is the upper part of the sternum and articulates with the first rib and the clavicle .</li><li>➤ Manubrium</li><li>➤ sternum</li><li>➤ upper part</li><li>➤ sternum</li><li>➤ articulates</li><li>➤ first rib</li><li>➤ clavicle</li><li>➤ Recognize that the first rib attaches to the manubrium of the sternum , distinguishing it from the other ribs which attach to the body of the sternum or not at all (in the case of the xiphoid process ).</li><li>➤ first rib</li><li>➤ manubrium</li><li>➤ sternum</li><li>➤ attach</li><li>➤ body</li><li>➤ sternum</li><li>➤ case</li><li>➤ xiphoid process</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 202.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 202.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male patient presents to the clinic with complaints of recurrent episodes of tingling and numbness in his right arm. The physician suspects thoracic outlet syndrome and decides to evaluate the anatomical structures in the region. Which of the following structures is most closely associated with the attachment of the first rib?", "options": [{"label": "A", "text": "Transverse Process of the Seventh Cervical Vertebra", "correct": true}, {"label": "B", "text": "Body of the Sternum", "correct": false}, {"label": "C", "text": "Manubrium of the Sternum", "correct": false}, {"label": "D", "text": "Xiphoid Process", "correct": false}], "correct_answer": "A. Transverse Process of the Seventh Cervical Vertebra", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture56.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture57.jpg"], "explanation": "<p><strong>Ans. A) Transverse process of the seventh cervical vertebra</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The Body of the sternum does not articulate with the first rib. It articulates with the second to the seventh ribs.</li><li>• Option B.</li><li>• Option C. The Manubrium of the sternum is the anterior attachment of the first rib, making it a close but not the most accurate choice for this question.</li><li>• Option C.</li><li>• Option D. The Xiphoid process is the most inferior portion of the sternum and does not articulate with the ribs.</li><li>• Option D.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The Transverse process of the seventh cervical vertebra is the correct answer as it is the posterior attachment site of the first rib .</li><li>➤ Transverse process</li><li>➤ seventh cervical vertebra</li><li>➤ correct answer</li><li>➤ posterior attachment site</li><li>➤ first rib</li><li>➤ Recognize that the first rib attaches posteriorly to the transverse process of the seventh cervical vertebra and anteriorly to the manubrium of the sternum , which is relevant in understanding the anatomical basis of thoracic outlet syndrome .</li><li>➤ Recognize that the first rib attaches posteriorly to the transverse process of the seventh cervical vertebra and anteriorly to the manubrium of the sternum , which is relevant in understanding the anatomical basis of thoracic outlet syndrome .</li><li>➤ first rib</li><li>➤ posteriorly</li><li>➤ transverse process</li><li>➤ seventh cervical vertebra</li><li>➤ anteriorly</li><li>➤ manubrium</li><li>➤ sternum</li><li>➤ relevant</li><li>➤ anatomical basis</li><li>➤ thoracic outlet syndrome</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 202.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 202.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A medical student is studying the anatomy of the thoracic cage and learns about the classification of ribs into true, false, and floating ribs. Which of the following best describes the true ribs?", "options": [{"label": "A", "text": "Ribs 1-7, Directly Articulating with the Sternum via their own Costal Cartilages", "correct": true}, {"label": "B", "text": "Ribs 8-10, connecting to the Sternum via the Costal Cartilage of the Rib Above", "correct": false}, {"label": "C", "text": "Ribs 11-12, not Articulating with the Aternum at all", "correct": false}, {"label": "D", "text": "Ribs 5-9, Articulating indirectly with the Sternum via a Common Costal Cartilage", "correct": false}], "correct_answer": "A. Ribs 1-7, Directly Articulating with the Sternum via their own Costal Cartilages", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture58.jpg"], "explanation": "<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Ribs 8-10 are known as false ribs . They do not directly connect to the sternum but are connected to the costal cartilage of the rib above and ultimately to the sternum .</li><li>• Option B.</li><li>• Ribs 8-10</li><li>• false ribs</li><li>• costal cartilage</li><li>• rib above</li><li>• ultimately to the sternum</li><li>• Option C. Ribs 11-12 are referred to as floating ribs because they do not have any anterior attachment to the sternum or to the costal cartilages of the ribs above.</li><li>• Option C.</li><li>• Ribs 11-12</li><li>• floating ribs</li><li>• do not</li><li>• anterior attachment</li><li>• sternum</li><li>• costal cartilages</li><li>• Option D. Ribs 5-9 do not fit the description of any specific category of ribs. The first seven are true ribs , the next three are false ribs , and the last two are floating ribs .</li><li>• Option D.</li><li>• first seven</li><li>• true ribs</li><li>• next three</li><li>• false ribs</li><li>• last two</li><li>• floating ribs</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Ribs 1-7 are the true ribs and they directly articulate with the sternum via their own costal cartilages , making this statement correct. Identify that true ribs ( ribs 1-7 ) directly articulate with the sternum via their own costal cartilages , distinguishing them from false ribs (ribs 8-10) and floating ribs (ribs 11-12 ).</li><li>➤ Ribs 1-7 are the true ribs and they directly articulate with the sternum via their own costal cartilages , making this statement correct.</li><li>➤ Ribs 1-7</li><li>➤ true ribs</li><li>➤ directly articulate</li><li>➤ sternum</li><li>➤ costal cartilages</li><li>➤ Identify that true ribs ( ribs 1-7 ) directly articulate with the sternum via their own costal cartilages , distinguishing them from false ribs (ribs 8-10) and floating ribs (ribs 11-12 ).</li><li>➤ true ribs</li><li>➤ ribs 1-7</li><li>➤ directly articulate</li><li>➤ sternum</li><li>➤ own costal cartilages</li><li>➤ false ribs</li><li>➤ (ribs 8-10)</li><li>➤ floating ribs (ribs 11-12</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 200.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 200.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A third-year medical student is reviewing cardiac anatomy in preparation for her cardiology rotation. She focuses on the atrial anatomy pertinent to electrophysiological studies. Which of the following best describes the boundaries of Koch's triangle, an important anatomical landmark for atrioventricular (AV) node location?", "options": [{"label": "A", "text": "The septal leaflet of the tricuspid valve, the opening of the coronary sinus, and the tendon of Todaro", "correct": true}, {"label": "B", "text": "The anterior and posterior leaflets of the mitral valve and the opening of the coronary sinus", "correct": false}, {"label": "C", "text": "The anterior and posterior leaflets of the tricuspid valve and the opening of the inferior vena cava", "correct": false}, {"label": "D", "text": "The septal and posterior leaflets of the tricuspid valve and the opening of the superior vena cava", "correct": false}], "correct_answer": "A. The septal leaflet of the tricuspid valve, the opening of the coronary sinus, and the tendon of Todaro", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture59.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture60.jpg"], "explanation": "<p><strong>Ans. A) The septal leaflet of the tricuspid valve, the opening of the coronary sinus, and the tendon of Todaro</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. The anterior and posterior leaflets of the mitral valve and the opening of the coronary sinus do not define Koch's triangle but are key structures in the left heart.</li><li>• Option B.</li><li>• do not</li><li>• Option C. The anterior and posterior leaflets of the tricuspid valve and the opening of the inferior vena cava do not correctly describe the boundaries of Koch's triangle.</li><li>• Option C.</li><li>• do not</li><li>• Option D. The septal and posterior leaflets of the tricuspid valve and the opening of the superior vena cava are not the correct anatomical landmarks that define Koch's triangle.</li><li>• Option D.</li><li>• not</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The correct boundaries of Koch's triangle are the septal leaflet of the tricuspid valve , the opening of the coronary sinus , and the tendon of Todaro (a fibrous band extending from the Eustachian valve to the central fibrous body ).</li><li>➤ septal leaflet</li><li>➤ tricuspid valve</li><li>➤ opening</li><li>➤ coronary sinus</li><li>➤ tendon</li><li>➤ Todaro</li><li>➤ fibrous band</li><li>➤ Eustachian valve</li><li>➤ central fibrous body</li><li>➤ This area is crucial for understanding the anatomy related to AV node ablation procedures . Identify Koch's triangle in the right atrium , which is bounded by the septal leaflet of the tricuspid valve , the opening of the coronary sinus , and the tendon of Todaro , as a crucial landmark for locating the atrio-ventricular node .</li><li>➤ This area is crucial for understanding the anatomy related to AV node ablation procedures .</li><li>➤ crucial</li><li>➤ understanding</li><li>➤ anatomy</li><li>➤ AV node ablation procedures</li><li>➤ Identify Koch's triangle in the right atrium , which is bounded by the septal leaflet of the tricuspid valve , the opening of the coronary sinus , and the tendon of Todaro , as a crucial landmark for locating the atrio-ventricular node .</li><li>➤ Koch's triangle</li><li>➤ right atrium</li><li>➤ bounded</li><li>➤ septal leaflet</li><li>➤ tricuspid valve</li><li>➤ coronary sinus</li><li>➤ tendon of Todaro</li><li>➤ crucial landmark</li><li>➤ locating</li><li>➤ atrio-ventricular node</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 266.</li><li>➤ Ref</li><li>➤ : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 266.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old woman presents to the clinic with shortness of breath and a dry cough. A chest X-ray reveals a small left apical pneumothorax. The physician explains to the medical student that the pneumothorax has not extended into the neck due to the presence of a specific anatomical structure. Which of the following structures is most likely responsible for limiting the spread of the pneumothorax?", "options": [{"label": "A", "text": "Diaphragmatic Pleura", "correct": false}, {"label": "B", "text": "Parietal Pleura", "correct": false}, {"label": "C", "text": "Sibson's Fascia", "correct": true}, {"label": "D", "text": "Mediastinal Pleura", "correct": false}], "correct_answer": "C. Sibson's Fascia", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture61.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/01/01/picture62.jpg"], "explanation": "<p><strong>Ans. C) Sibson's Fascia</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The Diaphragmatic pleura cover the diaphragm and is not involved in limiting the superior extent of a pneumothorax.</li><li>• Option A.</li><li>• Diaphragmatic pleura</li><li>• diaphragm</li><li>• Option B. The Parietal pleura lines the thoracic cavity but does not specifically limit the spread of a pneumothorax to the neck.</li><li>• Option B.</li><li>• Parietal pleura</li><li>• thoracic cavity</li><li>• Option D. The Mediastinal pleura covers the mediastinum and is not directly involved in limiting the superior spread of a pneumothorax.</li><li>• Option D.</li><li>• Mediastinal pleura</li><li>• mediastinum</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sibson's fascia forms a barrier at the apex of the lung , which can prevent a pneumothorax from extending into the neck area . Recognize Sibson's fascia ( suprapleural membrane ) as the anatomical structure that limits the superior extent of a pneumothorax , preventing its spread into the neck .</li><li>➤ Sibson's fascia forms a barrier at the apex of the lung , which can prevent a pneumothorax from extending into the neck area .</li><li>➤ Sibson's fascia</li><li>➤ barrier</li><li>➤ apex</li><li>➤ lung</li><li>➤ prevent</li><li>➤ pneumothorax</li><li>➤ extending</li><li>➤ neck area</li><li>➤ Recognize Sibson's fascia ( suprapleural membrane ) as the anatomical structure that limits the superior extent of a pneumothorax , preventing its spread into the neck .</li><li>➤ Recognize Sibson's fascia</li><li>➤ suprapleural membrane</li><li>➤ anatomical structure</li><li>➤ limits</li><li>➤ superior extent</li><li>➤ pneumothorax</li><li>➤ spread</li><li>➤ neck</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 189.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 189.</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 60 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 32-year-old woman presents to the emergency department after falling onto her outstretched hand. She complains of severe pain in her elbow. Physical examination reveals swelling and tenderness over the distal humerus. An X-ray confirms a supracondylar fracture. Upon further examination, the patient is unable to flex her thumb. Which nerve is most likely involved in this patient's presentation?", "options": [{"label": "A", "text": "Deep Branch of Ulnar Nerve", "correct": false}, {"label": "B", "text": "Posterior Interosseous Nerve", "correct": false}, {"label": "C", "text": "Anterior Interosseous Nerve", "correct": true}, {"label": "D", "text": "Superficial Branch of Ulnar Nerve", "correct": false}], "correct_answer": "C. Anterior Interosseous Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture3.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture4_qDLhjsN.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/12/whatsapp-image-2023-12-12-at-121914-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture5_MHmhzsS.jpg"], "explanation": "<p><strong>Ans. C) Anterior Interosseous Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Deep Branch of Ulnar Nerve :</li><li>• Option A. Deep Branch of Ulnar Nerve</li><li>• The deep branch of the ulnar nerve primarily innervates the intrinsic muscles of the hand ( excluding the thenar muscles and lateral two lumbricals ). It is involved in the adduction and abduction of fingers, and some aspects of thumb movements , but not primarily responsible for thumb flexion. Injuries to the ulnar nerve typically result in symptoms such as a \"claw hand\" deformity and sensory loss in the medial side of the hand, not specifically an inability to flex the thumb.</li><li>• The deep branch of the ulnar nerve primarily innervates the intrinsic muscles of the hand ( excluding the thenar muscles and lateral two lumbricals ).</li><li>• innervates</li><li>• intrinsic muscles</li><li>• hand</li><li>• excluding</li><li>• thenar muscles</li><li>• lateral two lumbricals</li><li>• It is involved in the adduction and abduction of fingers, and some aspects of thumb movements , but not primarily responsible for thumb flexion.</li><li>• involved</li><li>• adduction</li><li>• abduction</li><li>• thumb movements</li><li>• Injuries to the ulnar nerve typically result in symptoms such as a \"claw hand\" deformity and sensory loss in the medial side of the hand, not specifically an inability to flex the thumb.</li><li>• Injuries</li><li>• ulnar nerve</li><li>• \"claw hand\" deformity</li><li>• sensory loss</li><li>• medial side</li><li>• Option B. Posterior Interosseous Nerve :</li><li>• Option B. Posterior Interosseous Nerve</li><li>• The posterior interosseous nerve is a branch of the radial nerve . It primarily innervates the extensor muscles of the forearm . Damage to this nerve results in an inability to extend the fingers and the wrist (wrist drop) , not an inability to flex the thumb.</li><li>• The posterior interosseous nerve is a branch of the radial nerve .</li><li>• radial nerve</li><li>• It primarily innervates the extensor muscles of the forearm .</li><li>• innervates</li><li>• extensor muscles</li><li>• forearm</li><li>• Damage to this nerve results in an inability to extend the fingers and the wrist (wrist drop) , not an inability to flex the thumb.</li><li>• Damage</li><li>• inability</li><li>• extend</li><li>• fingers</li><li>• wrist (wrist drop)</li><li>• Option D. Superficial Branch of Ulnar Nerve :</li><li>• Option D. Superficial Branch of Ulnar Nerve</li><li>• The superficial branch of the ulnar nerve primarily provides sensory innervation to the medial one and a half fingers and the associated palm area . It does not play a significant role in motor control of the thumb, particularly in flexion.</li><li>• The superficial branch of the ulnar nerve primarily provides sensory innervation to the medial one and a half fingers and the associated palm area .</li><li>• sensory innervation</li><li>• medial one</li><li>• half fingers</li><li>• associated palm area</li><li>• It does not play a significant role in motor control of the thumb, particularly in flexion.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Interosseous Nerve:</li><li>➤ Anterior Interosseous Nerve:</li><li>➤ Anterior interosseous nerve is deep branch of the median nerve, innervates the flexor pollicis longus , the lateral half of the flexor digitorum profundus , and the pronator quadratus . Injury to this nerve leads to deficits in flexion of the thumb and the distal phalanges of the index and middle fingers , often assessed by the \"pinch grip\" test where the patient is unable to make an \"OK\" sign ( forming a circle with the thumb and index finger ).</li><li>➤ Anterior interosseous nerve is deep branch of the median nerve, innervates the flexor pollicis longus , the lateral half of the flexor digitorum profundus , and the pronator quadratus .</li><li>➤ flexor pollicis longus</li><li>➤ lateral half</li><li>➤ flexor digitorum profundus</li><li>➤ pronator quadratus</li><li>➤ Injury to this nerve leads to deficits in flexion of the thumb and the distal phalanges of the index and middle fingers , often assessed by the \"pinch grip\" test where the patient is unable to make an \"OK\" sign ( forming a circle with the thumb and index finger ).</li><li>➤ Injury</li><li>➤ deficits</li><li>➤ flexion of the thumb</li><li>➤ distal phalanges</li><li>➤ index</li><li>➤ middle fingers</li><li>➤ \"pinch grip\" test</li><li>➤ patient is unable</li><li>➤ \"OK\" sign</li><li>➤ forming a circle with the thumb and index finger</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 165</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 165</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old man presents with a laceration in the anterior region of his elbow following a biking accident. During surgical exploration of the wound, the surgeon notes a structure that has been partially transected. This structure is immediately superficial to a key anatomical structure in the cubital fossa, which the surgeon aims to protect. Which structure is most likely lying underneath the transected tissue?", "options": [{"label": "A", "text": "Median Cubital Vein", "correct": false}, {"label": "B", "text": "Radial Nerve", "correct": false}, {"label": "C", "text": "Brachial Artery", "correct": true}, {"label": "D", "text": "Anterior Interosseous Artery", "correct": false}], "correct_answer": "C. Brachial Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture6_Gavu47s.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture7_bOHj5lB.jpg"], "explanation": "<p><strong>Ans. C) Brachial Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Median Cubital Vein</li><li>• Option A. Median Cubital Vein</li><li>• It is superficial to the bicipital aponeurosis and is often used for venipuncture . Median cubital vein connects the cephalic and basilic vein .</li><li>• It is superficial to the bicipital aponeurosis and is often used for venipuncture .</li><li>• superficial</li><li>• bicipital aponeurosis</li><li>• venipuncture</li><li>• Median cubital vein connects the cephalic and basilic vein .</li><li>• connects</li><li>• cephalic</li><li>• basilic vein</li><li>• Option B. Radial Nerve :</li><li>• Option B. Radial Nerve</li><li>• The radial nerve does not typically lie directly under the bicipital aponeurosis. Instead, it travels along the radial side of the forearm and is more lateral in the cubital fossa .</li><li>• The radial nerve does not typically lie directly under the bicipital aponeurosis.</li><li>• Instead, it travels along the radial side of the forearm and is more lateral in the cubital fossa .</li><li>• travels along</li><li>• radial side</li><li>• forearm</li><li>• more lateral</li><li>• cubital fossa</li><li>• Option D. Anterior Interosseous Artery :</li><li>• Option D. Anterior Interosseous Artery</li><li>• This artery is a branch of the ulnar artery and is not covered by the bicipital aponeurosis. It runs on the anterior surface of the interosseous membrane of the forearm and is not located in the cubital fossa.</li><li>• This artery is a branch of the ulnar artery and is not covered by the bicipital aponeurosis.</li><li>• branch</li><li>• ulnar artery</li><li>• It runs on the anterior surface of the interosseous membrane of the forearm and is not located in the cubital fossa.</li><li>• anterior surface</li><li>• interosseous membrane</li><li>• forearm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Cubital Fossa &amp; Brachial Artery :</li><li>➤ Cubital Fossa &amp; Brachial Artery</li><li>➤ The bicipital aponeurosis covers the brachial artery as it courses through the cubital fossa , helping to protect it from compression or injury .</li><li>➤ The bicipital aponeurosis covers the brachial artery as it courses through the cubital fossa , helping to protect it from compression or injury .</li><li>➤ cubital fossa</li><li>➤ protect it</li><li>➤ compression or injury</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 70-year-old woman sustained a fall on the outstretched hand. She developed pain, tenderness and swelling over the dorsal aspect of her right wrist. She experienced difficulty in performing movements at the wrist. X-ray showed fracture of lower end of lateral bone of forearm. Which of the following statements is correct?", "options": [{"label": "A", "text": "In Colles fracture, the distal fragment shifts posteriorly and downward carrying with it the styloid process", "correct": false}, {"label": "B", "text": "In smith’s fracture the distal fragment is displaced posteriorly and upward", "correct": false}, {"label": "C", "text": "Both A and B", "correct": false}, {"label": "D", "text": "None of the above", "correct": true}], "correct_answer": "D. None of the above", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/22/picture-17_aN5kyzS.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture83.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture9_DZ7BSvz.jpg"], "explanation": "<p><strong>Ans. D) None of the above</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• In Colles Fracture, the distal fragment of radius shifts posteriorly and upwards carrying with it the styloid process . This is called dinner fork deformity . Because of this shortening the styloid process of radius and ulna are more or less in line with each other. So, therefore the statement given in Option A is incorrect.</li><li>• In Colles Fracture, the distal fragment of radius shifts posteriorly and upwards carrying with it the styloid process .</li><li>• distal fragment</li><li>• radius</li><li>• shifts posteriorly</li><li>• upwards</li><li>• styloid process</li><li>• This is called dinner fork deformity . Because of this shortening the styloid process of radius and ulna are more or less in line with each other. So, therefore the statement given in Option A is incorrect.</li><li>• dinner fork deformity</li><li>• shortening</li><li>• styloid process of radius</li><li>• ulna</li><li>• more or less</li><li>• Option B .</li><li>• Option B</li><li>• Smith’s fracture is a fracture of the distal end of the radius and occurs from a fall on the back of hand . Here, the distal fragment is displaced anteriorly . It is also called reverse Colles or Garden spade deformity . So, therefore the statement given in the option B is also incorrect.</li><li>• Smith’s fracture is a fracture of the distal end of the radius and occurs from a fall on the back of hand .</li><li>• fracture of the distal end of the radius</li><li>• fall</li><li>• back of hand</li><li>• Here, the distal fragment is displaced anteriorly . It is also called reverse Colles or Garden spade deformity . So, therefore the statement given in the option B is also incorrect.</li><li>• distal fragment</li><li>• displaced anteriorly</li><li>• reverse Colles</li><li>• Garden spade deformity</li><li>• Option C . Both A and B options are incorrect .</li><li>• Option C</li><li>• incorrect</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 861</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 861</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old male patient presents to the emergency department with severe pain in his left arm. The patient reports falling off a ladder approximately two hours prior to the presentation. On radiological examination, everything was seen as normal as shown in the image. Which of the following statements is true about the shaft of the pointed structure A in the image given below?", "options": [{"label": "A", "text": "The shaft is triangular in the upper half &amp; cylindrical in lower part in cross section", "correct": false}, {"label": "B", "text": "The shaft has 2 borders and three surfaces", "correct": false}, {"label": "C", "text": "The shaft has 3 borders &amp; 3 surface", "correct": true}, {"label": "D", "text": "Upper third of the lateral border forms the lateral lip of intertubercular sulcus", "correct": false}], "correct_answer": "C. The shaft has 3 borders & 3 surface", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/22/picture-18.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/22/picture10_PvxhQV9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture11.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture12.jpg"], "explanation": "<p><strong>Ans. C) The shaft has 3 borders &amp; 3 surface</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• The proximal or upper half of the humerus shaft does tend to have a more cylindrical cross-section whereas in the lower half , the humerus becomes more cylindrical . This triangular shape is better suited for the hinge-type joint at the elbow and provides a more uniform surface for muscle attachments and the interlocking of bones at the elbow joint .</li><li>• The proximal or upper half of the humerus shaft does tend to have a more cylindrical cross-section whereas in the lower half , the humerus becomes more cylindrical .</li><li>• lower half</li><li>• humerus</li><li>• cylindrical</li><li>• This triangular shape is better suited for the hinge-type joint at the elbow and provides a more uniform surface for muscle attachments and the interlocking of bones at the elbow joint .</li><li>• triangular shape</li><li>• hinge-type joint</li><li>• elbow</li><li>• more uniform surface</li><li>• muscle attachments</li><li>• interlocking</li><li>• bones</li><li>• elbow joint</li><li>• Option B.</li><li>• Option B.</li><li>• This statement is not accurate . The shaft of the humerus typically has three borders ( anterior, medial , and lateral ) and three surfaces ( anterolateral, anteromedial , and posterior ). These borders and surfaces serve as attachment sites for muscles and provide structural integrity .</li><li>• This statement is not accurate . The shaft of the humerus typically has three borders ( anterior, medial , and lateral ) and three surfaces ( anterolateral, anteromedial , and posterior ).</li><li>• not accurate</li><li>• three borders</li><li>• anterior, medial</li><li>• lateral</li><li>• three surfaces</li><li>• anterolateral, anteromedial</li><li>• posterior</li><li>• These borders and surfaces serve as attachment sites for muscles and provide structural integrity .</li><li>• attachment sites</li><li>• muscles</li><li>• provide structural integrity</li><li>• Option D.</li><li>• Option D.</li><li>• The bicipital groove runs along the proximal end of the humerus and gives attachment to the tendon of the long head of the biceps brachii muscle . The lateral border runs from the back part of the greater tubercle to the lateral epicondyle , and separates the anterolateral surface from posterior surface .</li><li>• The bicipital groove runs along the proximal end of the humerus and gives attachment to the tendon of the long head of the biceps brachii muscle .</li><li>• bicipital groove</li><li>• proximal end</li><li>• humerus</li><li>• tendon</li><li>• long head</li><li>• biceps brachii muscle</li><li>• The lateral border runs from the back part of the greater tubercle to the lateral epicondyle , and separates the anterolateral surface from posterior surface .</li><li>• lateral border</li><li>• back part</li><li>• greater tubercle</li><li>• lateral epicondyle</li><li>• separates</li><li>• anterolateral surface</li><li>• posterior surface</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The shaft has 3 borders and 3 surfaces.</li><li>➤ 3 borders</li><li>➤ 3 surfaces.</li><li>➤ 3 Borders : Anterior, Medial, and Lateral. 3 Surfaces : Antero-lateral, Antero-medial, and Posterior.</li><li>➤ 3 Borders : Anterior, Medial, and Lateral.</li><li>➤ 3 Borders</li><li>➤ 3 Surfaces : Antero-lateral, Antero-medial, and Posterior.</li><li>➤ 3 Surfaces</li><li>➤ Ref : Textbook of Anatomy upper limb and thorax, Vishram Singh 3 rd edition, pg. 9</li><li>➤ Ref : Textbook of Anatomy upper limb and thorax, Vishram Singh 3 rd edition, pg. 9</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old male patient was admitted with complaints of acute pain in the right shoulder of three-days duration associated with swelling and he also had difficulty in using his right shoulder since then. Pain was sudden at onset, continuous, and moderate to severe in intensity and it was aggravated on activity. In addition, he had severe night and rest pain. He also gave a history of intramuscular injection of Iron in the right deltoid region 2 weeks previously, which was administered in a local clinic. On examination, there was a globular swelling in the lateral aspect of the right arm extending up to the scapular region. There was a local rise of temperature and tenderness over the swelling, painful restriction of the right shoulder movements and he could not abduct his arm to the right angle. MRI scan of the right shoulder showed pyomyositis of the posterior belly of the right deltoid muscle with central abscess formation. Which among the following is not a possible complication that can be expected in this case if untreated?", "options": [{"label": "A", "text": "Loss of Sensation on Lower Lateral Aspect of Arm", "correct": true}, {"label": "B", "text": "Inability to Abduct the Shoulder", "correct": false}, {"label": "C", "text": "Weak of Flexion of Arm at Shoulder Joint", "correct": false}, {"label": "D", "text": "Inability to Extend the Arm at Shoulder Joint", "correct": false}], "correct_answer": "A. Loss of Sensation on Lower Lateral Aspect of Arm", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture13.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-22-191349.jpg"], "explanation": "<p><strong>Ans. A) Loss of Sensation on Lower Lateral Aspect of Arm</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B.</li><li>• Option B.</li><li>• Abduction of the shoulder:</li><li>• Abduction of the shoulder:</li><li>• Abduction</li><li>• Pyomyositis in the deltoid muscle would primarily affect the function of the deltoid, which is responsible for abduction .</li><li>• Pyomyositis in the deltoid muscle would primarily affect the function of the deltoid, which is responsible for abduction .</li><li>• Pyomyositis</li><li>• primarily affect</li><li>• responsible for abduction</li><li>• Option C.</li><li>• Option C.</li><li>• The deltoid muscle, particularly its anterior fibers , plays a role in flexing the arm at the shoulder . Pyomyositis affecting the deltoid muscle could feasibly lead to weakness in flexing the arm at the shoulder joint , as the compromised muscle may lose strength and functionality .</li><li>• The deltoid muscle, particularly its anterior fibers , plays a role in flexing the arm at the shoulder .</li><li>• anterior fibers</li><li>• flexing the arm</li><li>• shoulder</li><li>• Pyomyositis affecting the deltoid muscle could feasibly lead to weakness in flexing the arm at the shoulder joint , as the compromised muscle may lose strength and functionality .</li><li>• deltoid muscle</li><li>• lead to weakness</li><li>• shoulder joint</li><li>• compromised muscle</li><li>• lose strength</li><li>• functionality</li><li>• Option D.</li><li>• Option D.</li><li>• The primary muscles for extending the arm at the shoulder are the posterior deltoid , latissimus dorsi , and teres major . Since the posterior belly of the deltoid muscle is involved in this case, it could lead to an inability or weakness in extending the arm at the shoulder joint .</li><li>• The primary muscles for extending the arm at the shoulder are the posterior deltoid , latissimus dorsi , and teres major .</li><li>• posterior deltoid</li><li>• latissimus dorsi</li><li>• teres major</li><li>• Since the posterior belly of the deltoid muscle is involved in this case, it could lead to an inability or weakness in extending the arm at the shoulder joint .</li><li>• posterior belly</li><li>• lead</li><li>• inability</li><li>• weakness</li><li>• extending</li><li>• arm at the shoulder joint</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sensation in the lower lateral aspect of the arm is generally mediated by the cutaneous nerves , which is branch of radial nerve . Pyomyositis of the deltoid muscle primarily affects the muscle tissue and potentially the surrounding structures due to inflammation . However, it is less likely to directly impact the axillary nerve &amp; radial nerve unless there is a significant spread of infection or inflammation. Thus, a loss of sensation is not a typical complication of deltoid muscle pyomyositis.</li><li>➤ Sensation in the lower lateral aspect of the arm is generally mediated by the cutaneous nerves , which is branch of radial nerve .</li><li>➤ Sensation</li><li>➤ lower lateral aspect</li><li>➤ mediated</li><li>➤ cutaneous nerves</li><li>➤ radial nerve</li><li>➤ Pyomyositis of the deltoid muscle primarily affects the muscle tissue and potentially the surrounding structures due to inflammation .</li><li>➤ primarily affects</li><li>➤ muscle tissue</li><li>➤ potentially</li><li>➤ inflammation</li><li>➤ However, it is less likely to directly impact the axillary nerve &amp; radial nerve unless there is a significant spread of infection or inflammation. Thus, a loss of sensation is not a typical complication of deltoid muscle pyomyositis.</li><li>➤ less likely</li><li>➤ directly impact</li><li>➤ axillary nerve</li><li>➤ radial nerve</li><li>➤ Ref : Textbook of Anatomy upper limb and thorax, Vishram Singh 3 rd edition, pg. 89</li><li>➤ Ref : Textbook of Anatomy upper limb and thorax, Vishram Singh 3 rd edition, pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male patient presents to the clinic with a concern about a \"visible vein\" in his right shoulder area. He reports that the vein becomes more pronounced during exercise or when lifting heavy objects. There is no associated pain, redness, or swelling. He denies any history of trauma to the area. On inspection of the right shoulder area reveals a prominent, non-pulsatile, linear structure running along the deltopectoral groove is seen. Which of the following structure is seen in this area?", "options": [{"label": "A", "text": "Axillary Artery", "correct": false}, {"label": "B", "text": "Cephalic Vein", "correct": true}, {"label": "C", "text": "Basilic Vein", "correct": false}, {"label": "D", "text": "Radial Nerve", "correct": false}], "correct_answer": "B. Cephalic Vein", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture14.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture15.jpg"], "explanation": "<p><strong>Ans. B) Cephalic Vein</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Axillary Artery supplies blood to the upper limb and runs through the axilla . While the axillary artery is in the vicinity, it is not specifically related to the deltopectoral groove. The artery is deeper and more medially located compared to this groove.</li><li>• Axillary Artery supplies blood to the upper limb and runs through the axilla .</li><li>• upper limb</li><li>• runs through</li><li>• axilla</li><li>• While the axillary artery is in the vicinity, it is not specifically related to the deltopectoral groove.</li><li>• The artery is deeper and more medially located compared to this groove.</li><li>• deeper</li><li>• more medially</li><li>• Option C.</li><li>• Option C.</li><li>• Basilic Vein is another superficial vein of the upper limb , located more medially compared to the cephalic vein . The basilic vein does not run through the deltopectoral groove. It is situated on the medial side of the arm and does not have a direct anatomical relationship with this groove.</li><li>• Basilic Vein is another superficial vein of the upper limb , located more medially compared to the cephalic vein .</li><li>• another superficial vein</li><li>• upper limb</li><li>• more medially</li><li>• cephalic vein</li><li>• The basilic vein does not run through the deltopectoral groove.</li><li>• It is situated on the medial side of the arm and does not have a direct anatomical relationship with this groove.</li><li>• situated</li><li>• medial side</li><li>• arm</li><li>• Option D.</li><li>• Option D.</li><li>• Radial Nerve is one of the major nerves of the upper limb , involved in the motor and sensory innervation of the arm and hand . The radial nerve does not pass through the deltopectoral groove. It travels along the posterior compartment of the arm and is more related to the triceps muscle and the radial groove of the humerus .</li><li>• Radial Nerve is one of the major nerves of the upper limb , involved in the motor and sensory innervation of the arm and hand .</li><li>• major nerves</li><li>• upper limb</li><li>• motor</li><li>• sensory innervation</li><li>• arm</li><li>• hand</li><li>• The radial nerve does not pass through the deltopectoral groove.</li><li>• It travels along the posterior compartment of the arm and is more related to the triceps muscle and the radial groove of the humerus .</li><li>• posterior compartment</li><li>• arm</li><li>• triceps muscle</li><li>• radial groove</li><li>• humerus</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The cephalic vein is a superficial vein of the upper limb . It runs along the preaxial border of the upper limb . It passes through the deltopectoral groove . It is a significant landmark for certain surgical procedures , running between the deltoid and pectoralis major muscles before it drains into the axillary vein.</li><li>➤ The cephalic vein is a superficial vein of the upper limb .</li><li>➤ cephalic vein</li><li>➤ superficial vein</li><li>➤ upper limb</li><li>➤ It runs along the preaxial border of the upper limb .</li><li>➤ preaxial border</li><li>➤ upper limb</li><li>➤ It passes through the deltopectoral groove .</li><li>➤ passes</li><li>➤ deltopectoral groove</li><li>➤ It is a significant landmark for certain surgical procedures , running between the deltoid and pectoralis major muscles before it drains into the axillary vein.</li><li>➤ significant landmark</li><li>➤ surgical procedures</li><li>➤ deltoid</li><li>➤ pectoralis major muscles</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 33</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following muscles have dual nerve supply except?", "options": [{"label": "A", "text": "Subscapularis", "correct": false}, {"label": "B", "text": "Pectoralis Major", "correct": false}, {"label": "C", "text": "Pronator Teres", "correct": true}, {"label": "D", "text": "Flexor Digitorum Profundus", "correct": false}], "correct_answer": "C. Pronator Teres", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-22-191557_jm9qfch.jpg"], "explanation": "<p><strong>Ans. C) Pronator Teres</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Subscapularis is innervated by the upper and lower subscapular nerves .</li><li>• Option A.</li><li>• upper</li><li>• lower subscapular nerves</li><li>• Option B. Pectoralis major is innervated by the medial and lateral pectoral nerves .</li><li>• Option B.</li><li>• medial</li><li>• lateral pectoral nerves</li><li>• Option D. FDP tendon for medial ½ is innervated by the ulnar nerve and FDP tendon lateral ½ is innervated by the anterior interosseous branch of the median nerve .</li><li>• Option D.</li><li>• medial ½</li><li>• ulnar nerve</li><li>• FDP tendon lateral ½</li><li>• anterior interosseous branch</li><li>• median nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The pronator teres muscle, helps to pronate the forearm and receives its nerve supply from the median nerve . The median nerve originates from the brachial plexus , specifically from the lateral and medial cords and travels down the arm and into the forearm, it innervates several muscles , including the pronator teres .</li><li>➤ The pronator teres muscle, helps to pronate the forearm and receives its nerve supply from the median nerve .</li><li>➤ pronate</li><li>➤ forearm</li><li>➤ receives</li><li>➤ nerve supply</li><li>➤ median nerve</li><li>➤ The median nerve originates from the brachial plexus , specifically from the lateral and medial cords and travels down the arm and into the forearm, it innervates several muscles , including the pronator teres .</li><li>➤ originates</li><li>➤ brachial plexus</li><li>➤ lateral and medial cords</li><li>➤ travels down the arm</li><li>➤ innervates several muscles</li><li>➤ pronator teres</li><li>➤ Hybrid muscles of Upper Limb:</li><li>➤ Hybrid muscles of Upper Limb:</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 101</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram singh, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon is performing a dissection in the shoulder region and notes the structures passing through the clavipectoral fascia. Which of the following structures is known to pierce the clavipectoral fascia?", "options": [{"label": "A", "text": "Axillary Nerve", "correct": false}, {"label": "B", "text": "Thoracoacromial Artery", "correct": true}, {"label": "C", "text": "Suprascapular Artery", "correct": false}, {"label": "D", "text": "Long Thoracic Nerve", "correct": false}], "correct_answer": "B. Thoracoacromial Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture16.jpg"], "explanation": "<p><strong>Ans. B) Thoracoacromial Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A .</li><li>• Option A</li><li>• The axillary nerve does not pierce the clavipectoral fascia. It travels through the quadrangular space and is primarily associated with the innervation of the deltoid and teres minor muscles .</li><li>• The axillary nerve does not pierce the clavipectoral fascia.</li><li>• It travels through the quadrangular space and is primarily associated with the innervation of the deltoid and teres minor muscles .</li><li>• quadrangular space</li><li>• deltoid</li><li>• teres minor muscles</li><li>• Option C .</li><li>• Option C</li><li>• The suprascapular artery, while important in the shoulder region, does not pierce the clavipectoral fascia. It travels above the scapula and supplies the supraspinatus and infraspinatus muscles .</li><li>• The suprascapular artery, while important in the shoulder region, does not pierce the clavipectoral fascia.</li><li>• It travels above the scapula and supplies the supraspinatus and infraspinatus muscles .</li><li>• above</li><li>• scapula</li><li>• supplies the supraspinatus</li><li>• infraspinatus muscles</li><li>• Option D .</li><li>• Option D</li><li>• This nerve runs superficial to the clavipectoral fascia. It innervates the serratus anterior muscle and is known for its vulnerability in surgical procedures in the axillary region , but it does not pierce the clavipectoral fascia.</li><li>• This nerve runs superficial to the clavipectoral fascia.</li><li>• superficial</li><li>• It innervates the serratus anterior muscle and is known for its vulnerability in surgical procedures in the axillary region , but it does not pierce the clavipectoral fascia.</li><li>• innervates</li><li>• serratus anterior muscle</li><li>• vulnerability</li><li>• surgical procedures</li><li>• axillary region</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ The clavipectoral fascia serves as a key landmark for identifying these structures during surgical dissections and interventions . The thoracoacromial artery is the structure that pierces the clavipectoral fascia .</li><li>➤ The clavipectoral fascia serves as a key landmark for identifying these structures during surgical dissections and interventions .</li><li>➤ key landmark</li><li>➤ during surgical dissections</li><li>➤ interventions</li><li>➤ The thoracoacromial artery is the structure that pierces the clavipectoral fascia .</li><li>➤ pierces</li><li>➤ clavipectoral fascia</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A surgeon is performing a procedure in the anterior axillary region and observes the clavipectoral fascia enclosing the pectoralis minor muscle. As the surgeon dissects further, they note that this fascia continues distally beyond the pectoralis minor. What does the clavipectoral fascia become after enclosing the pectoralis minor muscle?", "options": [{"label": "A", "text": "Axillary sheath", "correct": false}, {"label": "B", "text": "Costocoracoid ligament", "correct": false}, {"label": "C", "text": "Costoclavicular ligament", "correct": false}, {"label": "D", "text": "Suspensory ligament", "correct": true}], "correct_answer": "D. Suspensory ligament", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture17.jpg"], "explanation": "<p><strong>Ans. D) Suspensory ligament</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Axillary sheath is derived from the prevertebral layer of deep cervical fascia . It is a fascial sleeve that surrounds the neurovascular bundle ( the axillary artery, axillary vein, and the brachial plexus) in the axilla. While the axillary sheath is in the same region as the clavipectoral fascia, it is not a direct continuation of the clavipectoral fascia. The axillary sheath is more associated with the neurovascular structures of the axilla .</li><li>• Axillary sheath is derived from the prevertebral layer of deep cervical fascia .</li><li>• derived</li><li>• prevertebral layer</li><li>• deep cervical fascia</li><li>• It is a fascial sleeve that surrounds the neurovascular bundle ( the axillary artery, axillary vein, and the brachial plexus) in the axilla.</li><li>• surrounds</li><li>• neurovascular bundle</li><li>• the axillary artery, axillary vein, and the brachial plexus)</li><li>• While the axillary sheath is in the same region as the clavipectoral fascia, it is not a direct continuation of the clavipectoral fascia.</li><li>• The axillary sheath is more associated with the neurovascular structures of the axilla .</li><li>• neurovascular structures</li><li>• axilla</li><li>• Option B.</li><li>• Option B.</li><li>• Costocoracoid ligament extends from the coracoid process to the first costochondral junction .</li><li>• Costocoracoid ligament extends from the coracoid process to the first costochondral junction .</li><li>• coracoid process</li><li>• first costochondral junction</li><li>• Option C.</li><li>• Option C.</li><li>• Costoclavicular ligament extends from the first rib and its cartilage to the sternal end of the clavicle.</li><li>• Costoclavicular ligament extends from the first rib and its cartilage to the sternal end of the clavicle.</li><li>• first rib</li><li>• cartilage</li><li>• sternal end</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Suspensory Ligament, also known as the costoclavicular ligament or ligament of Gerdy. It is sometimes considered an extension of the clavipectoral fascia . It extends from the axillary fascia and suspends the axillary fascia and overlying skin . After enclosing the pectoralis minor , the clavipectoral fascia extends inferiorly as the suspensory ligament of the axilla. This ligament helps to support the axillary fascia and is particularly noticeable when the upper limb is raised .</li><li>• Suspensory Ligament, also known as the costoclavicular ligament or ligament of Gerdy.</li><li>• Suspensory Ligament,</li><li>• costoclavicular ligament</li><li>• ligament of Gerdy.</li><li>• It is sometimes considered an extension of the clavipectoral fascia .</li><li>• extension</li><li>• clavipectoral fascia</li><li>• It extends from the axillary fascia and suspends the axillary fascia and overlying skin .</li><li>• extends</li><li>• axillary fascia</li><li>• axillary fascia</li><li>• overlying skin</li><li>• After enclosing the pectoralis minor , the clavipectoral fascia extends inferiorly as the suspensory ligament of the axilla.</li><li>• pectoralis minor</li><li>• extends inferiorly</li><li>• suspensory ligament</li><li>• This ligament helps to support the axillary fascia and is particularly noticeable when the upper limb is raised .</li><li>• support</li><li>• axillary fascia</li><li>• particularly noticeable</li><li>• upper limb is raised</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 33</li><li>• Ref :</li><li>• Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old female came to the surgeon with complaints of a hard, painless lump in the upper outer quadrant of the left breast. The axillary nodes on the right side were enlarged and there was loss of mobility of the breast. X-ray of the vertebral column showed irregular shadows in the bodies of L1 &amp; L2 vertebra. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Axillary tail of Spence is in contact with anterior group of axillary lymph nodes", "correct": false}, {"label": "B", "text": "Retromammary space intervenes between deep fascia of pectoral region and pectoralis major muscle", "correct": true}, {"label": "C", "text": "External oblique aponeurosis separates the breast from rectus abdominis muscle", "correct": false}, {"label": "D", "text": "Suspensory ligaments of cooper extends from skin to the underlying pectoral fascia", "correct": false}], "correct_answer": "B. Retromammary space intervenes between deep fascia of pectoral region and pectoralis major muscle", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture19_E9WgsuW.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-33253-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture21.jpg"], "explanation": "<p><strong>Ans. B) Retromammary space intervenes between deep fascia of pectoral region and pectoralis major muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• This is an extension of the glandular tissue of the breast that extends into the axilla . The axillary tail of Spence is indeed in close proximity to the axillary lymph nodes , particularly the anterior group . These lymph nodes are a primary route for lymphatic drainage from the breast , making them clinically significant, especially in breast cancer cases.</li><li>• This is an extension of the glandular tissue of the breast that extends into the axilla .</li><li>• extension</li><li>• glandular tissue</li><li>• extends into the axilla</li><li>• The axillary tail of Spence is indeed in close proximity to the axillary lymph nodes , particularly the anterior group .</li><li>• axillary tail</li><li>• Spence</li><li>• close proximity</li><li>• axillary lymph nodes</li><li>• anterior group</li><li>• These lymph nodes are a primary route for lymphatic drainage from the breast , making them clinically significant, especially in breast cancer cases.</li><li>• lymph nodes</li><li>• primary route</li><li>• lymphatic drainage</li><li>• breast</li><li>• Option C.</li><li>• Option C.</li><li>• External oblique aponeurosis is a strong , flat sheet of fibrous tissue that forms part of the abdominal wall . The external oblique aponeurosis lies superficial to the rectus abdominis muscle . The lower portion of the breast lies above this aponeurosis . While it does not directly separate the breast from the rectus abdominis muscle, it is part of the layered structure of the anterior abdominal wall in which the breast is located .</li><li>• External oblique aponeurosis is a strong , flat sheet of fibrous tissue that forms part of the abdominal wall . The external oblique aponeurosis lies superficial to the rectus abdominis muscle .</li><li>• strong</li><li>• flat sheet</li><li>• fibrous tissue</li><li>• forms part</li><li>• abdominal wall</li><li>• external oblique aponeurosis</li><li>• superficial</li><li>• rectus abdominis muscle</li><li>• The lower portion of the breast lies above this aponeurosis . While it does not directly separate the breast from the rectus abdominis muscle, it is part of the layered structure of the anterior abdominal wall in which the breast is located .</li><li>• lower portion</li><li>• breast lies above this aponeurosis</li><li>• part</li><li>• layered structure</li><li>• anterior abdominal wall</li><li>• breast is located</li><li>• Option D.</li><li>• Option D.</li><li>• Suspensory ligaments of cooper are fibrous bands that traverse the breast tissue , providing support . They extend from the dermis of the skin through the breast tissue and attach to the deep fascia . Their role is to maintain the structural integrity and shape of the breast. They do indeed extend to the underlying pectoral fascia .</li><li>• Suspensory ligaments of cooper are fibrous bands that traverse the breast tissue , providing support . They extend from the dermis of the skin through the breast tissue and attach to the deep fascia .</li><li>• fibrous bands</li><li>• traverse</li><li>• breast tissue</li><li>• support</li><li>• dermis</li><li>• skin</li><li>• breast tissue</li><li>• attach</li><li>• deep fascia</li><li>• Their role is to maintain the structural integrity and shape of the breast. They do indeed extend to the underlying pectoral fascia .</li><li>• maintain</li><li>• structural integrity</li><li>• shape</li><li>• extend</li><li>• underlying pectoral fascia</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Retromammary Space Intervenes Between Deep Fascia of Pectoral Region and Pectoralis Major Muscle:</li><li>➤ Retromammary Space Intervenes Between Deep Fascia of Pectoral Region and Pectoralis Major Muscle:</li><li>➤ The retromammary space is an anatomical space located between the breast tissue and the pectoralis major muscle . The deep fascia of the pectoral region is what lies directly over the pectoralis major muscle . The retromammary space is actually between the breast tissue and the pectoral fascia , not between the deep fascia of the pectoral region and the pectoralis major muscle.</li><li>➤ The retromammary space is an anatomical space located between the breast tissue and the pectoralis major muscle .</li><li>➤ anatomical space</li><li>➤ between</li><li>➤ breast tissue</li><li>➤ pectoralis major muscle</li><li>➤ The deep fascia of the pectoral region is what lies directly over the pectoralis major muscle . The retromammary space is actually between the breast tissue and the pectoral fascia , not between the deep fascia of the pectoral region and the pectoralis major muscle.</li><li>➤ deep fascia</li><li>➤ pectoral region</li><li>➤ directly</li><li>➤ pectoralis major muscle</li><li>➤ actually between</li><li>➤ breast tissue</li><li>➤ pectoral fascia</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 945</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg no. 945</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A daily wage worker who carries loads, experienced great difficulty in raising his left arm above his head. The physician asked the patient to press his hands against the wall in front. While doing so, the medial border and inferior angle of his left scapula became prominent. Which of the following statements is correct concerning this patient?", "options": [{"label": "A", "text": "Lower fibres of serratus anterior causes glenoid cavity to turn downward", "correct": false}, {"label": "B", "text": "Actions of serratus anterior is antagonized by contraction of rhomboids and middle fibres of trapezius", "correct": true}, {"label": "C", "text": "Serratus anterior is supplied by Lateral pectoral nerve", "correct": false}, {"label": "D", "text": "First digitation of serratus anterior is seen in the anterior triangle of neck", "correct": false}], "correct_answer": "B. Actions of serratus anterior is antagonized by contraction of rhomboids and middle fibres of trapezius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture22.jpg"], "explanation": "<p><strong>Ans. B) Actions of serratus anterior is antagonized by contraction of rhomboids and middle fibres of trapezius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• The serratus anterior muscle primarily functions to protract the scapula and to hold it against the chest wall . The lower fibres can assist in upward rotation of the scapula , which would be necessary for raising the arm above the head . The role of the serratus anterior in the movement of the glenoid cavity is more related to its stabilization and rotation rather than specifically turning it downward.</li><li>• The serratus anterior muscle primarily functions to protract the scapula and to hold it against the chest wall .</li><li>• serratus anterior muscle</li><li>• protract the scapula</li><li>• hold it</li><li>• against</li><li>• chest wall</li><li>• The lower fibres can assist in upward rotation of the scapula , which would be necessary for raising the arm above the head .</li><li>• lower fibres</li><li>• upward rotation</li><li>• scapula</li><li>• raising the arm</li><li>• above</li><li>• head</li><li>• The role of the serratus anterior in the movement of the glenoid cavity is more related to its stabilization and rotation rather than specifically turning it downward.</li><li>• role</li><li>• serratus anterior</li><li>• movement</li><li>• glenoid cavity</li><li>• its stabilization</li><li>• rotation</li><li>• Option C.</li><li>• Option C.</li><li>• The serratus anterior is actually innervated by the long thoracic nerve , not the lateral pectoral nerve. The lateral pectoral nerve primarily supplies the pectoral muscles . Damage to the long thoracic nerve can lead to paralysis of the serratus anterior , resulting in winging of the scapula , as described in the patient's case.</li><li>• The serratus anterior is actually innervated by the long thoracic nerve , not the lateral pectoral nerve.</li><li>• serratus anterior</li><li>• innervated by</li><li>• long thoracic nerve</li><li>• The lateral pectoral nerve primarily supplies the pectoral muscles . Damage to the long thoracic nerve can lead to paralysis of the serratus anterior , resulting in winging of the scapula , as described in the patient's case.</li><li>• primarily supplies</li><li>• pectoral muscles</li><li>• Damage</li><li>• long thoracic nerve</li><li>• paralysis</li><li>• serratus anterior</li><li>• winging of the scapula</li><li>• Option D.</li><li>• Option D.</li><li>• The serratus anterior is located on the side of the thorax , extending from the lateral aspect of the ribs to the anterior part of the scapula . It does not extend into the anterior triangle of the neck.</li><li>• The serratus anterior is located on the side of the thorax , extending from the lateral aspect of the ribs to the anterior part of the scapula . It does not extend into the anterior triangle of the neck.</li><li>• serratus anterior</li><li>• side of the thorax</li><li>• extending</li><li>• lateral aspect</li><li>• ribs</li><li>• anterior part</li><li>• scapula</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Actions of Serratus Anterior is Antagonized by Contraction of Rhomboids and Middle Fibres of Trapezius:</li><li>➤ Actions of Serratus Anterior is Antagonized by Contraction of Rhomboids and Middle Fibres of Trapezius:</li><li>➤ The serratus anterior protracts the scapula while the rhomboids ( major and minor ) and the middle fibers of the trapezius retract the scapula . Thus, these muscles work in opposition to each other. The serratus anterior's protraction is balanced by the retraction action of the rhomboids and middle trapezius .</li><li>➤ The serratus anterior protracts the scapula while the rhomboids ( major and minor ) and the middle fibers of the trapezius retract the scapula .</li><li>➤ serratus anterior</li><li>➤ protracts</li><li>➤ scapula</li><li>➤ rhomboids</li><li>➤ major and minor</li><li>➤ middle fibers</li><li>➤ trapezius</li><li>➤ retract</li><li>➤ scapula</li><li>➤ Thus, these muscles work in opposition to each other. The serratus anterior's protraction is balanced by the retraction action of the rhomboids and middle trapezius .</li><li>➤ work in opposition</li><li>➤ serratus anterior's protraction</li><li>➤ balanced by</li><li>➤ retraction action</li><li>➤ rhomboids</li><li>➤ middle trapezius</li><li>➤ Ref : Gray’s Anatomy 41 st edition</li><li>➤ Ref : Gray’s Anatomy 41 st edition</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 20-year-old male fractured his left tibia in a motor bike accident. His left leg was fixed in a cast and he used crutches for ambulation. Two weeks later, he had difficulty in extending his wrist. Which nerve is most probably injured?", "options": [{"label": "A", "text": "Long Thoracic Nerve", "correct": false}, {"label": "B", "text": "Radial Nerve", "correct": true}, {"label": "C", "text": "Musculocutaneous Nerve", "correct": false}, {"label": "D", "text": "Median Nerve", "correct": false}], "correct_answer": "B. Radial Nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Radial Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Long Thoracic Nerve innervates the serratus anterior muscle , which is crucial for stabilizing the scapula . Damage to this nerve can lead to winging of the scapula , but it would not affect wrist extension.</li><li>• Long Thoracic Nerve innervates the serratus anterior muscle , which is crucial for stabilizing the scapula . Damage to this nerve can lead to winging of the scapula , but it would not affect wrist extension.</li><li>• serratus anterior muscle</li><li>• crucial</li><li>• stabilizing</li><li>• scapula</li><li>• Damage</li><li>• winging of the scapula</li><li>• Option C.</li><li>• Option C.</li><li>• Musculocutaneous Nerve innervates muscles in the anterior compartment of the arm , like the biceps brachii , and is involved in flexing the elbow . Damage to the musculocutaneous nerve would lead to weakness in elbow flexion and a diminished sensation in the lateral forearm .</li><li>• Musculocutaneous Nerve innervates muscles in the anterior compartment of the arm , like the biceps brachii , and is involved in flexing the elbow .</li><li>• anterior compartment</li><li>• arm</li><li>• biceps brachii</li><li>• involved</li><li>• flexing the elbow</li><li>• Damage to the musculocutaneous nerve would lead to weakness in elbow flexion and a diminished sensation in the lateral forearm .</li><li>• Damage</li><li>• weakness</li><li>• elbow flexion</li><li>• diminished sensation</li><li>• lateral forearm</li><li>• Option D.</li><li>• Option D.</li><li>• Median Nerve innervates most of the muscles of the anterior compartment of the forearm and some muscles in the hand. It is primarily involved in flexing the wrist and fingers and providing sensation to the palmar side of the hand. Injury to the median nerve would lead to problems with wrist and finger flexion and sensory deficits in the hand, but not difficulty in extending the wrist.</li><li>• Median Nerve innervates most of the muscles of the anterior compartment of the forearm and some muscles in the hand.</li><li>• anterior compartment</li><li>• forearm</li><li>• some muscles</li><li>• It is primarily involved in flexing the wrist and fingers and providing sensation to the palmar side of the hand.</li><li>• primarily involved</li><li>• flexing the wrist</li><li>• fingers</li><li>• providing sensation</li><li>• palmar side</li><li>• Injury to the median nerve would lead to problems with wrist and finger flexion and sensory deficits in the hand, but not difficulty in extending the wrist.</li><li>• Injury</li><li>• problems with wrist</li><li>• finger flexion</li><li>• sensory deficits</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Radial Nerve innervates the muscles in the posterior compartment of the forearm , which are responsible for extending the wrist and fingers . Injury to the radial nerve can lead to wrist drop , a condition characterized by difficulty in extending the wrist and fingers . Given the patient's symptoms and the use of crutches , which can compress the radial nerve in the axillary region ( crutch palsy ), this is the most likely injured nerve.</li><li>➤ Radial Nerve innervates the muscles in the posterior compartment of the forearm , which are responsible for extending the wrist and fingers .</li><li>➤ Radial Nerve</li><li>➤ posterior compartment</li><li>➤ forearm</li><li>➤ extending</li><li>➤ wrist</li><li>➤ fingers</li><li>➤ Injury to the radial nerve can lead to wrist drop , a condition characterized by difficulty in extending the wrist and fingers .</li><li>➤ Injury</li><li>➤ wrist drop</li><li>➤ difficulty</li><li>➤ extending the wrist and fingers</li><li>➤ Given the patient's symptoms and the use of crutches , which can compress the radial nerve in the axillary region ( crutch palsy ), this is the most likely injured nerve.</li><li>➤ use of crutches</li><li>➤ compress</li><li>➤ radial nerve</li><li>➤ axillary region</li><li>➤ crutch palsy</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 832</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 832</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old man, hard of hearing, while riding his motorbike met with a head-on collision with the truck on a national highway. He was thrown off the motorbike and fell down with an impact on his back a few metres away from the accident site. He was received in casualty. X-ray pictures taken showed multiple fractures of the left scapula. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "Suprascapular artery passes above the suprascapular notch", "correct": false}, {"label": "B", "text": "Suprascapular nerve arises at Erb's point", "correct": false}, {"label": "C", "text": "If suprascapular nerve is injured at spinoglenoid notch medial rotation of arm is affected", "correct": true}, {"label": "D", "text": "Articular branches to acromioclavicular joint arises from suprascapular nerve proximal to suprascapular notch", "correct": false}], "correct_answer": "C. If suprascapular nerve is injured at spinoglenoid notch medial rotation of arm is affected", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/whatsapp-image-2023-12-23-at-33305-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture24.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture25.jpg"], "explanation": "<p><strong>Ans. C) If Suprascapular Nerve is injured at Spinoglenoid Notch medial rotation of arm is affected</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation</li><li>• :</li><li>• Option A.</li><li>• Option A.</li><li>• The suprascapular artery typically passes over the suprascapular notch , while the suprascapular nerve passes under it through this notch. Mnemonic : N for Nerve, N for Navy (Navy is under water) A for Artery, A for Air (Air is above)</li><li>• The suprascapular artery typically passes over the suprascapular notch , while the suprascapular nerve passes under it through this notch.</li><li>• suprascapular artery</li><li>• typically passes</li><li>• over</li><li>• suprascapular notch</li><li>• Mnemonic : N for Nerve, N for Navy (Navy is under water) A for Artery, A for Air (Air is above)</li><li>• Mnemonic</li><li>• N for Nerve, N for Navy (Navy is under water) A for Artery, A for Air (Air is above)</li><li>• N for Nerve, N for Navy (Navy is under water)</li><li>• N for Nerve, N for Navy (Navy is under water)</li><li>• A for Artery, A for Air (Air is above)</li><li>• A for Artery, A for Air (Air is above)</li><li>• Option B.</li><li>• Option B.</li><li>• The Suprascapular Nerve originates from the upper trunk of the brachial plexus , which is formed by the union of the C5 and C6 nerve roots . Erb's point refers to a site near the neck where nerves from the brachial plexus converge and are superficial enough to be impacted by trauma .</li><li>• The Suprascapular Nerve originates from the upper trunk of the brachial plexus , which is formed by the union of the C5 and C6 nerve roots .</li><li>• originates</li><li>• upper trunk</li><li>• brachial plexus</li><li>• formed by</li><li>• union</li><li>• C5 and C6 nerve roots</li><li>• Erb's point refers to a site near the neck where nerves from the brachial plexus converge and are superficial enough to be impacted by trauma .</li><li>• Erb's point</li><li>• site near</li><li>• neck</li><li>• nerves</li><li>• brachial plexus converge</li><li>• superficial enough</li><li>• impacted by trauma</li><li>• Option D.</li><li>• Option D.</li><li>• The suprascapular nerve does give off articular branches to the shoulder joint , including the acromioclavicular joint . These branches typically arise before the nerve passes through the suprascapular notch .</li><li>• The suprascapular nerve does give off articular branches to the shoulder joint , including the acromioclavicular joint . These branches typically arise before the nerve passes through the suprascapular notch .</li><li>• give off articular branches</li><li>• shoulder joint</li><li>• including</li><li>• acromioclavicular joint</li><li>• arise before</li><li>• nerve passes</li><li>• suprascapular notch</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The suprascapular nerve primarily innervates the supraspinatus and infraspinatus muscles . These muscles are involved in the abduction and lateral rotation of the shoulder , respectively. If the suprascapular nerve is injured at the spinoglenoid notch, it would predominantly affect the infraspinatus muscle , leading to difficulties in lateral rotation of the arm , not medial rotation.</li><li>➤ The suprascapular nerve primarily innervates the supraspinatus and infraspinatus muscles . These muscles are involved in the abduction and lateral rotation of the shoulder , respectively.</li><li>➤ innervates</li><li>➤ supraspinatus</li><li>➤ infraspinatus muscles</li><li>➤ involved</li><li>➤ abduction</li><li>➤ lateral rotation</li><li>➤ shoulder</li><li>➤ If the suprascapular nerve is injured at the spinoglenoid notch, it would predominantly affect the infraspinatus muscle , leading to difficulties in lateral rotation of the arm , not medial rotation.</li><li>➤ predominantly affect</li><li>➤ infraspinatus muscle</li><li>➤ leading</li><li>➤ difficulties</li><li>➤ lateral rotation</li><li>➤ arm</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 831</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg no. 831</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 32 years patient Vinod came after RTA and on radiological examination fracture at upper part of humerus was observed. For fracture treatment Orthopedician team decided for open surgery. Boundaries of spaces of arm were very important anatomical knowledge during surgery. Related to spaces of arm what does “A” represent in the given image?", "options": [{"label": "A", "text": "Anatomical Neck of Humerus", "correct": false}, {"label": "B", "text": "Shaft of Humerus", "correct": false}, {"label": "C", "text": "Surgical Neck of Humerus", "correct": true}, {"label": "D", "text": "Deltoid Tuberosity of Humerus", "correct": false}], "correct_answer": "C. Surgical Neck of Humerus", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/10/17/screenshot-2023-10-17-152000.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2024/05/14/03.jpg"], "explanation": "<p><strong>Ans. C) Surgical Neck of Humerus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Anatomical neck is a constriction that immediately succeeds the head of the humerus .</li><li>• Option A.</li><li>• Anatomical neck</li><li>• constriction</li><li>• immediately succeeds</li><li>• head of the humerus</li><li>• Option B. Shaft of the humerus contains a radial groove on its posterior surface and forms the lateral boundary for lower triangular space .</li><li>• Option B.</li><li>• Shaft of the humerus</li><li>• radial groove</li><li>• posterior surface</li><li>• lateral boundary</li><li>• lower triangular space</li><li>• Option D. Deltoid tuberosity is v shaped and lies on the anterolateral surface near the middle of the shaft and receives the insertion of deltoid muscle .</li><li>• Option D.</li><li>• Deltoid tuberosity</li><li>• v shaped</li><li>• anterolateral surface</li><li>• middle</li><li>• shaft</li><li>• receives</li><li>• insertion of deltoid muscle</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Surgical neck of the humerus forms the lateral boundary for quadrangular space . It is the junction between the expanded upper end and the shaft of the humerus .</li><li>➤ lateral boundary</li><li>➤ quadrangular space</li><li>➤ junction between</li><li>➤ expanded upper end</li><li>➤ shaft of the humerus</li><li>➤ Ref : Textbook of Anatomy upper limb and thorax, Vishram singh, 3 rd edition, pg. 9</li><li>➤ Ref :</li><li>➤ Textbook of Anatomy upper limb and thorax, Vishram singh, 3 rd edition, pg. 9</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following statements is not true concerning the given image?", "options": [{"label": "A", "text": "Axillary nerve passes through the space labelled B", "correct": false}, {"label": "B", "text": "Profunda brachii vessels pass through the space labelled C", "correct": false}, {"label": "C", "text": "Dorsal scapular vessels pass through the space labelled A", "correct": true}, {"label": "D", "text": "Long head of triceps forms the medial boundary for space B", "correct": false}], "correct_answer": "C. Dorsal scapular vessels pass through the space labelled A", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-171248.png"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture29.jpg"], "explanation": "<p><strong>Ans. C)</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Space labelled B is Quadrangular space and axillary nerve pass through it.</li><li>• Option A</li><li>• Quadrangular space</li><li>• axillary nerve</li><li>• Option B. Space labelled C is the Lower triangular space traversed by profunda brachii vessels .</li><li>• Option B.</li><li>• Lower triangular space</li><li>• profunda brachii vessels</li><li>• Option D . Long head of the triceps forms the medial boundary for quadrangular space and lower triangular space .</li><li>• Option D</li><li>• Long head of the triceps</li><li>• medial boundary</li><li>• quadrangular space</li><li>• lower triangular space</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Quadrangular space is an anatomic interval formed by the shaft of the humerus laterally, the long head of triceps medially, teres minor superiorly and teres major inferiorly. The quadrangular space contains Axillary nerve and the Posterior humeral circumflex artery.</li><li>• Quadrangular space is an anatomic interval formed by the shaft of the humerus laterally, the long head of triceps medially, teres minor superiorly and teres major inferiorly. The quadrangular space contains Axillary nerve and the Posterior humeral circumflex artery.</li><li>• Ref : Textbook of Anatomy upper limb and thorax, Vishram Singh, 3 rd edition, pg. 47</li><li>• Ref :</li><li>• Textbook of Anatomy upper limb and thorax, Vishram Singh, 3 rd edition, pg. 47</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old male presents to the emergency department with weakness in his right hand and difficulty extending his fingers and wrist. Physical examination reveals intact sensation but significant weakness in wrist and finger extension on the affected side. He recently had a fall and sustained a forearm injury. Which of the following muscles is most likely affected in this patient's condition, and which nerve is responsible for its innervation?", "options": [{"label": "A", "text": "Flexor Digitorum Superficialis", "correct": false}, {"label": "B", "text": "Pronator Quadratus", "correct": false}, {"label": "C", "text": "Brachioradialis", "correct": false}, {"label": "D", "text": "Extensor Digitorum", "correct": true}], "correct_answer": "D. Extensor Digitorum", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture30.jpg"], "explanation": "<p><strong>Ans. D) Extensor Digitorum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Flexor digitorum superficialis is innervated by the median nerve .</li><li>• Option A.</li><li>• median nerve</li><li>• Option B. Pronator quadratus is innervated by the anterior interosseous branch of the median nerve .</li><li>• Option B.</li><li>• anterior interosseous branch</li><li>• median nerve</li><li>• Option C. Brachioradialis is innervated by the radial nerve before termination .</li><li>• Option C.</li><li>• radial nerve</li><li>• before termination</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Extensor digitorum in the posterior compartment of the forearm is innervated by the posterior interosseous nerve .</li><li>➤ posterior compartment</li><li>➤ posterior interosseous nerve</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old office worker complains of persistent wrist pain and difficulty performing repetitive tasks on a computer keyboard. Physical examination reveals tenderness at the wrist joint and decreased range of motion, particularly during wrist flexion and extension. Radiographic evaluation shows evidence of degenerative changes in the joint space. Which of the following bones is NOT directly involved in the formation of the wrist joint?", "options": [{"label": "A", "text": "Scaphoid", "correct": false}, {"label": "B", "text": "Ulna", "correct": true}, {"label": "C", "text": "Radius", "correct": false}, {"label": "D", "text": "Triquetral", "correct": false}], "correct_answer": "B. Ulna", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture31.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/screenshot-2023-12-23-173323.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture32.jpg"], "explanation": "<p><strong>Ans. B) Ulna</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Scaphoid takes part in the formation of wrist joint.</li><li>• Option A.</li><li>• takes part</li><li>• Option C. Lower end of radius participates in the formation of wrist joint.</li><li>• Option C.</li><li>• participates</li><li>• Option D. Triquetral also participates in the formation of wrist joint.</li><li>• Option D.</li><li>• participates</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Wrist joint is an ellipsoid joint formed by articulation between lower end of radius and scaphoid , lunate and triquetral .</li><li>• ellipsoid joint</li><li>• articulation</li><li>• lower end of radius</li><li>• scaphoid</li><li>• lunate</li><li>• triquetral</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 153</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 28-year-old male presents to the emergency department with a deep laceration to his forearm sustained during a machinery accident at work. The wound is located in the forearm's anterolateral region, and bleeding is controlled. On physical examination, there is concern for potential damage to critical structures. Which of the following arteries is most likely to pierce the interosseous membrane of the forearm and be at risk for injury in this patient?", "options": [{"label": "A", "text": "Brachial Artery", "correct": false}, {"label": "B", "text": "Anterior Interosseous Artery", "correct": true}, {"label": "C", "text": "Posterior Interosseous Artery", "correct": false}, {"label": "D", "text": "Ulnar Recurrent Artery", "correct": false}], "correct_answer": "B. Anterior Interosseous Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture33.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture34.jpg"], "explanation": "<p><strong>Ans. B) Anterior Interosseous Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Brachial Artery runs down the arm and near the elbow , divides into the radial and ulnar arteries . The brachial artery does not pierce the interosseous membrane of the forearm. It remains in the upper arm and is not directly involved with the membrane.</li><li>• Brachial Artery runs down the arm and near the elbow , divides into the radial and ulnar arteries .</li><li>• down the arm</li><li>• near the elbow</li><li>• radial</li><li>• ulnar arteries</li><li>• The brachial artery does not pierce the interosseous membrane of the forearm. It remains in the upper arm and is not directly involved with the membrane.</li><li>• remains</li><li>• upper arm</li><li>• Option C.</li><li>• Option C.</li><li>• Posterior Interosseous Artery is also a branch of the common interosseous artery and primarily supplies the posterior compartment of the forearm. While it is closely associated with the interosseous membrane, it does not actually pierce the membrane. It travels around the interosseous membrane to reach the posterior compartment of the forearm.</li><li>• Posterior Interosseous Artery is also a branch of the common interosseous artery and primarily supplies the posterior compartment of the forearm.</li><li>• branch</li><li>• common interosseous artery</li><li>• supplies the posterior compartment of the forearm.</li><li>• While it is closely associated with the interosseous membrane, it does not actually pierce the membrane. It travels around the interosseous membrane to reach the posterior compartment of the forearm.</li><li>• While it is closely associated with the interosseous membrane, it does not actually pierce the membrane. It travels around the interosseous membrane to reach the posterior compartment of the forearm.</li><li>• Option D.</li><li>• Option D.</li><li>• The ulnar recurrent arteries are branches of the ulnar artery and are involved in the blood supply around the elbow joint . These arteries do not pierce the interosseous membrane. They are primarily involved in the vascular network near the elbow and do not have a direct relationship with the interosseous membrane of the forearm.</li><li>• The ulnar recurrent arteries are branches of the ulnar artery and are involved in the blood supply around the elbow joint .</li><li>• branches</li><li>• ulnar artery</li><li>• involved</li><li>• blood supply</li><li>• elbow joint</li><li>• These arteries do not pierce the interosseous membrane. They are primarily involved in the vascular network near the elbow and do not have a direct relationship with the interosseous membrane of the forearm.</li><li>• vascular network</li><li>• elbow</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Interosseous Artery is a branch of the common interosseous artery , which itself is a branch of the ulnar artery . This artery runs along the anterior surface of the interosseous membrane . The anterior interosseous artery does indeed pierce the interosseous membrane . It supplies blood to both the radius and ulna , as well as to the interosseous membrane and the deep muscles of the forearm .</li><li>➤ Anterior Interosseous Artery is a branch of the common interosseous artery , which itself is a branch of the ulnar artery .</li><li>➤ Anterior Interosseous Artery</li><li>➤ common interosseous artery</li><li>➤ branch of the ulnar artery</li><li>➤ This artery runs along the anterior surface of the interosseous membrane . The anterior interosseous artery does indeed pierce the interosseous membrane .</li><li>➤ anterior surface</li><li>➤ interosseous membrane</li><li>➤ interosseous membrane</li><li>➤ It supplies blood to both the radius and ulna , as well as to the interosseous membrane and the deep muscles of the forearm .</li><li>➤ blood</li><li>➤ both the radius</li><li>➤ ulna</li><li>➤ interosseous membrane</li><li>➤ deep muscles</li><li>➤ forearm</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 89</li><li>➤ Ref :</li><li>➤ Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 89</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 50-year-old patient presents to the clinic with weakness in the thumb and difficulty gripping objects. On examination, the patient exhibits a loss of opposition of the thumb, as well as atrophy of the thenar eminence. Which of the following muscles is primarily supplied by the median nerve and is most likely affected in this patient?", "options": [{"label": "A", "text": "Palmaris Brevis", "correct": false}, {"label": "B", "text": "Dorsal Interossei", "correct": false}, {"label": "C", "text": "Extensor Pollicis Longus", "correct": false}, {"label": "D", "text": "Flexor Pollicis Brevis", "correct": true}], "correct_answer": "D. Flexor Pollicis Brevis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture35.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture36.jpg"], "explanation": "<p><strong>Ans. D) Flexor Pollicis Brevis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Palmaris brevis is innervated by the superficial branch of the ulnar nerve .</li><li>• Option A.</li><li>• superficial branch</li><li>• ulnar nerve</li><li>• Option B. All dorsal interossei are innervated by the deep branch of the ulnar nerve .</li><li>• Option B.</li><li>• deep branch</li><li>• ulnar nerve</li><li>• Option C. Extensor pollicis longus is innervated by the posterior interosseous nerve .</li><li>• Option C.</li><li>• posterior interosseous nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Flexor pollicis brevis , Opponens pollicis , Abductor pollicis brevis , first and second lumbricals in the hand are innervated by the median nerve .</li><li>➤ Flexor pollicis brevis</li><li>➤ Opponens pollicis</li><li>➤ Abductor pollicis brevis</li><li>➤ first</li><li>➤ second lumbricals</li><li>➤ median nerve</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 166</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 166</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following muscle causes flexion of the forearm except?", "options": [{"label": "A", "text": "Brachialis", "correct": false}, {"label": "B", "text": "Brachioradialis", "correct": false}, {"label": "C", "text": "Anconeus", "correct": true}, {"label": "D", "text": "Flexor Carpi Radialis", "correct": false}], "correct_answer": "C. Anconeus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture37.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture38.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture39.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture40.jpg"], "explanation": "<p><strong>Ans. C) Anconeus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Brachialis inserts into the ulnar tuberosity and causes flexion of the forearm .</li><li>• Option A.</li><li>• ulnar tuberosity</li><li>• flexion</li><li>• forearm</li><li>• Option B. Brachioradialis is the muscle of the extensor compartment but causes flexion of the forearm.</li><li>• Option B.</li><li>• extensor compartment</li><li>• causes flexion</li><li>• Option D. Flexor carpi radialis is innervated by the median nerve and causes flexion of the forearm.</li><li>• Option D.</li><li>• median nerve</li><li>• flexion</li><li>• 5 Muscles of flexor compartment of forearm ( Superficial group ) shown in below image:</li><li>• 5 Muscles of flexor compartment of forearm ( Superficial group ) shown in below image:</li><li>• 5 Muscles</li><li>• flexor compartment</li><li>• Superficial group</li><li>• 3 Muscles of flexor compartment of forearm ( deep group ) shown in below image:</li><li>• 3 Muscles of flexor compartment of forearm ( deep group ) shown in below image:</li><li>• 3 Muscles</li><li>• flexor compartment</li><li>• forearm</li><li>• deep group</li><li>• 7 Muscles of extensor compartment of forearm ( Superficial group ) shown in below image:</li><li>• 7 Muscles of extensor compartment of forearm ( Superficial group ) shown in below image:</li><li>• 7 Muscles</li><li>• extensor compartment</li><li>• forearm</li><li>• Superficial group</li><li>• 5 Muscles of extensor compartment of forearm ( deep group ) shown in below image:</li><li>• 5 Muscles of extensor compartment of forearm ( deep group ) shown in below image:</li><li>• 5 Muscles</li><li>• extensor compartment</li><li>• forearm</li><li>• deep group</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The anconeus is a small muscle located at the Posterior aspect of the elbow.</li><li>➤ Elbow Extension : The primary function of the anconeus is to assist in extending the elbow joint . It works in conjunction with the triceps brachii , the major extensor of the elbow.</li><li>➤ Elbow Extension</li><li>➤ extending</li><li>➤ elbow joint</li><li>➤ conjunction</li><li>➤ triceps brachii</li><li>➤ Stabilization of the Elbow Joint : The anconeus also helps stabilize the elbow joint , particularly during forearm movements.</li><li>➤ Stabilization of the Elbow Joint</li><li>➤ stabilize</li><li>➤ elbow joint</li><li>➤ Forearm Supination and Pronation : Some anatomical studies suggest that the anconeus may play a minor role in supination and pronation of the forearm , although these actions are mainly performed by other muscles like the supinator and pronator teres.</li><li>➤ Forearm Supination and Pronation</li><li>➤ anconeus</li><li>➤ minor role</li><li>➤ supination</li><li>➤ pronation of the forearm</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A four year old boy while playing in the park, tried to get down from the merry-go-round all by himself but eventually fell down. His father came running towards him and picked him up with both hands. The boy started to cry and said his right elbow hurt a lot. The doctor who examined him found that the boy held his right elbow semi-flexed and forearm pronated. Identify the correct statement.", "options": [{"label": "A", "text": "Supination and pronation takes place at the elbow joint", "correct": false}, {"label": "B", "text": "Triceps brachii is a powerful supinator", "correct": false}, {"label": "C", "text": "In children less than 6 years, annular ligament is larger in diameter and head of radius can be pulled out", "correct": false}, {"label": "D", "text": "The pronators of forearm are supplied by median nerve", "correct": true}], "correct_answer": "D. The pronators of forearm are supplied by median nerve", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. D) The pronators of forearm are supplied by median nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Supination and pronation takes place at the superior and inferior radioulnar joint not at elbow joint.</li><li>• Option A.</li><li>• Supination</li><li>• pronation</li><li>• superior</li><li>• inferior radioulnar joint</li><li>• Option B. Biceps brachii and supinator causes supination . Triceps brachii causes the extension of the forearm at the elbow joint . Also, its long head contributes to the extension and adduction of the arm at the shoulder joint .</li><li>• Option B.</li><li>• Biceps brachii</li><li>• supinator</li><li>• supination</li><li>• extension</li><li>• forearm</li><li>• elbow joint</li><li>• long head</li><li>• extension</li><li>• adduction</li><li>• shoulder joint</li><li>• Option C. In children less than 6 years, the head of radius is smaller in size than the annular ligament and it can be pulled out.</li><li>• Option C.</li><li>• head of radius</li><li>• smaller in size</li><li>• annular ligament</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pronator teres and pronator quadratus are muscles of anterior compartment of forearm. Hence these are supplied by nerve of anterior compartment of forearm ie. median nerve . ( Hilton’s law )</li><li>➤ Pronator teres and pronator quadratus are muscles of anterior compartment of forearm.</li><li>➤ Pronator teres</li><li>➤ pronator quadratus</li><li>➤ anterior compartment</li><li>➤ Hence these are supplied by nerve of anterior compartment of forearm ie. median nerve . ( Hilton’s law )</li><li>➤ nerve of anterior compartment</li><li>➤ median nerve</li><li>➤ Hilton’s law</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 846</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 846</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 65-year-old patient with a history of hypertension and diabetes is admitted to the hospital with complaints of weakness in the hand and difficulty holding objects. The patient's medical history includes a recent cerebrovascular accident (CVA). A \"card test\" is performed as part of the neurological examination. Which of the following muscle groups is primarily assessed with this test to check for motor function in the hand?", "options": [{"label": "A", "text": "Lumbricals", "correct": false}, {"label": "B", "text": "Palmar Interossei", "correct": true}, {"label": "C", "text": "Dorsal Interossei", "correct": false}, {"label": "D", "text": "Adductor Pollicis", "correct": false}], "correct_answer": "B. Palmar Interossei", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture46.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/whatsapp-image-2023-12-26-at-52701-pm.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture48.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/23/picture49.jpg"], "explanation": "<p><strong>Ans. B) Palmar Interossei</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Lumbricals are involved in flexing the metacarpophalangeal joints and extending the interphalangeal joints . The lumbricals are not directly tested by the card test. This test is more focused on the adduction and abduction of fingers , which are not the primary actions of the lumbricals.</li><li>• Lumbricals are involved in flexing the metacarpophalangeal joints and extending the interphalangeal joints .</li><li>• flexing</li><li>• metacarpophalangeal joints</li><li>• extending</li><li>• interphalangeal joints</li><li>• The lumbricals are not directly tested by the card test. This test is more focused on the adduction and abduction of fingers , which are not the primary actions of the lumbricals.</li><li>• adduction</li><li>• abduction of fingers</li><li>• Option C.</li><li>• Option C.</li><li>• Dorsal Interossei are responsible for abducting the fingers away from the midline . While the dorsal interossei are important for finger movements , they are primarily involved in abduction , not adduction. Therefore, they are not the primary focus of the card test.</li><li>• Dorsal Interossei are responsible for abducting the fingers away from the midline .</li><li>• abducting</li><li>• fingers away</li><li>• midline</li><li>• While the dorsal interossei are important for finger movements , they are primarily involved in abduction , not adduction. Therefore, they are not the primary focus of the card test.</li><li>• finger movements</li><li>• abduction</li><li>• Option D.</li><li>• Option D.</li><li>• Adductor Pollicis is responsible for adducting the thumb . This muscle is not specifically evaluated by the card test. The adductor pollicis is typically tested by other maneuvers, such as asking the patient to grip something between the thumb and another finger.</li><li>• Adductor Pollicis is responsible for adducting the thumb .</li><li>• adducting the thumb</li><li>• This muscle is not specifically evaluated by the card test. The adductor pollicis is typically tested by other maneuvers, such as asking the patient to grip something between the thumb and another finger.</li><li>• asking</li><li>• patient</li><li>• grip something</li><li>• thumb</li><li>• another finger.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Palmar Interossei are responsible for adducting the fingers towards the middle finger . The card test is used to assess the function of the palmar interossei . During this test, a patient is asked to hold a card between two fingers . Difficulty in holding the card can indicate weakness in the palmar interossei , which would compromise the adduction strength of the fingers.</li><li>➤ Palmar Interossei are responsible for adducting the fingers towards the middle finger . The card test is used to assess the function of the palmar interossei .</li><li>➤ adducting the fingers</li><li>➤ towards</li><li>➤ middle finger</li><li>➤ card test</li><li>➤ assess</li><li>➤ palmar interossei</li><li>➤ During this test, a patient is asked to hold a card between two fingers . Difficulty in holding the card can indicate weakness in the palmar interossei , which would compromise the adduction strength of the fingers.</li><li>➤ asked</li><li>➤ hold</li><li>➤ card</li><li>➤ two fingers</li><li>➤ Difficulty in holding</li><li>➤ indicate weakness</li><li>➤ palmar interossei</li><li>➤ compromise</li><li>➤ adduction strength</li><li>➤ fingers.</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 170</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 170</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which muscle does not take part in dorsal digital expansion?", "options": [{"label": "A", "text": "Interossei", "correct": false}, {"label": "B", "text": "Lumbricals", "correct": false}, {"label": "C", "text": "Extensor Digitorum", "correct": false}, {"label": "D", "text": "Adductor Pollicis", "correct": true}], "correct_answer": "D. Adductor Pollicis", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture50.jpg"], "explanation": "<p><strong>Ans. D) Adductor Pollicis</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Interossei are the proximal wing tendons .</li><li>• Option A</li><li>• proximal wing tendons</li><li>• Option B. Lumbricals are the distal wing tendons .</li><li>• Option B.</li><li>• distal wing tendons</li><li>• Option C . Extensor expansion inserts into the dorsal aspect of the proximal , middle and distal phalanx .</li><li>• Option C</li><li>• dorsal aspect</li><li>• proximal</li><li>• middle</li><li>• distal phalanx</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Adductor pollicis inserts into the proximal phalanx of the thumb and is innervated by deep branch of the ulnar nerve and doesn’t contribute to extensor expansion.</li><li>• inserts</li><li>• proximal phalanx</li><li>• thumb</li><li>• innervated</li><li>• deep branch</li><li>• ulnar nerve</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 131</li><li>• Ref :</li><li>• Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old patient presents to the emergency department after sustaining a laceration to the wrist in a work-related accident. On examination, the patient exhibits difficulty extending the wrist and fingers. There is also a noticeable loss of sensation in the dorsum of the hand, specifically in the first web space. Which of the following clinical findings is most likely associated with injury to the radial nerve at the wrist?", "options": [{"label": "A", "text": "Wrist drop", "correct": false}, {"label": "B", "text": "Sensory loss on dorsum of first web space", "correct": true}, {"label": "C", "text": "Paralysis of adductor pollicis", "correct": false}, {"label": "D", "text": "Loss of supination in extended position", "correct": false}], "correct_answer": "B. Sensory loss on dorsum of first web space", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Sensory loss on dorsum of first web space</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Wrist Drop is caused by paralysis of the wrist extensors , which are primarily innervated by the PIN . However, for wrist drop to occur , the radial nerve injury would typically need to be at or above the elbow , where the nerve innervates the extensor muscles of the forearm . An injury at the wrist level usually does not cause wrist drop because the motor branches to the extensors have already branched off from the radial nerve proximally.</li><li>• Wrist Drop is caused by paralysis of the wrist extensors , which are primarily innervated by the PIN .</li><li>• paralysis</li><li>• wrist extensors</li><li>• primarily innervated</li><li>• PIN</li><li>• However, for wrist drop to occur , the radial nerve injury would typically need to be at or above the elbow , where the nerve innervates the extensor muscles of the forearm .</li><li>• wrist drop to occur</li><li>• radial nerve injury</li><li>• at or above the elbow</li><li>• nerve innervates</li><li>• extensor muscles</li><li>• forearm</li><li>• An injury at the wrist level usually does not cause wrist drop because the motor branches to the extensors have already branched off from the radial nerve proximally.</li><li>• Option C.</li><li>• Option C.</li><li>• The adductor pollicis muscle is involved in the adduction of the thumb and is innervated by the ulnar nerve , not the radial nerve. An injury to the radial nerve, regardless of the location, would not typically cause paralysis of the adductor pollicis.</li><li>• The adductor pollicis muscle is involved in the adduction of the thumb and is innervated by the ulnar nerve , not the radial nerve.</li><li>• adductor pollicis muscle</li><li>• adduction</li><li>• thumb</li><li>• innervated</li><li>• ulnar nerve</li><li>• An injury to the radial nerve, regardless of the location, would not typically cause paralysis of the adductor pollicis.</li><li>• Option D.</li><li>• Option D.</li><li>• Supination of the forearm is primarily performed by the biceps brachii and the supinator muscle . The biceps brachii is innervated by the musculocutaneous nerve , and the supinator muscle is innervated by the radial nerve . While the radial nerve does innervate the supinator muscle, its branch to this muscle is given off higher up in the arm, not at the wrist. Therefore, an injury to the radial nerve at the wrist level is unlikely to significantly impact supination.</li><li>• Supination of the forearm is primarily performed by the biceps brachii and the supinator muscle .</li><li>• Supination</li><li>• forearm</li><li>• biceps brachii</li><li>• supinator muscle</li><li>• The biceps brachii is innervated by the musculocutaneous nerve , and the supinator muscle is innervated by the radial nerve .</li><li>• biceps brachii</li><li>• musculocutaneous nerve</li><li>• supinator muscle</li><li>• radial nerve</li><li>• While the radial nerve does innervate the supinator muscle, its branch to this muscle is given off higher up in the arm, not at the wrist. Therefore, an injury to the radial nerve at the wrist level is unlikely to significantly impact supination.</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Sensory Loss on Dorsum of First Web Space:</li><li>➤ Sensory Loss on Dorsum of First Web Space:</li><li>➤ The radial nerve provides sensory innervation to the dorsum of the hand , including the first web space between the thumb and index finger . An injury to the radial nerve at the wrist level would affect its sensory function , potentially causing sensory loss in this area.</li><li>➤ The radial nerve provides sensory innervation to the dorsum of the hand , including the first web space between the thumb and index finger .</li><li>➤ sensory innervation</li><li>➤ dorsum of the hand</li><li>➤ first web space</li><li>➤ thumb</li><li>➤ index finger</li><li>➤ An injury to the radial nerve at the wrist level would affect its sensory function , potentially causing sensory loss in this area.</li><li>➤ sensory function</li><li>➤ sensory loss</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 168</li><li>➤ Ref :</li><li>➤ Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 168</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 25-year-old patient presents to the clinic with a complaint of difficulty pointing their index finger. On examination, it is noted that the patient has weakness in flexing the index finger at the metacarpophalangeal (MCP) joint, while the other fingers remain unaffected. Which nerve is most likely to be affected in this patient's injury?", "options": [{"label": "A", "text": "Median Nerve", "correct": true}, {"label": "B", "text": "Ulnar Nerve", "correct": false}, {"label": "C", "text": "Radial Nerve", "correct": false}, {"label": "D", "text": "Musculocutaneous Nerve", "correct": false}], "correct_answer": "A. Median Nerve", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture52.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture53.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture54.jpg"], "explanation": "<p><strong>Ans. A) Median Nerve</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Ulnar nerve injury will result in claw hands .</li><li>• Option B.</li><li>• Ulnar nerve injury</li><li>• claw hands</li><li>• Option C. Radial nerve injury results in wrist drop .</li><li>• Option C.</li><li>• Radial nerve injury</li><li>• wrist drop</li><li>• Option D. Injury to musculocutaneous nerve results in inability to flex elbow joint ( brachialis , biceps brachii paralysis) and loss of cutaneous sensation over lateral aspect of forearm ( Lateral cutaneous nerve of forearm ).</li><li>• Option D.</li><li>• Injury</li><li>• musculocutaneous nerve</li><li>• inability</li><li>• flex elbow joint</li><li>• brachialis</li><li>• biceps brachii paralysis)</li><li>• loss</li><li>• cutaneous sensation</li><li>• lateral aspect of forearm</li><li>• Lateral cutaneous nerve of forearm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Inability to flex the distal phalanx of index finger is called pointing index which occurs due to paralysis of Flexor digitorum profundus innervated by anterior interosseous nerve , branch of median nerve .</li><li>➤ Inability to flex</li><li>➤ distal phalanx</li><li>➤ index finger</li><li>➤ pointing index</li><li>➤ paralysis of Flexor digitorum</li><li>➤ profundus</li><li>➤ anterior interosseous nerve</li><li>➤ median nerve</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 165</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 165</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents to the clinic with symptoms of numbness and tingling in the median nerve distribution of the hand. During the examination, the physician discusses the anatomy of the wrist and flexor retinaculum. Which of the following structures does NOT pass under the flexor retinaculum in the wrist?", "options": [{"label": "A", "text": "Flexor Digitorum Superficialis", "correct": false}, {"label": "B", "text": "Median Nerve", "correct": false}, {"label": "C", "text": "Radial Artery", "correct": true}, {"label": "D", "text": "Flexor Digitorum Profundus", "correct": false}], "correct_answer": "C. Radial Artery", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture55.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture56_o73j8G9.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture57.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/screenshot-2023-12-26-094429.jpg"], "explanation": "<p><strong>Ans. C) Radial Artery</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Flexor Digitorum Superficialis tendons pass under the flexor retinaculum . They are part of the tendons that travel through the carpal tunnel and are involved in flexing the fingers .</li><li>• Option A.</li><li>• flexor retinaculum</li><li>• tendons</li><li>• travel through</li><li>• carpal tunnel</li><li>• involved</li><li>• flexing the fingers</li><li>• Option B. Median Nerve also travels under the flexor retinaculum . It is a significant structure within the carpal tunnel and is responsible for the sensory and motor innervation of parts of the hand .</li><li>• Option B.</li><li>• travels under</li><li>• flexor retinaculum</li><li>• significant structure</li><li>• carpal tunnel</li><li>• responsible</li><li>• sensory</li><li>• motor innervation</li><li>• parts</li><li>• hand</li><li>• Option D. The tendons of the flexor digitorum profundus also pass under the flexor retinaculum . Like the flexor digitorum superficialis, these tendons are involved in the flexion of the fingers and travel through the carpal tunnel .</li><li>• Option D.</li><li>• pass under the flexor retinaculum</li><li>• tendons</li><li>• involved</li><li>• flexion</li><li>• fingers</li><li>• travel</li><li>• carpal tunnel</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Radial Artery, one of the major arteries of the forearm, does not pass under the flexor retinaculum. It travels on the lateral side of the forearm and wrist and does not enter the carpal tunnel. Radial artery enters the palmar surface of the hand by passing between two heads of the first dorsal interossei .</li><li>➤ Radial Artery, one of the major arteries of the forearm, does not pass under the flexor retinaculum.</li><li>➤ Radial Artery,</li><li>➤ It travels on the lateral side of the forearm and wrist and does not enter the carpal tunnel.</li><li>➤ travels</li><li>➤ lateral side</li><li>➤ forearm</li><li>➤ wrist</li><li>➤ Radial artery enters the palmar surface of the hand by passing between two heads of the first dorsal interossei .</li><li>➤ enters</li><li>➤ palmar surface</li><li>➤ hand</li><li>➤ passing between</li><li>➤ two heads</li><li>➤ first dorsal interossei</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 131</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents to the neurology clinic with complaints of weakness and clumsiness in their hand, particularly involving the ulnar-sided fingers. The physician is evaluating for possible ulnar nerve injury and discusses various diagnostic tests during the examination. Which of the following tests is NOT typically used to detect ulnar nerve injury?", "options": [{"label": "A", "text": "Card Test", "correct": false}, {"label": "B", "text": "Egawa Test", "correct": false}, {"label": "C", "text": "Pen Test", "correct": true}, {"label": "D", "text": "Froment's Sign", "correct": false}], "correct_answer": "C. Pen Test", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture58.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture59.jpg"], "explanation": "<p><strong>Ans. C) Pen Test</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B. Egawa Test is less commonly referenced and not a standard test for ulnar nerve functions. It's not typically associated with the assessment of ulnar nerve injury.</li><li>• Option B.</li><li>• less commonly referenced</li><li>• Option D. Froment's Sign is a clinical test specifically used to identify ulnar nerve palsy . The test involves asking the patient to grip a piece of paper between the thumb and index finger . If the patient flexes the thumb’s distal phalanx (due to weakness in the adductor pollicis , which is innervated by the ulnar nerve ), it indicates a positive Froment's sign .</li><li>• Option D.</li><li>• clinical test</li><li>• identify ulnar nerve palsy</li><li>• grip</li><li>• piece of paper</li><li>• thumb and index finger</li><li>• flexes</li><li>• thumb’s distal phalanx</li><li>• weakness</li><li>• adductor pollicis</li><li>• ulnar nerve</li><li>• positive Froment's sign</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Card Test is used to assess the function of the palmar interossei muscles , which are innervated by the ulnar nerve . The test involves holding a card between two fingers ( other than the thumb ) and can reveal weakness in these muscles, indicating potential ulnar nerve injury .</li><li>• Card Test</li><li>• assess</li><li>• function</li><li>• palmar interossei</li><li>• muscles</li><li>• ulnar nerve</li><li>• holding</li><li>• card</li><li>• two fingers</li><li>• other than the thumb</li><li>• reveal weakness</li><li>• potential ulnar nerve injury</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 165</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 165</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A patient suffering from Hansen’s disease had burnt his left hand unintentionally. The physician on examination noted loss of sensation in medial one and half fingers and medial side of palmar and dorsal aspects of left hand. In addition, there was flattening of hypothenar eminence and difficulty in holding a card between thumb and index finger. Identify the incorrect statement pertaining to the above scenario:", "options": [{"label": "A", "text": "Ulnar Nerve is injured", "correct": false}, {"label": "B", "text": "Card Test is done to test for contraction of Dorsal Interossei", "correct": true}, {"label": "C", "text": "Hypothenar Muscles arise from Pisiform and Hamate", "correct": false}, {"label": "D", "text": "Palmaris Brevis is remnant of Panniculus Carnosus", "correct": false}], "correct_answer": "B. Card Test is done to test for contraction of Dorsal Interossei", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. B) Card test is done to test for contraction of Dorsal Interossei</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• The symptoms of loss of sensation in the medial one and a half fingers and the medial side of the hand, along with flattening of the hypothenar eminence , are indicative of ulnar nerve injury or impairment. The ulnar nerve innervates the hypothenar muscles and provides sensation to this area of the hand.</li><li>• The symptoms of loss of sensation in the medial one and a half fingers and the medial side of the hand, along with flattening of the hypothenar eminence , are indicative of ulnar nerve injury or impairment.</li><li>• loss of sensation</li><li>• medial one</li><li>• half fingers</li><li>• medial side</li><li>• flattening</li><li>• hypothenar eminence</li><li>• indicative</li><li>• ulnar nerve injury</li><li>• impairment.</li><li>• The ulnar nerve innervates the hypothenar muscles and provides sensation to this area of the hand.</li><li>• hypothenar muscles</li><li>• sensation</li><li>• area</li><li>• Option C.</li><li>• Option C.</li><li>• The Hypothenar muscles, which include the Abductor Digiti Minimi, Flexor Digiti Minimi Brevis, and Opponens Digiti Minimi , indeed have origins involving the pisiform and the hook of the hamate . These muscles contribute to movements of the little finger and are innervated by the ulnar nerve .</li><li>• The Hypothenar muscles, which include the Abductor Digiti Minimi, Flexor Digiti Minimi Brevis, and Opponens Digiti Minimi , indeed have origins involving the pisiform and the hook of the hamate .</li><li>• Abductor Digiti Minimi, Flexor Digiti Minimi Brevis,</li><li>• Opponens Digiti Minimi</li><li>• origins</li><li>• pisiform</li><li>• hook</li><li>• hamate</li><li>• These muscles contribute to movements of the little finger and are innervated by the ulnar nerve .</li><li>• contribute</li><li>• movements</li><li>• little finger</li><li>• innervated</li><li>• ulnar nerve</li><li>• Option D.</li><li>• Option D.</li><li>• Palmaris Brevis is a small muscle in the hand that is considered a remnant of the panniculus carnosus , an extensive sheet of muscle found in many mammals . In humans, only a few remnants of this muscle group remain, including the palmaris brevis .</li><li>• Palmaris Brevis is a small muscle in the hand that is considered a remnant of the panniculus carnosus , an extensive sheet of muscle found in many mammals .</li><li>• small muscle</li><li>• hand</li><li>• remnant</li><li>• panniculus carnosus</li><li>• extensive sheet</li><li>• many mammals</li><li>• In humans, only a few remnants of this muscle group remain, including the palmaris brevis .</li><li>• only</li><li>• few remnants</li><li>• palmaris brevis</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Card Test is done to Test for Contraction of Dorsal Interosseous: The card test is actually used to assess the function of the palmar interossei muscles , which are responsible for adducting the fingers and are innervated by the ulnar nerve . The dorsal interossei , responsible for finger abduction , are not specifically tested by the card test.</li><li>➤ assess the function</li><li>➤ palmar interossei muscles</li><li>➤ adducting the fingers</li><li>➤ ulnar nerve</li><li>➤ dorsal interossei</li><li>➤ finger abduction</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 893</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg no. 893</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 22-year-old male was referred to the emergency room after a fall from height on stretched left wrist. Pain, tenderness were noticed in the region of the anatomical snuff box of her left hand. X-ray showed fracture of scaphoid bone. Identify the correct statement:", "options": [{"label": "A", "text": "Fracture of Scaphoid has a Low incidence of Non Union", "correct": false}, {"label": "B", "text": "Scaphoid Bone Articulates with Five Bones totally", "correct": true}, {"label": "C", "text": "Scaphoid Bone can be easily Immobilized", "correct": false}, {"label": "D", "text": "Fracture Line on the Scaphoid Bone may deprive the Distal Fragment of its Arterial Supply", "correct": false}], "correct_answer": "B. Scaphoid Bone Articulates with Five Bones totally", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture60.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/whatsapp-image-2023-12-26-at-52701-pm-1.jpeg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/screenshot-2023-12-26-095943.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture62_w8ptSL7.jpg"], "explanation": "<p><strong>Ans. B) Scaphoid Bone Articulates with Five Bones totally</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Scaphoid fractures actually have a relatively high incidence of non-union . This is due to the peculiar blood supply of the scaphoid , where the blood enters the bone distally and travels proximally .</li><li>• Scaphoid fractures actually have a relatively high incidence of non-union .</li><li>• Scaphoid fractures</li><li>• relatively high incidence</li><li>• non-union</li><li>• This is due to the peculiar blood supply of the scaphoid , where the blood enters the bone distally and travels proximally .</li><li>• peculiar blood supply</li><li>• scaphoid</li><li>• blood</li><li>• bone distally</li><li>• travels proximally</li><li>• In case of a fracture , especially in the proximal part , this can lead to avascular necrosis and non-union .</li><li>• In case of a fracture , especially in the proximal part , this can lead to avascular necrosis and non-union .</li><li>• fracture</li><li>• proximal part</li><li>• avascular necrosis</li><li>• non-union</li><li>• Option C.</li><li>• Option C.</li><li>• Immobilization of the scaphoid bone can be challenging due to its location and the range of movements in the wrist . Proper healing often requires a specific type of cast or splint known as GLASS HOLDING CAST that immobilizes not just the wrist but also the thumb , as movement of the thumb can disturb the scaphoid .</li><li>• Immobilization of the scaphoid bone can be challenging due to its location and the range of movements in the wrist .</li><li>• Immobilization</li><li>• scaphoid bone</li><li>• challenging</li><li>• location</li><li>• range of movements</li><li>• wrist</li><li>• Proper healing often requires a specific type of cast or splint known as GLASS HOLDING CAST that immobilizes not just the wrist but also the thumb , as movement of the thumb can disturb the scaphoid .</li><li>• Proper healing</li><li>• specific type of cast</li><li>• splint</li><li>• GLASS HOLDING CAST</li><li>• immobilizes not just the wrist</li><li>• thumb</li><li>• disturb the scaphoid</li><li>• Option D.</li><li>• Option D.</li><li>• In scaphoid fractures, it's typically the proximal fragment that is at risk of losing its blood supply , not the distal fragment. This is because the blood supply to the scaphoid enters distally and travels proximally . If there is a fracture, especially in the proximal part, it can compromise the blood flow to the proximal fragment .</li><li>• In scaphoid fractures, it's typically the proximal fragment that is at risk of losing its blood supply , not the distal fragment.</li><li>• proximal fragment</li><li>• risk</li><li>• losing</li><li>• blood supply</li><li>• This is because the blood supply to the scaphoid enters distally and travels proximally .</li><li>• blood supply</li><li>• scaphoid</li><li>• distally</li><li>• travels proximally</li><li>• If there is a fracture, especially in the proximal part, it can compromise the blood flow to the proximal fragment .</li><li>• compromise</li><li>• blood flow</li><li>• proximal fragment</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Scaphoid Bone Articulates with Five Bones Totally : The scaphoid bone, one of the carpal bones in the wrist , articulates with five other bones: the radius proximally; the trapezium distally on the thumb side; and the lunate, capitate, and trapezoid on its ulnar side.</li><li>➤ Scaphoid Bone Articulates with Five Bones Totally</li><li>➤ one</li><li>➤ carpal bones</li><li>➤ wrist</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 868</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 868</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 54-year-old man had noticed during the past 3 months a thickening of the skin at the base of his right ring finger, which tried to pull his finger towards palm. He consulted his physician. On examination of the palms of both hands, a localized thickening of subcutaneous tissue could be felt at the base of the right ring and little fingers. The metacarpophalangeal joint of the ring finger could not be fully extended, either actively or passively. Identify the incorrect statement:", "options": [{"label": "A", "text": "The patient had Dupuytren's Contracture", "correct": false}, {"label": "B", "text": "Palmar Aponeurosis is thickening of Deep Fascia of Palm", "correct": false}, {"label": "C", "text": "Each slip is attached to the Base of the Middle Phalanx and to the Fibrous Flexor Sheath of each finger", "correct": true}, {"label": "D", "text": "The Palmar Aponeurosis distally it divides into Four Slips", "correct": false}], "correct_answer": "C. Each slip is attached to the Base of the Middle Phalanx and to the Fibrous Flexor Sheath of each finger", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) Each slip is attached to the Base of the Middle Phalanx and to the Fibrous Flexor Sheath of each finger</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Dupuytren's Contracture is characterized by progressive thickening and shortening of the palmar fascia , leading to flexion contractures of the fingers, commonly the ring and little fingers . The symptoms described, including the thickening of the skin at the base of the ring finger and the inability to fully extend the metacarpophalangeal joint , align with Dupuytren's contracture .</li><li>• Dupuytren's Contracture is characterized by progressive thickening and shortening of the palmar fascia , leading to flexion contractures of the fingers, commonly the ring and little fingers .</li><li>• characterized</li><li>• thickening</li><li>• shortening</li><li>• palmar fascia</li><li>• leading</li><li>• flexion contractures</li><li>• ring</li><li>• little fingers</li><li>• The symptoms described, including the thickening of the skin at the base of the ring finger and the inability to fully extend the metacarpophalangeal joint , align with Dupuytren's contracture .</li><li>• thickening</li><li>• base</li><li>• ring finger</li><li>• inability</li><li>• fully extend</li><li>• metacarpophalangeal joint</li><li>• Dupuytren's contracture</li><li>• Option B.</li><li>• Option B.</li><li>• The palmar aponeurosis is indeed a thickening of the deep fascia in the palm of the hand. It plays a key role in the structure and function of the hand, and its pathological thickening and contraction are central to Dupuytren's contracture .</li><li>• The palmar aponeurosis is indeed a thickening of the deep fascia in the palm of the hand. It plays a key role in the structure and function of the hand, and its pathological thickening and contraction are central to Dupuytren's contracture .</li><li>• thickening</li><li>• deep fascia</li><li>• palm</li><li>• key role</li><li>• structure</li><li>• function</li><li>• pathological thickening</li><li>• contraction</li><li>• central</li><li>• Dupuytren's contracture</li><li>• Option D.</li><li>• Option D.</li><li>• The palmar aponeurosis distally divides into slips that extend towards the fingers . While the number of slips can vary , typically, it divides into four or five slips extending towards the digits .</li><li>• The palmar aponeurosis distally divides into slips that extend towards the fingers . While the number of slips can vary , typically, it divides into four or five slips extending towards the digits .</li><li>• extend towards</li><li>• fingers</li><li>• number of slips</li><li>• vary</li><li>• four or five slips</li><li>• towards the digits</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ In Dupuytren's contracture, the pathological changes occur in the palmar aponeurosis and related structures. However, the palmar aponeurosis does not normally attach to the base of the middle phalanx. Instead, it primarily attaches to the bases of the proximal phalanges and the overlying skin .</li><li>➤ In Dupuytren's contracture, the pathological changes occur in the palmar aponeurosis and related structures.</li><li>➤ pathological changes</li><li>➤ palmar aponeurosis</li><li>➤ However, the palmar aponeurosis does not normally attach to the base of the middle phalanx. Instead, it primarily attaches to the bases of the proximal phalanges and the overlying skin .</li><li>➤ attaches</li><li>➤ bases</li><li>➤ proximal phalanges</li><li>➤ overlying skin</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 86</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg no. 86</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 10-year-old boy was trying to pour water from a glass jar into his cup but the glass jar slipped off his fingers and fell down. As he tried to gather the broken pieces of glass, he noticed that one of those glass pieces deeply pierced the skin on the front of his right wrist. On examination, a small wound was present in the front of his forearm and the palmaris longus tendon had been severed. The thumb was laterally rotated and adducted, and the boy was unable to oppose his thumb to the other fingers. There was loss of skin sensation over the lateral half of the palm and the palmar aspect of the lateral three and a half fingers.The following facts concerning this patient are correct except?", "options": [{"label": "A", "text": "Adduction of thumb is caused by adductor pollicis that is supplied by ulnar nerve", "correct": false}, {"label": "B", "text": "Opposition of thumb is produced by opponens pollicis that is innervated by median nerve", "correct": false}, {"label": "C", "text": "The median nerve lies in the interval between the tendons of flexor digitorum superficialis and the palmaris longus just proximal to the wrist joint", "correct": true}, {"label": "D", "text": "Sensory loss of the distal part of the dorsal surfaces of the lateral three and a half fingers was present", "correct": false}], "correct_answer": "C. The median nerve lies in the interval between the tendons of flexor digitorum superficialis and the palmaris longus just proximal to the wrist joint", "question_images": [], "explanation_images": [], "explanation": "<p><strong>Ans. C) The median nerve lies in the interval between the tendons of flexor digitorum superficialis and the palmaris longus just proximal to the wrist joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The adductor pollicis muscle is indeed responsible for the adduction of the thumb , and it is innervated by the ulnar nerve . This aligns with the clinical presentation if the ulnar nerve is affected.</li><li>• Option A.</li><li>• adductor pollicis muscle</li><li>• responsible</li><li>• adduction</li><li>• thumb</li><li>• ulnar nerve</li><li>• aligns</li><li>• Option B. The opponens pollicis muscle , which facilitates the opposition of the thumb , is innervated by the median nerve . Loss of opposition ability in the thumb suggests median nerve injury .</li><li>• Option B.</li><li>• opponens pollicis muscle</li><li>• facilitates</li><li>• opposition</li><li>• thumb</li><li>• median nerve</li><li>• Loss of opposition</li><li>• thumb</li><li>• median nerve injury</li><li>• Option D. The median nerve provides sensory innervation to the palmar aspect of the lateral three and a half fingers .</li><li>• Option D.</li><li>• median nerve</li><li>• sensory innervation</li><li>• palmar aspect</li><li>• lateral three</li><li>• half fingers</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ :</li><li>➤ The Median Nerve Lies in the Interval between the Tendons of Flexor Digitorum Superficialis and the Palmaris Longus Just Proximal to the Wrist Joint: The median nerve does not lie between the tendons of the flexor digitorum superficialis and the palmaris longus. Just proximal to the wrist joint, the median nerve is actually located more medially , typically lying just lateral to the tendon of the flexor carpi radialis and under the flexor retinaculum . The palmaris longus , when present, tends to be more superficial and median to the median nerve .</li><li>➤ The Median Nerve Lies in the Interval between the Tendons of Flexor Digitorum Superficialis and the Palmaris Longus Just Proximal to the Wrist Joint: The median nerve does not lie between the tendons of the flexor digitorum superficialis and the palmaris longus.</li><li>➤ does not lie</li><li>➤ Just proximal to the wrist joint, the median nerve is actually located more medially , typically lying just lateral to the tendon of the flexor carpi radialis and under the flexor retinaculum . The palmaris longus , when present, tends to be more superficial and median to the median nerve .</li><li>➤ actually located</li><li>➤ medially</li><li>➤ lateral</li><li>➤ tendon of the flexor carpi radialis</li><li>➤ under</li><li>➤ flexor retinaculum</li><li>➤ palmaris longus</li><li>➤ tends</li><li>➤ more superficial</li><li>➤ median</li><li>➤ median nerve</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg. 891</li><li>➤ Ref :</li><li>➤ Gray’s Anatomy 41 st edition, pg. 891</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are incorrect about the pointed Area A in the given image except?", "options": [{"label": "A", "text": "It is located on the dorsal aspect of hand and becomes visible when the thumb is fully abducted adducted", "correct": false}, {"label": "B", "text": "Floor is formed by styloid process of radius, base of first metacarpal bone", "correct": true}, {"label": "C", "text": "Medially by tendon of extensor pollicis brevis", "correct": false}, {"label": "D", "text": "Laterally by extensor carpi radialis longus", "correct": false}], "correct_answer": "B. Floor is formed by styloid process of radius, base of first metacarpal bone", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/12/whatsapp-image-2023-12-12-at-121915-pm-1.jpeg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture64.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture65_0rLdSLz.jpg"], "explanation": "<p><strong>Ans. B) Floor is formed by styloid process of radius, base of first metacarpal bone</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• This statement is incorrect . The anatomical snuffbox is located on the dorsal (back) aspect of the hand and becomes more prominent when the thumb is hyperextended .</li><li>• This statement is incorrect . The anatomical snuffbox is located on the dorsal (back) aspect of the hand and becomes more prominent when the thumb is hyperextended .</li><li>• incorrect</li><li>• dorsal (back)</li><li>• more prominent</li><li>• thumb</li><li>• hyperextended</li><li>• Option C .</li><li>• Option C</li><li>• This statement is incorrect . The medial border or boundary of the anatomical snuffbox is indeed formed by the tendon of the extensor pollicis longus muscle . This muscle plays a role in extending the thumb at the metacarpophalangeal joint .</li><li>• This statement is incorrect . The medial border or boundary of the anatomical snuffbox is indeed formed by the tendon of the extensor pollicis longus muscle . This muscle plays a role in extending the thumb at the metacarpophalangeal joint .</li><li>• incorrect</li><li>• medial border</li><li>• boundary</li><li>• anatomical snuffbox</li><li>• tendon</li><li>• extensor pollicis longus muscle</li><li>• extending</li><li>• thumb</li><li>• metacarpophalangeal joint</li><li>• Option D.</li><li>• Option D.</li><li>• This statement is also incorrect . The lateral border or boundary of the anatomical snuffbox is indeed formed by the tendon of the abductor pollicis longus and Extensor pollicis brevis . This muscle extends the wrist and abducts the hand .</li><li>• This statement is also incorrect . The lateral border or boundary of the anatomical snuffbox is indeed formed by the tendon of the abductor pollicis longus and Extensor pollicis brevis . This muscle extends the wrist and abducts the hand .</li><li>• incorrect</li><li>• lateral border</li><li>• boundary</li><li>• tendon</li><li>• abductor pollicis longus</li><li>• Extensor pollicis brevis</li><li>• extends</li><li>• wrist</li><li>• abducts</li><li>• hand</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anatomical Snuff Box (ASB) - From proximal to distal, floor is formed by the styloid process of radius, scaphoid , trapezium and base of first metacarpal bone . Radial artery crosses the floor .</li><li>➤ Anatomical Snuff Box (ASB) - From proximal to distal, floor is formed by the styloid process of radius, scaphoid , trapezium and base of first metacarpal bone . Radial artery crosses the floor .</li><li>➤ Anatomical Snuff Box (ASB) -</li><li>➤ proximal</li><li>➤ distal, floor</li><li>➤ styloid process</li><li>➤ radius, scaphoid</li><li>➤ trapezium</li><li>➤ base of first metacarpal bone</li><li>➤ Radial artery</li><li>➤ crosses</li><li>➤ floor</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 101</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which among the following is true about the structure labelled A?", "options": [{"label": "A", "text": "It begins at the level of Head of Radius", "correct": false}, {"label": "B", "text": "It is the Lateral most structure at the level of the Wrist", "correct": false}, {"label": "C", "text": "It passes between the two heads of first Dorsal Interossei Muscle", "correct": true}, {"label": "D", "text": "It winds dorsally beneath the tendons of Extensor Pollicis Longus", "correct": false}], "correct_answer": "C. It passes between the two heads of first Dorsal Interossei Muscle", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture66.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture67.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture68.jpg"], "explanation": "<p><strong>Ans. C) It passes between the two heads of first dorsal interossei muscle</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The radial artery does not begin at the level of the head of the radius. It is a branch of the brachial artery and originates at the level of the neck of the radius , just below the elbow , not at the head of the radius.</li><li>• Option A.</li><li>• branch</li><li>• brachial artery</li><li>• originates</li><li>• level</li><li>• neck</li><li>• radius</li><li>• below the elbow</li><li>• Option B. At the wrist level , the radial artery is not the lateral-most structure. It lies on the lateral side of the wrist but is usually accompanied by other structures such as tendons .</li><li>• Option B.</li><li>• wrist level</li><li>• lies</li><li>• lateral side</li><li>• usually accompanied</li><li>• tendons</li><li>• Option D. The radial artery does not wind dorsally beneath the tendons of the extensor pollicis longus. The artery remains primarily on the palmar aspect of the wrist and does not traverse to the dorsal side beneath these tendons.</li><li>• Option D.</li><li>• artery</li><li>• palmar aspect</li><li>• wrist</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ It Passes Between the Two Heads of First Dorsal Interossei Muscle: The radial artery pass between the two heads of the first dorsal interossei muscle and enters into the palm from the dorsum of the hand.</li><li>➤ It Passes Between the Two Heads of First Dorsal Interossei Muscle:</li><li>➤ two heads</li><li>➤ first dorsal interossei muscle</li><li>➤ palm</li><li>➤ dorsum</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 101</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 101</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "Which of the following statements is incorrect about the nerve involved in causing the deformity in the given image?", "options": [{"label": "A", "text": "It passes deep to the flexor retinaculum", "correct": true}, {"label": "B", "text": "In the lower half of forearm it has a subfascial course", "correct": false}, {"label": "C", "text": "It enters the palm on the radial side of pisiform bone", "correct": false}, {"label": "D", "text": "In the lower half, it lies superficial and lateral to flexor carpi ulnaris.", "correct": false}], "correct_answer": "A. It passes deep to the flexor retinaculum", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/22/picture-24_j4EczZD.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture70.jpg"], "explanation": "<p><strong>Ans. A) It passes deep to the flexor retinaculum</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option B . Ulnar nerve is deeply placed in the proximal part of the forearm, whereas in the distal forearm, it has a subfascial course.</li><li>• Option B</li><li>• Option C . Ulnar nerve is accompanied by ulnar artery that enters the palm on the radial side of the pisiform bone.</li><li>• Option C</li><li>• Option D . The nerve enters the forearm by passing between the two heads of flexor carpi ulnaris. In the upper third of forearm, it runs almost vertically downwards under flexor carpi ulnaris. In the lower two-third of the forearm, it becomes superficial and lies lateral to the flexor carpi ulnaris. In this part of its course the ulnar nerve and artery descend together, artery being on the lateral side of the nerve.</li><li>• Option D</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The ulnar nerve does not pass deep to the flexor retinaculum. Instead, it travels superficial to the flexor retinaculum, entering the hand via Guyon's canal, a space different from the carpal tunnel where the median nerve and flexor tendons pass under the flexor retinaculum.</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 110</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 110</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 60-year-old patient presents to the orthopedic clinic with complaints of progressive weakness in his right hand. The patient reports difficulty in fine movements of hand. Doctor performed a test over patient as shown in image. Which of the following statements is true about the given image?", "options": [{"label": "A", "text": "The median nerve of the right hand is injured.", "correct": false}, {"label": "B", "text": "There is weakness of thenar muscles on the right side", "correct": false}, {"label": "C", "text": "The adductor pollicis of the right side is weak", "correct": true}, {"label": "D", "text": "The flexor muscles of the thumb of the right hand is weak", "correct": false}], "correct_answer": "C. The adductor pollicis of the right side is weak", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/22/picture-25.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. C) The adductor pollicis of the right side is weak</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . The median nerve is not injured as the inability to adduct the thumb is due to injury to the ulnar nerve .</li><li>• Option A</li><li>• due to injury</li><li>• ulnar nerve</li><li>• Option B. The thenar muscles are innervated by the median nerve. Hence no weakness of thenar muscles on the right side will be found because damaged nerve in this case is ulnar nerve.</li><li>• Option B.</li><li>• no weakness of thenar muscles</li><li>• Option D. The flexor pollicis brevis muscles is supplied by the median nerve and flexor pollicis longus is supplied by the anterior interosseous branch of the median nerve in the forearm . So, they are not weak on the right side.</li><li>• Option D.</li><li>• flexor pollicis brevis muscles</li><li>• median nerve</li><li>• flexor pollicis longus</li><li>• anterior interosseous</li><li>• median nerve</li><li>• forearm</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ The adductor pollicis is innervated by a deep branch of the ulnar nerve and causes adduction of the thumb . The patient is unable to adduct his thumb due to paralysis of adductor pollicis which is supplied by the ulnar nerve . He tries to hold the book by flexing his thumb.</li><li>➤ The adductor pollicis is innervated by a deep branch of the ulnar nerve and causes adduction of the thumb . The patient is unable to adduct his thumb due to paralysis of adductor pollicis which is supplied by the ulnar nerve . He tries to hold the book by flexing his thumb.</li><li>➤ adductor pollicis</li><li>➤ deep branch</li><li>➤ ulnar nerve</li><li>➤ adduction</li><li>➤ thumb</li><li>➤ unable</li><li>➤ adduct his thumb</li><li>➤ paralysis</li><li>➤ adductor pollicis</li><li>➤ ulnar nerve</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 131</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 131</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "An eight-year-old male child managed to take his board game from the loft after standing on top of two chairs one over the other. But while trying to get down, he fell down from the topmost and experienced severe pain over his right hand, back &amp; leg. The image given is his x-ray. Which of the following statements is true pertaining to the given case?", "options": [{"label": "A", "text": "The scaphoid is the largest carpal bone", "correct": false}, {"label": "B", "text": "Trapezium is the largest carpal bone", "correct": false}, {"label": "C", "text": "Pisiform bone is not seen in this x-ray", "correct": true}, {"label": "D", "text": "Lunate is the smallest carpal bone", "correct": false}], "correct_answer": "C. Pisiform bone is not seen in this x-ray", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture-27_zmze7bs.jpg"], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture74.jpg"], "explanation": "<p><strong>Ans. C) Pisiform bone is not seen in this x-ray</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. The scaphoid is not the largest carpal bone; capitate is the largest carpal bone .</li><li>• Option A.</li><li>• capitate</li><li>• largest carpal bone</li><li>• Option B. Trapezium is also not the the largest carpal bone.</li><li>• Option B.</li><li>• not</li><li>• Option D . Pisiform is the smallest carpal bone, not the Lunate.</li><li>• Option D</li><li>• Pisiform</li><li>• smallest</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pisiform bone is the: Smallest Bone Last Bone to ossify ( 12 th year ) Sesamoid Bone ( within the tendon of flexor carpi ulnaris ) Capitate is the largest of carpal bones and starts ossification first .</li><li>➤ Pisiform bone is the: Smallest Bone Last Bone to ossify ( 12 th year ) Sesamoid Bone ( within the tendon of flexor carpi ulnaris ) Capitate is the largest of carpal bones and starts ossification first .</li><li>➤ Pisiform bone</li><li>➤ Smallest Bone Last Bone to ossify ( 12 th year ) Sesamoid Bone ( within the tendon of flexor carpi ulnaris ) Capitate is the largest of carpal bones and starts ossification first .</li><li>➤ Smallest Bone</li><li>➤ Smallest Bone</li><li>➤ Last Bone to ossify ( 12 th year )</li><li>➤ Last Bone</li><li>➤ ossify</li><li>➤ 12 th year</li><li>➤ Sesamoid Bone ( within the tendon of flexor carpi ulnaris )</li><li>➤ Sesamoid Bone</li><li>➤ within</li><li>➤ tendon</li><li>➤ flexor carpi ulnaris</li><li>➤ Capitate is the largest of carpal bones and starts ossification first .</li><li>➤ Capitate</li><li>➤ largest</li><li>➤ starts ossification first</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 29</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 29</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 45-year-old patient presents to the orthopedic clinic with a history of shoulder pain and limited range of motion. The physician suspects rotator cuff pathology and discusses the relevant muscles during the examination. Which of the following muscles is NOT considered part of the rotator cuff group and is not typically associated with rotator cuff injuries?", "options": [{"label": "A", "text": "Subscapularis", "correct": false}, {"label": "B", "text": "Supraspinatus", "correct": false}, {"label": "C", "text": "Teres Major", "correct": true}, {"label": "D", "text": "Teres Minor", "correct": false}], "correct_answer": "C. Teres Major", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture75.jpg"], "explanation": "<p><strong>Ans. C) Teres Major</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Subscapularis is innervated by upper and lower subscapular nerves .</li><li>• Option A</li><li>• upper</li><li>• lower subscapular nerves</li><li>• Option B . Supraspinatus and infraspinatus are innervated by suprascapular nerve .</li><li>• Option B</li><li>• suprascapular nerve</li><li>• Option D. Teres minor is innervated by the axillary nerve . Teres major is innervated by lower subscapular nerve .</li><li>• Option D.</li><li>• axillary nerve</li><li>• lower subscapular nerve</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• Subscapularis , supraspinatus , infraspinatus and teres minor form the rotator cuff muscles .</li><li>• Subscapularis , supraspinatus , infraspinatus and teres minor form the rotator cuff muscles .</li><li>• Subscapularis</li><li>• supraspinatus</li><li>• infraspinatus</li><li>• teres minor</li><li>• rotator cuff muscles</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 73</li><li>• Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 73</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 35-year-old patient is seen in the Orthopedic clinic for complaints of shoulder pain and limited range of motion following a recent injury. During the examination, the physician assesses the patient's shoulder muscles and their functions. Which of the following actions is NOT typically caused by the deltoid muscle?", "options": [{"label": "A", "text": "Flexion Shoulder", "correct": false}, {"label": "B", "text": "Extension Shoulder", "correct": false}, {"label": "C", "text": "Internal Rotation Shoulder", "correct": false}, {"label": "D", "text": "Adduction Shoulder", "correct": true}], "correct_answer": "D. Adduction Shoulder", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture76.jpg"], "explanation": "<p><strong>Ans. D) Adduction Shoulder</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation :</li><li>• Option A . Anterior fibres of deltoid arising from the clavicle causes flexion and internal rotation of the shoulder joint.</li><li>• Option A</li><li>• flexion</li><li>• internal rotation</li><li>• Option B . Posterior fibres of deltoid arising from spine of scapula causes extension of shoulder joint.</li><li>• Option B</li><li>• spine</li><li>• extension</li><li>• Option C . Internal rotation is the rotation toward the midline . The muscles subscapularis , pectoralis major , latissimus dorsi , teres major and the anterior fibres of deltoid. Deltoid is innervated by the Axillary nerve .</li><li>• Option C</li><li>• midline</li><li>• subscapularis</li><li>• pectoralis major</li><li>• latissimus dorsi</li><li>• teres major</li><li>• anterior fibres</li><li>• Axillary nerve</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective :</li><li>➤ Anterior Fibers : Primary Action : Flexion of the shoulder joint. Additional Actions : Medial ( internal ) rotation and horizontal adduction of the arm at the shoulder joint. Middle Fibers : Primary Action : Abduction of the arm at the shoulder joint. The middle fibers are particularly crucial for this movement, especially from 15 to 90 degrees of abduction . The initial 0 to 15 degrees of abduction is primarily facilitated by the supraspinatus muscle . Additional Actions : These fibers contribute to stabilization of the shoulder joint during various arm movements. Posterior Fibers : Primary Action : Extension of the shoulder joint. Additional Actions : Lateral ( External ) rotation and horizontal abduction of the arm at the shoulder joint.</li><li>➤ Anterior Fibers : Primary Action : Flexion of the shoulder joint. Additional Actions : Medial ( internal ) rotation and horizontal adduction of the arm at the shoulder joint.</li><li>➤ Anterior Fibers</li><li>➤ Primary Action : Flexion of the shoulder joint. Additional Actions : Medial ( internal ) rotation and horizontal adduction of the arm at the shoulder joint.</li><li>➤ Primary Action : Flexion of the shoulder joint.</li><li>➤ Primary Action</li><li>➤ Flexion</li><li>➤ Additional Actions : Medial ( internal ) rotation and horizontal adduction of the arm at the shoulder joint.</li><li>➤ Additional Actions</li><li>➤ Medial</li><li>➤ internal</li><li>➤ rotation</li><li>➤ horizontal adduction</li><li>➤ Middle Fibers : Primary Action : Abduction of the arm at the shoulder joint. The middle fibers are particularly crucial for this movement, especially from 15 to 90 degrees of abduction . The initial 0 to 15 degrees of abduction is primarily facilitated by the supraspinatus muscle . Additional Actions : These fibers contribute to stabilization of the shoulder joint during various arm movements.</li><li>➤ Middle Fibers</li><li>➤ Primary Action : Abduction of the arm at the shoulder joint. The middle fibers are particularly crucial for this movement, especially from 15 to 90 degrees of abduction . The initial 0 to 15 degrees of abduction is primarily facilitated by the supraspinatus muscle . Additional Actions : These fibers contribute to stabilization of the shoulder joint during various arm movements.</li><li>➤ Primary Action : Abduction of the arm at the shoulder joint. The middle fibers are particularly crucial for this movement, especially from 15 to 90 degrees of abduction . The initial 0 to 15 degrees of abduction is primarily facilitated by the supraspinatus muscle .</li><li>➤ Primary Action</li><li>➤ Abduction</li><li>➤ middle fibers</li><li>➤ 15 to 90 degrees of abduction</li><li>➤ initial 0 to 15 degrees</li><li>➤ primarily facilitated</li><li>➤ supraspinatus</li><li>➤ muscle</li><li>➤ Additional Actions : These fibers contribute to stabilization of the shoulder joint during various arm movements.</li><li>➤ Additional Actions</li><li>➤ stabilization</li><li>➤ shoulder joint</li><li>➤ Posterior Fibers : Primary Action : Extension of the shoulder joint. Additional Actions : Lateral ( External ) rotation and horizontal abduction of the arm at the shoulder joint.</li><li>➤ Posterior Fibers</li><li>➤ Primary Action : Extension of the shoulder joint. Additional Actions : Lateral ( External ) rotation and horizontal abduction of the arm at the shoulder joint.</li><li>➤ Primary Action : Extension of the shoulder joint.</li><li>➤ Primary Action</li><li>➤ Extension</li><li>➤ Additional Actions : Lateral ( External ) rotation and horizontal abduction of the arm at the shoulder joint.</li><li>➤ Additional Actions</li><li>➤ Lateral</li><li>➤ External</li><li>➤ rotation</li><li>➤ horizontal abduction</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 57</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 57</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 30-year-old patient presents to the clinic with a recent shoulder injury following a fall. The patient complains of pain and difficulty lifting their arm away from the body. During the examination, the physician assesses the muscles responsible for shoulder abduction. Which of the following muscles is NOT primarily responsible for causing abduction at the shoulder joint?", "options": [{"label": "A", "text": "Deltoid", "correct": false}, {"label": "B", "text": "Supraspinatus", "correct": false}, {"label": "C", "text": "Serratus Anterior", "correct": false}, {"label": "D", "text": "Pectoralis Major", "correct": true}], "correct_answer": "D. Pectoralis Major", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture78.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/screenshot-2023-12-22-191349.jpg"], "explanation": "<p><strong>Ans. D) Pectoralis Major</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . Deltoid causes abduction of the shoulder from 0 to 90 degrees .</li><li>• Option A</li><li>• Deltoid</li><li>• abduction</li><li>• 0 to 90 degrees</li><li>• Option B. Supraspinatus initiates abduction upto 90 degrees according to latest update from Gray’s anatomy.</li><li>• Option B.</li><li>• Supraspinatus</li><li>• abduction upto 90 degrees</li><li>• Option C . Serratus anterior , trapezius causes overhead abduction .</li><li>• Option C</li><li>• Serratus anterior</li><li>• trapezius</li><li>• overhead abduction</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Pectoralis major causes flexion , adduction and medial rotation of shoulder joint .</li><li>➤ Pectoralis major</li><li>➤ flexion</li><li>➤ adduction</li><li>➤ medial rotation</li><li>➤ shoulder joint</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 71</li><li>➤ Ref : Textbook of Anatomy, Upper limb and thorax, 3 rd edition, Vishram Singh, pg. 71</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 40-year-old man stumbled down a flight of stairs and experienced severe pain over his right shoulder. X-ray showed fracture in the middle third of the right clavicle. He entered the emergency room supporting his sagging right upper limb with his opposite hand. The following statements concerning this case are all true except?", "options": [{"label": "A", "text": "Middle 1/3 rd is most common site for clavicle fracture.", "correct": false}, {"label": "B", "text": "Sternocleidomastoid muscle elevates the medial fragment of the fractured bone", "correct": false}, {"label": "C", "text": "Lateral fragment is pulled medially by contraction of trapezius", "correct": true}, {"label": "D", "text": "Coracoclavicular ligament prevents dislocation of acromioclavicular joint", "correct": false}], "correct_answer": "C. Lateral fragment is pulled medially by contraction of trapezius", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture79.jpg", "https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/picture80.jpg"], "explanation": "<p><strong>Ans. C) Lateral fragment is pulled medially by contraction of trapezius</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• According to Allman’s classification 80% of clavicle fracture at middle 1/3 rd .</li><li>• According to Allman’s classification 80% of clavicle fracture at middle 1/3 rd .</li><li>• Allman’s classification</li><li>• 80% of clavicle fracture at middle 1/3 rd</li><li>• Option B. After a fracture of the clavicle, the sternocleidomastoid muscle can elevate the medial fragment due to its attachment to the clavicle and its relative strength .</li><li>• Option B.</li><li>• sternocleidomastoid muscle</li><li>• elevate</li><li>• medial fragment</li><li>• attachment</li><li>• clavicle</li><li>• relative strength</li><li>• Option D. The coracoclavicular ligament , which attaches the clavicle to the coracoid process of the scapula , plays a crucial role in stabilizing the acromioclavicular joint . In cases of clavicle fractures, especially if the fracture is lateral enough , this ligament can prevent complete dislocation of the acromioclavicular joint .</li><li>• Option D.</li><li>• coracoclavicular ligament</li><li>• attaches</li><li>• clavicle</li><li>• coracoid process</li><li>• scapula</li><li>• crucial role</li><li>• stabilizing</li><li>• acromioclavicular joint</li><li>• fracture</li><li>• lateral enough</li><li>• prevent complete dislocation</li><li>• acromioclavicular joint</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective</li><li>➤ Lateral Fragment is Pulled Medially by Contraction of Trapezius: In the event of a clavicle fracture, the lateral fragment is typically pulled downwards by the weight of the arm and the pull of the shoulder muscles , particularly the deltoid muscle . The trapezius muscle , on the other hand, helps support the shoulder and clavicle but does not typically pull the lateral fragment medially.</li><li>➤ Lateral Fragment is Pulled Medially by Contraction of Trapezius:</li><li>➤ In the event of a clavicle fracture, the lateral fragment is typically pulled downwards by the weight of the arm and the pull of the shoulder muscles , particularly the deltoid muscle . The trapezius muscle , on the other hand, helps support the shoulder and clavicle but does not typically pull the lateral fragment medially.</li><li>➤ downwards</li><li>➤ weight of the arm</li><li>➤ pull of the shoulder muscles</li><li>➤ deltoid muscle</li><li>➤ trapezius muscle</li><li>➤ helps support</li><li>➤ shoulder</li><li>➤ clavicle</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 776</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 776</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "A 26-year-old right-handed female tourist was excited to plunge into the swimming pool. After 15 minutes of breast stroke swimming, she suddenly felt her right shoulder going out of place and unable to continue swimming. She described the feeling and the sound as a “pop” during the pull phase of the stroke. In physical examination the right shoulder was in slight abduction and external rotation. There was flattening of the right shoulder and overlying skin insensitive to pinprick. Which of the injuries is most likely possible?", "options": [{"label": "A", "text": "Acromioclavicular Joint Subluxation", "correct": false}, {"label": "B", "text": "Posterior Dislocation of Humerus", "correct": false}, {"label": "C", "text": "Rotator Cuff Tear", "correct": false}, {"label": "D", "text": "Anterior Dislocation of Humerus", "correct": true}], "correct_answer": "D. Anterior Dislocation of Humerus", "question_images": [], "explanation_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/26/screenshot-2023-12-26-112804.jpg"], "explanation": "<p><strong>Ans. D) Anterior Dislocation of Humerus</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A. Acromioclavicular Joint Subluxation involves partial dislocation where the clavicle separates from the acromion but not completely. It typically results from direct blows to the shoulder or falls on an outstretched arm. It would generally cause pain and swelling over the acromioclavicular joint rather than a 'Pop' sound or the sensation of the shoulder going out of place.</li><li>• Option A.</li><li>• partial dislocation</li><li>• clavicle</li><li>• separates</li><li>• acromion</li><li>• results</li><li>• direct blows</li><li>• shoulder</li><li>• falls</li><li>• cause pain</li><li>• swelling</li><li>• acromioclavicular joint</li><li>• Option B. Posterior Dislocation of Humerus is less common and often result from seizures or electric shocks , which cause violent muscle contractions . The shoulder would typically be held in internal rotation , not external rotation, in the case of a posterior dislocation .</li><li>• Option B.</li><li>• less common</li><li>• seizures</li><li>• electric shocks</li><li>• violent muscle contractions</li><li>• typically</li><li>• internal rotation</li><li>• posterior dislocation</li><li>• Option C. Rotator Cuff Tear involves a tear in one or more of the rotator cuff muscles and is a common injury in overhead activities . Although it can be painful and limit shoulder movement , a rotator cuff tear does not typically lead to dislocation or the 'pop' sensation as described in this case.</li><li>• Option C.</li><li>• tear</li><li>• one or more</li><li>• rotator cuff muscles</li><li>• common injury</li><li>• overhead activities</li><li>• painful</li><li>• limit shoulder movement</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Anterior Dislocation of Humerus is the most common type of shoulder dislocation and can occur from trauma or unusual arm movements like those in swimming. It often presents with the arm in slight abduction and external rotation , a visible deformity or flattening of the shoulder contour , and can be associated with a 'pop' sound or sensation . Neurovascular compromise, such as numbness can occur due to the dislocation's impact on nearby nerves .</li><li>➤ Anterior Dislocation of Humerus</li><li>➤ most common type</li><li>➤ shoulder dislocation</li><li>➤ trauma</li><li>➤ unusual arm movements</li><li>➤ slight abduction</li><li>➤ external rotation</li><li>➤ visible deformity</li><li>➤ flattening of the shoulder contour</li><li>➤ 'pop' sound</li><li>➤ sensation</li><li>➤ numbness</li><li>➤ dislocation's impact</li><li>➤ nearby nerves</li><li>➤ Axillary Nerve:</li><li>➤ Axillary Nerve:</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 813</li><li>➤ Ref : Gray’s Anatomy 41 st edition, pg no. 813</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true about the structure labelled A in the given image except?", "options": [{"label": "A", "text": "It inserts into Coracoid Process", "correct": false}, {"label": "B", "text": "The Second part of Axillary Artery lies behind A", "correct": false}, {"label": "C", "text": "Its Upper border is accompanied by superior thoracic artery", "correct": false}, {"label": "D", "text": "Its contraction causes Upward rotation of Glenoid cavity of Scapula", "correct": true}], "correct_answer": "D. Its contraction causes Upward rotation of Glenoid cavity of Scapula", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/12/12/picture2_CBzXxMP.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. D) Its contraction causes upward rotation of glenoid cavity of scapula</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A . It originates from 3rd to 5th ribs and inserts into the medial border and upper surface of the coracoid process.</li><li>• Option A</li><li>• Option B . The axillary artery is divided into 3 parts by pectoralis minor muscle. Among which second part lies behind the pectoralis minor.</li><li>• Option B</li><li>• Option C . Its upper border gives attachment to clavipectoral fascia. Lower border is accompanied by lateral thoracic artery and upper border by superior thoracic artery.</li><li>• Option C</li></ul>\n<p><strong>Educational Objective:</strong></p><ul><li>➤ Educational Objective:</li><li>➤ Its contraction causes protraction, depression of the scapula and downward rotation of the glenoid cavity of the scapula.</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 33</li><li>➤ Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3rd edition, pg. 33</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}, {"text": "All of the following statements are true about the coloured joint in the given image except?", "options": [{"label": "A", "text": "It is a Plane Synovial Joint", "correct": false}, {"label": "B", "text": "It is a type of Suture Joint", "correct": true}, {"label": "C", "text": "Coracoclavicular Ligament serves as a Syndesmosis", "correct": false}, {"label": "D", "text": "During dislocation the Acromial Process is driven below the Lateral end of clavicle", "correct": false}], "correct_answer": "B. It is a type of Suture Joint", "question_images": ["https://cerebellum-web-static.s3.amazonaws.com/media/public/images/2023/04/24/picture-29.jpg"], "explanation_images": [], "explanation": "<p><strong>Ans. B) It is a type of Suture Joint</strong></p>\n<p><strong>Explanation:</strong></p><ul><li>• Explanation:</li><li>• Option A.</li><li>• Option A.</li><li>• Acromioclavicular joint is a plane synovial joint which allows only gliding movement.</li><li>• Acromioclavicular joint is a plane synovial joint which allows only gliding movement.</li><li>• plane synovial joint</li><li>• only</li><li>• gliding</li><li>• Option C .</li><li>• Option C</li><li>• Coracoclavicular ligament connects the clavicle to the coracoid process of scapula . Hence it acts as syndesmosis ligament . It is a strong stabilizer of the acromioclavicular joint and helps in weight transmission of the upper limb .</li><li>• Coracoclavicular ligament connects the clavicle to the coracoid process of scapula . Hence it acts as syndesmosis ligament .</li><li>• connects</li><li>• clavicle</li><li>• coracoid process of scapula</li><li>• syndesmosis ligament</li><li>• It is a strong stabilizer of the acromioclavicular joint and helps in weight transmission of the upper limb .</li><li>• strong stabilizer</li><li>• acromioclavicular joint</li><li>• weight transmission</li><li>• upper limb</li><li>• Option D.</li><li>• Option D.</li><li>• The clavicular facet on acromion process faces laterally and downward to meet the acromial facet which is inclined in opposite direction . Hence, during dislocation the acromial process is driven below the lateral end of the clavicle .</li><li>• The clavicular facet on acromion process faces laterally and downward to meet the acromial facet which is inclined in opposite direction .</li><li>• clavicular facet</li><li>• acromion process</li><li>• laterally</li><li>• downward</li><li>• acromial facet</li><li>• inclined</li><li>• opposite direction</li><li>• Hence, during dislocation the acromial process is driven below the lateral end of the clavicle .</li><li>• during dislocation</li><li>• below</li><li>• lateral end</li><li>• clavicle</li><li>• Educational objective:</li><li>• Educational objective:</li><li>• The articular surfaces are covered with fibrocartilage , which is a unique feature of acromioclavicular joint .</li><li>• fibrocartilage</li><li>• unique feature</li><li>• acromioclavicular joint</li><li>• Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 153</li><li>• Ref : Textbook of Anatomy, upper limb and thorax, Vishram Singh, 3 rd edition, pg. 153</li></ul>\n<p>@dams_new_robot</p>", "bot": "@dams_new_robot", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 53 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">